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Genuis SK, Luth W, Magnussen C, Vande Velde C, Taylor D, Johnston WS. Patient engagement in research: lessons learned from CAPTURE ALS, a longitudinal observational ALS study. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:634-643. [PMID: 38519870 DOI: 10.1080/21678421.2024.2328599] [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: 12/06/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE There are compelling ethical and practical reasons for patient engagement in research (PEIR), however, evidence for best practices remains limited. We investigated PEIR as implemented in CAPTURE ALS, a longitudinal observational study, from study inception through the first 2.5 years of operations. METHODS Data were drawn from three engagement initiatives: a community-led letter-writing campaign; consultation with patient and caregiver focus groups; and a study-embedded 'participant partner advisory council' (PPAC). Data were derived retrospectively from study documentation. We used the International Association of Public Participation (IAP2) participation spectrum as a framework for investigation. RESULTS 2401 letters from community members to the Canadian government affirmed study objectives and advocated for funding. Feedback from focus group consultation influenced study design and supported the study's data-sharing plan. PPAC collaboration shaped all aspects of the study. Contributions included: co-creation of governance documents, input on study protocols and public-facing communication, and development of engagement webinars for study participants and feedback surveys. Effective communication practices fostered collaboration and helped avoid tokenistic engagement. CAPTURE ALS encompassed all IAP2 participation levels. CONCLUSIONS CAPTURE ALS was shaped by meaningful engagement initiatives over the course of the study. Lessons learned included: begin early and embed PEIR within research; build relationships and foster mutual learning; be flexible, open to adaptation, and seek diversity. Primary challenges included funding for early implementation, time needed to maintain relationships, and attrition due to disease progression. All IAP2 participation levels contributed to meaningful PEIR. 'Empowerment' was demonstrated through advocacy.
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Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Claire Magnussen
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
| | | | | | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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de Wit M, Aouad K, Elhai M, Benavent D, Bertheussen H, Blackburn S, Böhm P, Duarte C, Falahee M, Karlfeldt S, Kiltz U, Mateus EF, Richards DP, Rodríguez-Carrio J, Sagen J, Shumnalieva R, Stones SR, Tas SW, Tillett W, Vieira A, Wilhelmer TC, Zabalan C, Primdahl J, Studenic P, Gossec L. EULAR recommendations for the involvement of patient research partners in rheumatology research: 2023 update. Ann Rheum Dis 2024:ard-2024-225566. [PMID: 38876509 DOI: 10.1136/ard-2024-225566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/22/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Since the publication of the 2011 European Alliance of Associations for Rheumatology (EULAR) recommendations for patient research partner (PRP) involvement in rheumatology research, the role of PRPs has evolved considerably. Therefore, an update of the 2011 recommendations was deemed necessary. METHODS In accordance with the EULAR Standardised Operational Procedures, a task force comprising 13 researchers, 2 health professionals and 10 PRPs was convened. The process included an online task force meeting, a systematic literature review and an in-person second task force meeting to formulate overarching principles (OAPs) and recommendations. The level of agreement of task force members was assessed anonymously (0-10 scale). RESULTS The task force developed five new OAPs, updated seven existing recommendations and formulated three new recommendations. The OAPs address the definition of a PRP, the contribution of PRPs, the role of informal caregivers, the added value of PRPs and the importance of trust and communication in collaborative research efforts. The recommendations address the research type and phases of PRP involvement, the recommended number of PRPs per project, the support necessary for PRPs, training of PRPs and acknowledgement of PRP contributions. New recommendations concern the benefits of support and guidance for researchers, the need for regular evaluation of the patient-researcher collaboration and the role of a designated coordinator to facilitate collaboration. Agreements within the task force were high and ranged between 9.16 and 9.96. CONCLUSION The updated EULAR recommendations for PRP involvement are more substantially based on evidence. Together with added OAPs, they should serve as a guide for researchers and PRPs and will ultimately strengthen the involvement of PRPs in rheumatology research.
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Affiliation(s)
- Maarten de Wit
- Patient Research Partner, EULAR, Amsterdam, The Netherlands
| | - Krystel Aouad
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Muriel Elhai
- University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Diego Benavent
- Rheumatology, Hospital Universitari de Bellvitge, Madrid, Spain
| | | | - Steven Blackburn
- Institute of Applied Health Research, Univeristy of Birmingham, Birmingham, UK
| | - Peter Böhm
- Patient Research Partner, EULAR, Berlin, Germany
| | - Catia Duarte
- Rheumatology, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Marie Falahee
- Institute of Inflammation and Ageing, University of Birmingham Rheumatology Research Group, Birmingham, UK
| | - Susanne Karlfeldt
- Academic Specialist Center, Karolinska Institutet, Stockholm, Sweden
| | - Uta Kiltz
- Ruhr University Bochum, Bochum, Germany
- Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Elsa F Mateus
- Patient Research Partner, EULAR, Lisbon, Portugal
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
| | - Dawn P Richards
- Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada
| | - Javier Rodríguez-Carrio
- Area of Immunology, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
| | - Joachim Sagen
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway
- Norwegian Rheumatism Association, Oslo, Norway
| | - Russka Shumnalieva
- Department of Rheumatology, Clinic of Rheumatology, University Hospital "St Ivan Rilski", Medical University-Sofia, Sofia, Bulgaria
| | - Simon R Stones
- Patient Research Partner, EULAR, Manchester, UK
- Envision Pharma Group, Wilmslow, UK
| | - Sander W Tas
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - William Tillett
- Royal National Hospital for Rheumatic Disease, Bath, UK
- Life Sciences, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Ana Vieira
- Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal
- Patient Research Partner, EULAR, Lissabon, Portugal
| | - Tanita-Christina Wilhelmer
- EULAR Young PARE, Zürich, Switzerland
- Österreichische Rheumaliga, Maria Alm, Austria
- EULAR PRP, Vienna, Austria
| | - Condruta Zabalan
- Romanian League Against Rheumatism, Bucharest, Romania
- EULAR PRP, Bucharest, Romania
| | - Jette Primdahl
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Paul Studenic
- Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria
- Department of Medicine (Solna), Karolinska Institutet, Division of Rheumatology, Stockholm, Sweden
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France
- APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
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Tremblay M, Brais B, Asselin V, Buffet M, Girard A, Girard D, Berbiche D, Gagnon C. The Development of a New Patient-Reported Outcome Measure in Recessive Ataxias: The Person-Reported Ataxia Impact Scale. CEREBELLUM (LONDON, ENGLAND) 2024; 23:512-522. [PMID: 37165279 DOI: 10.1007/s12311-023-01565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Abstract
Autosomal recessive cerebellar ataxias (ARCAs) are inherited neurological disorders that can affect both the central and peripheral nervous systems. To assess the effects of interventions according to the perception of people affected, patient-reported outcome measures (PROMs) must be available. This paper presents the development process of the Person-Reported Ataxia Impact Scale (PRAIS), a new PROM in recessive ataxias, and the documentation of its content validity, interpretability, and construct validity (structural and discriminant). The development followed the PROMIS framework and the Food and Drug Administration guidelines. A mixed-method study design was used to develop the PROM. A systematic review of the literature, semistructured interviews, and discussion groups was conducted to constitute an item pool. Experts' consultation helped formulate items, and the questionnaire was sent online to be completed by people affected. Statistical analyses were performed to assess the structural and discriminant validity. A total of 125 people affected by recessive ataxia completed the questionnaire. The factor analysis confirmed the three components: physical functions and activities, mental functions, and social functions. The statistical analysis showed that it can discriminate between stages of mobility and level of autonomy. It showed very good levels of internal consistency (0.79 to 0.89). The Person-Reported Ataxia Impact Scale (PRAIS) is a 38-item questionnaire that assesses the manifestations and impacts of the disease according to the perception of people affected by recessive ataxia. It can be used in clinical and research settings.
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Affiliation(s)
- Marjolaine Tremblay
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada.
- Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, QC, J1K 2R1, Canada.
| | - Bernard Brais
- McGill University, 845 Rue Sherbrooke O, Montréal, QC, H3A 0G4, Canada
- Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Véronique Asselin
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada
| | - Martin Buffet
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada
| | - André Girard
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada
| | - Denis Girard
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada
| | - Djamal Berbiche
- Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, QC, J1K 2R1, Canada
- Centre de Recherche Charles-Lemoyne, 150, Place Charles-Le Moyne Bureau 200, Longueuil, QC, J4K 0A8, Canada
| | - Cynthia Gagnon
- Groupe de Recherche Interdisciplinaire Sur Les Maladies Neuromusculaires, 2230 de L'Hôpital Cp 1200, Jonquière, QC, G7X 7X2, Canada
- Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, QC, J1K 2R1, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, 3001, 12e Avenue Nord, Aile 9, Porte 6, Sherbrooke, Québec, J1H 5N4, Canada
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Dolgoy N, Bernard S, Huang F, Driga A, Hall-Lavoie D, Brown A, Pituskin E, Fairchild A, McNeely ML. Determining the destination: a co-designed chronic advanced cancer rehabilitation conceptual framework for engagement of individuals with lived experience in rehabilitation research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:35. [PMID: 38528573 DOI: 10.1186/s40900-024-00566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Individuals living with chronic advanced cancer (CAC) often face distinct physical, functional, and cognitive issues. Their rehabilitation needs are not yet routinely met, warranting further CAC-specific rehabilitation-based research. Given the complexity of functional and symptom presentations, engagement of individuals living with CAC as partners in the research process is encouraged to better understand the lived perspective. Formal engagement requires both structured approaches and iterative processes. The aim was to co-design a conceptual framework to develop and integrate engagement strategies into rehabilitation research focused on CAC populations. METHODS A multidisciplinary team of authors, including two individuals with lived experience, conducted an implementation-focused descriptive study to inform future research design, including: interviews and follow-up, review of current models and approaches, and development of a co-designed conceptual framework for engaging individuals with lived experience into CAC-specific rehabilitation research. RESULTS Emergent themes include shared understanding, transparent appreciation, iterative processes and unique partnership needs. A definition, guiding principles and tools for engagement were identified. In consultation with individuals with lived experience, and application of the emergent themes in context, a conceptual framework to guide the engagement process was developed. CONCLUSION A novel conceptual framework for engaging individuals with lived experience with CAC as partners in rehabilitation research is proposed to facilitate implementation-focused team-based approaches for this population.
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Affiliation(s)
- Naomi Dolgoy
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada.
| | - Stephanie Bernard
- École des sciences de la réadaptation, Faculté de Médecine, Université Laval, Quebec City, Canada
| | - Fleur Huang
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Amy Driga
- Alberta Health Services, Edmonton, AB, Canada
| | | | - Adam Brown
- Individuals With Lived Experience, Edmonton, AB, Canada
| | - Edith Pituskin
- Faculty of Nursing, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - Alysa Fairchild
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada
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Blackburn S, Clinch M, de Wit M, Moser A, Primdahl J, van Vliet E, Walker C, Stevenson F. Series: Public engagement with research. Part 1: The fundamentals of public engagement with research. Eur J Gen Pract 2023; 29:2232111. [PMID: 37578421 PMCID: PMC10431741 DOI: 10.1080/13814788.2023.2232111] [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: 02/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND In the first of a four-part series, we describe the fundamentals of public engagement in primary care research. OBJECTIVES The article's purpose is to encourage, inform and improve the researcher's awareness about public engagement in research. For a growing number of researchers, funders and patient organisations in Europe, public engagement is a moral and ethical imperative for conducting high-quality research. DISCUSSION Starting with an explanation of the role of public engagement in research, we highlight its diversity and benefits to research, researchers and the public members involved. We summarise principles of good practice and provide valuable resources for researchers to use in their public engagement activities. Finally, we discuss some of the issues encountered when researchers collaborate with members of the public and provide practical steps to address them. Case studies of real-life situations are used to illustrate and aid understanding. CONCLUSION We hope this article and the other papers in this series will encourage researchers to better consider the role and practice of public engagement and the potential added value to research that collaborating with the public could provide.
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Affiliation(s)
- Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Megan Clinch
- Centre for Public Health & Policy, Queen Mary University of London, London, UK
| | - Maarten de Wit
- Patient Research Partner Stichting Tools, Amsterdam, the Netherlands
| | - Albine Moser
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, the Netherlands
| | - Christine Walker
- Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Fiona Stevenson
- Primary Care and Population Health, University College London, London, UK
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Reeder S, Ayton D, Teede HJ, Skouteris H, Simmons M, Jones A. Opportunities to enhance consumer and community engagement training for researchers and healthcare providers: a qualitative study. BMJ Open 2023; 13:e073114. [PMID: 37739468 PMCID: PMC10533718 DOI: 10.1136/bmjopen-2023-073114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/30/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE To identify key training content for the education of researchers and healthcare providers in consumer and community engagement. DESIGN A qualitative descriptive design, underpinned by pragmatism, involved semi-structured interviews and a focus group. We conducted a thematic analysis using a framework approach. SETTING Community, hospital and university settings in Australia PARTICIPANTS: This study involved 28 individual interviews with researchers, ethics officers, leaders from consumer organisations and a focus group with six people working in health service settings. RESULTS Key findings from our study reveal a wide scope of consumer and community involvement (CCI) training content recommended for researchers and healthcare providers. Four main themes for training content were identified: (1) Embedding consumer and community involvement in research and health improvement projects; (2) Connecting with consumers and the community; (3) Considerations for consumer and community involvement; and (4) Progressing CCI in research and healthcare. Participants emphasised the importance of building foundational relationships with consumers and community, as well as connecting with experts. While how to partner authentically with consumers and the community was another important training topic raised, so too were the administrative considerations involved in CCI partnerships. Furthermore, the identification of training content including reducing duplication of effort, embedding CCI training into the education of healthcare providers and researchers and building an evidence base for CCI, shows the importance participants placed on investing in and advancing the field. CONCLUSIONS A wide scope of training content is required to support CCI capacity building in researchers and healthcare providers. Key training content is recommended to cover practical, relational, administrative, ethical and logistical aspects of CCI as well as guidance about how to advance CCI practice and its evidence base. Future work needs to focus on how the training content can be successfully implemented, evaluated and updated.
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Affiliation(s)
- Sandra Reeder
- Monash Centre for Health Research Implementation, Monash University, Melbourne, Victoria, Australia
- Monash Partners, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Health and Social Care Unit, Monash University, Melbourne, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research Implementation, Monash University, Melbourne, Victoria, Australia
- Monash Partners, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, Monash University, Melbourne, Victoria, Australia
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Karlsson AW, Kragh-Sørensen A, Børgesen K, Behrens KE, Andersen T, Kidholm ML, Rothmann MJ, Ketelaar M, Janssens A. Roles, outcomes, and enablers within research partnerships: A rapid review of the literature on patient and public involvement and engagement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:43. [PMID: 37322525 PMCID: PMC10268359 DOI: 10.1186/s40900-023-00448-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Recent studies mention a need to investigate partnership roles and dynamics within patient and public involvement and engagement (PPIE) in health research, and how impact and outcomes are achieved. Many labels exist to describe involvement processes, but it is unknown whether the label has implications on partnerships and outcomes. This rapid review investigates how roles between patients, relatives and researchers in a broad variety of PPIE activities in health research are described in peer reviewed papers and explores what enables these partnerships. METHODS Rapid review of articles published between 2012 and February 2022 describing, evaluating, or reflecting on experiences of PPIE in health research. All research disciplines and research areas were eligible. Four databases (Medline, Embase, PsychInfo and CINAHL) were searched between November 2021 and February 2022. We followed PRISMA guidelines and extracted descriptive factors: year, origin, research area and discipline, study focus, framework used and co-authorship. On a selection of articles, we performed a narrative analysis of partnership roles using Smits et al.'s. Involvement Matrix. Lastly, we performed a meta synthesis of reported enablers and outcomes of the partnerships. Patients and Relatives (PRs) have been involved in the whole rapid review process and are co-authors of this article. RESULTS Seventy articles from various research disciplines and areas were included. Forty articles were selected for a narrative analysis of the role description of PRs and researchers, and a meta synthesis of enablers and outcomes. Most articles described researchers as decision-makers throughout the research cycle. PRs most often were partners when they were included as co-authors; they were mostly partners in the design, analysis, write-up, and dissemination stages. Enablers of partnerships included: PR training, personality of PRs and communication skills, trust, remuneration and time. CONCLUSIONS Researchers' decision-making roles gives them control of where and when to include PRs in their projects. Co-authorship is a way of acknowledging patients' contributions which may lead to legitimation of their knowledge and the partnership. Authors describe common enablers, which can help future partnership formation.
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Affiliation(s)
- Anne Wettergren Karlsson
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Anne Kragh-Sørensen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Kirsten Børgesen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Karsten Erik Behrens
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Torben Andersen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Maiken Langhoff Kidholm
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Mette Juel Rothmann
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Center for Innovative Medical Innovation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Astrid Janssens
- Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark.
- University of Exeter Medical School, Exeter, UK.
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Al-Omari B, Farhat J, Shraim M. The Role of Web-Based Adaptive Choice-Based Conjoint Analysis Technology in Eliciting Patients' Preferences for Osteoarthritis Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3364. [PMID: 36834057 PMCID: PMC9959784 DOI: 10.3390/ijerph20043364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To assess the feasibility of using adaptive choice-based conjoint (ACBC) analysis to elicit patients' preferences for pharmacological treatment of osteoarthritis (OA), patients' satisfaction with completing the ACBC questionnaire, and factors associated with questionnaire completion time. METHODS Adult patients aged 18 years and older with a medical diagnosis of OA, experiencing joint pain in the past 12 months, and living in the Northeast of England participated in the study. The participants completed a web-based ACBC questionnaire about their preferences regarding pharmaceutical treatment for OA using a touchscreen laptop independently, and accordingly, the questionnaire completion time was measured. Moreover, the participants completed a pen-and-paper feedback form about their experience in completing the ACBC questionnaire. RESULTS Twenty participants aged 40 years and older, 65% females, 75% had knee OA, and suffering from OA for more than 5 years participated in the study. About 60% of participants reported completing a computerized questionnaire in the past. About 85% of participants believed that the ACBC task helped them in making decisions regarding their OA medications, and 95% agreed or strongly agreed that they would be happy to complete a similar ACBC questionnaire in the future. The average questionnaire completion time was 16 min (range 10-24 min). The main factors associated with longer questionnaire completion time were older age, never using a computer in the past, and no previous experience in completing a questionnaire. CONCLUSIONS The ACBC analysis is a feasible and efficient method to elicit patients' preferences for pharmacological treatment of OA, which could be used in clinical settings to facilitate shared decision-making and patient-centered care. The ACBC questionnaire completion consumes a significantly longer time for elderly participants, who never used a computer, and never completed any questionnaire previously. Therefore, the contribution of patients and public involvement (PPI) group in the development of the ACBC questionnaire could facilitate participants' understanding and satisfaction with the task. Future research including patients with different chronic conditions may provide more useful information about the efficiency of ACBC analysis in eliciting patients' preferences for osteoarthritis treatment.
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Affiliation(s)
- Basem Al-Omari
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Faculty of Health and Life Sciences, The University of Northumbria, Benton, Newcastle upon Tyne NE7 7XA, UK
| | - Joviana Farhat
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, Qatar University, QU Health, Doha P.O. Box 2713, Qatar
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Brett J, Davey Z, Matley F, Butcher H, Keenan J, Catton D, Watson E, Wright P, Gavin A, Glaser AW. Impact of patient and public (PPI) involvement in the Life After Prostate Cancer Diagnosis (LAPCD) study: a mixed-methods study. BMJ Open 2022; 12:e060861. [PMID: 36375983 PMCID: PMC9664269 DOI: 10.1136/bmjopen-2022-060861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Standardised reporting of patient and public involvement (PPI) in research studies is needed to facilitate learning about how to achieve effective PPI. The aim of this evaluation was to explore the impact of PPI in a large UK study, the Life After Prostate Cancer Diagnosis (LAPCD) study, and to explore the facilitators and challenges experienced. DESIGN Mixed-methods study using an online survey and semistructured interviews. Survey and topic guide were informed by systematic review evidence of the impact of PPI and by realist evaluation. Descriptive analysis of survey data and thematic analysis of interview data were conducted. Results are reported using the GRIPP2 (Guidance for Reporting Involvement of Patients and the Public, Version 2) reporting guidelines. SETTING LAPCD study, a UK-wide patient-reported outcome study. PARTICIPANTS User Advisory Group (UAG) members (n=9) and researchers (n=29) from the LAPCD study. RESULTS Impact was greatest on improving survey design and topic guides for interviews, enhancing clarity of patient-facing materials, informing best practices around data collection and ensuring steering group meetings were grounded in what is important to the patient. Further impacts included ensuring patient-focused dissemination of study findings at conference presentations and in lay summaries.Facilitating context factors included clear aims, time to contribute, confidence to contribute, and feeling valued and supported by researchers and other UAG members. Facilitating mechanisms included embedding the UAG within the study as a separate workstream, allocating time and resources to the UAG reflecting the value of input, and putting in place clear communication channels. Hindering factors included time commitment, geographical distance, and lack of standardised feedback mechanisms. CONCLUSION Including PPI as an integral component of the LAPCD study and providing the right context and mechanisms for involving the UAG helped maximise the programme's effectiveness and impact.
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Affiliation(s)
- Jo Brett
- Oxford Institute of Nursing Midwifery and Allied Health Research, Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Zoe Davey
- Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Fiona Matley
- Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Hugh Butcher
- Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - John Keenan
- Oxford Institute of Nursing Midwifery and Allied Health Research, Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - Darryl Catton
- Oxford Institute of Nursing Midwifery and Allied Health Research, Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - Eila Watson
- Faculty Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Penny Wright
- School of Medicine, University of Leeds, Leeds, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
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10
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Finderup J, Buur LE, Tscherning SC, Jensen AL, Kristensen AW, Petersen AP, Toft BS, Rasmussen GS, Skovlund P, Vedelø TW, Rodkjær LØ. Developing and testing guidance to support researchers engaging patient partners in health-related research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:43. [PMID: 36028911 PMCID: PMC9413931 DOI: 10.1186/s40900-022-00378-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/18/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Although interest in Patient and Public Involvement in health-related research is growing, there seems to be a lack of guidance supporting researchers in deciding on methods and levels for Patient and Public Involvement in health-related research throughout the research process. Furthermore, the numerous definitions, methods, and frameworks make it challenging for researchers new to this field to decide on the most appropriate approach for their project. METHODS This study aimed to develop and test guidance for researchers deciding on approaches, levels, and methods for engaging patient partners in health-related research. A group of 11 researchers in Patient and Public Involvement in health-related research participated in six workshops to develop the guidance. The feasibility and acceptability of the guidance were tested in a survey of 14 researchers using the System Usability Scale plus two elaborative questions. The guidance was also tested by five PhD students engaging patient partners in their projects. RESULTS The guidance developed consisted of two resources: Resource I outlined five international approaches to Patient and Public Involvement in health-related research, and Resource II described the different levels and methods for engaging patient partners in research. The System Usability Scale score (at the 50th percentile) was 80, indicating excellent usability. Qualitative data showed that the two resources supported reflections regarding different approaches, levels, and methods. CONCLUSION The researchers found the guidance to be supportive of their reflective thinking about engaging patient partners in their research. The testing provided knowledge about when and how to use the guidance but also raised questions about the usefulness of the guidance in communications with patients.
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Affiliation(s)
- Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, 8200, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark.
| | - Louise Engelbrecht Buur
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, 8200, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sarah Cecilie Tscherning
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Wilhøft Kristensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Poder Petersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Skovsby Toft
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
| | - Gitte Susanne Rasmussen
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Dermatology and Venerology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Skovlund
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Tina Wang Vedelø
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Ørneborg Rodkjær
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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11
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Khatmi N, Michels D, Rojas Castro D, Roux P. Interaction and conflict between outreach workers and research officers in implementing collaborative action research in the field of harm reduction: a qualitative study. Harm Reduct J 2021; 18:101. [PMID: 34627273 PMCID: PMC8502328 DOI: 10.1186/s12954-021-00551-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effectiveness of collaborative approaches in health interventions is underlined in the literature. Given the serious challenges to adequately managing the HCV epidemic in people who inject drugs (PWID), and the need to improve existing harm reduction (HR) interventions in this population, it seems important to investigate how collaboration between stakeholders is ensured in action research interventions. The present study aimed to explore interactions between outreach workers and research officers collaborating in the implementation of an action research project for PWID entitled OUTSIDER. METHODS Using three focus groups, we studied the views of 24 outreach workers involved in the implementation and evaluation of a harm reduction educational intervention to help PWID inject more safely in off-site settings. RESULTS The analysis of participants' discourses highlighted the mixed perceptions they had about OUTSIDER. Several limitations to collaboration emerged. Epistemological (theoretical vs. practical knowledge), methodological (science vs. intervention), axiological (standardised vs. adapted approach), and material (mobilised vs. available resources) issues all placed a burden on the outreach worker-research officer relationship. Outreach workers' acceptance of the project's intervention dimension but rejection of its scientific dimension highlights a lack of contractualisation between the stakeholders involved, and a more general problematisation of the role of outreach workers in implementing action research in HR. How collaboration was perceived and practised by outreach workers participating in OUTSIDER can be considered a reflection of the current challenges to implementing action research in HR. CONCLUSION This study of the interaction between the research and implementation dimensions of an action research project explored the tensions between different intervention stakeholders that must work together. Equitable participation and integration of the expertise, practices, and knowledge of all stakeholders involved is essential for successful action research. Given current HCV epidemiological challenges, new forms of cooperation are needed when developing healthcare services and when strengthening collaborative approaches.
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Affiliation(s)
- Nicolas Khatmi
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
| | - David Michels
- AIDES, 14 Rue Scandicci, 93508, Pantin, France.,Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Daniela Rojas Castro
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
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12
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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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Holmen H, Riiser K, Løyland B, Sandbekken IH, Almendingen K, Andenæs R, Bjørnnes AK, Fagerlund BH, Früh EA, Helseth S, Kvarme LG, Leegaard M, Misvær N, Pallesen S, Rasalingam A, Ravn I, Ribu L, Rostad HM, Sparboe-Nilsen B, Sæterstrand TM, Torbjørnsen A, Utne I, Valeberg BT, Valla L, Winger A, Grov EK. Students' top 10 priorities of research uncertainties on students' sleep: a pragmatic James Lind Alliance approach. BMJ Open 2021; 11:e043697. [PMID: 33500290 PMCID: PMC7839855 DOI: 10.1136/bmjopen-2020-043697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Inspired by the James Lind Alliance (JLA) user involvement approach, the aim of the present study was to identify the top 10 uncertainties for sleep research raised by students in higher education, and to discuss our experiences with adapting the JLA method to a student population. DESIGN The study design is a pragmatic JLA approach, including a priority setting partnership within the field of sleep, collection of sleep-related research uncertainties as reported by students in higher education, sorting of the uncertainties and a final identification of the top 10 uncertainties through collaborative work between researchers, students, stakeholders and experts in the field. Uncertainties were collected using a one-question online survey: 'as a student, which question(s) do you consider to be important with regards to sleep?'. A variety of approaches were applied to promote the survey to the students, including social media, radio, the university website, stands in university cafeterias and a sleep stunt. NVivo V.12 was used to code and sort the questions. SETTING A higher education institution in Norway. PARTICIPANTS 555 students. RESULTS The data collection provided 608 uncertainties, and the following prioritised top 10: (1) screen time, (2) stress, (3) educational achievements, (4) social relations, (5) mental health, (6) physical activity, (7) indoor environment, (8) substance abuse, (9) shift work and (10) sleep quality. Despite successful data collection, we found sleep to be a broad topic, and defining specific questions throughout the sorting and verification process proved difficult. CONCLUSIONS We identified the prioritised top 10 research uncertainties as reported by students in higher education, ranking screen time first. However, the process was time and resource consuming. The research uncertainties addressed by the students showed great diversity, characterised by heterogeneity and a lack of specificity, making verification of the uncertainties challenging.
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ida Hellum Sandbekken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kari Almendingen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marit Leegaard
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ståle Pallesen
- University of Bergen Faculty of Social Sciences, Bergen, Norway
| | - Anurajee Rasalingam
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ingrid Ravn
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lis Ribu
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Hanne Marie Rostad
- Centre for Care Research, Norwegian University of Science and Technology, Gjovik Campus, Gjovik, Norway
| | - Bente Sparboe-Nilsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Hospitality, Culinary Arts and Meal Science, Örebro Universitet, Campus Grythyttan, Grythyttan, Sweden
| | - Torill Margaret Sæterstrand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Berit Taraldsen Valeberg
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Vojtila L, Ashfaq I, Ampofo A, Dawson D, Selby P. Engaging a person with lived experience of mental illness in a collaborative care model feasibility study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:5. [PMID: 33419484 PMCID: PMC7796603 DOI: 10.1186/s40900-020-00247-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/20/2020] [Indexed: 05/26/2023]
Abstract
Researchers have explored different types of treatment to help people with a mental illness with other problems they might be experiencing, such as their health condition and quality of life. Care models that involve many different health care providers working together to provide complete physical and mental health care are becoming popular. There has been a push from the research community to understand the value of including people with lived experience in such programs. While research suggests that people with lived experience may help a patient's treatment, there is little evidence on including them in a team based program. This paper describes how our research team included a person with lived experience of psychosis in both the research and care process. We list some guiding principles we used to work through some of the common challenges that are mentioned in research. Lastly, experiences from the research team, lessons learned, and a personal statement from the person with lived experience (AA) are provided to help future researchers and people with lived experience collaborate in research and healthcare. Background In our current healthcare system, people with a mental illness experience poorer physical health and early mortality in part due to the inconsistent collaboration between primary care and specialized mental health care. In efforts to bridge this gap, hospitals and primary care settings have begun to take an integrated approach to care by implementing collaborative care models to treat a variety of conditions in the past decade. The collaborative care model addresses common barriers to treatment, such as geographical distance and lack of individualized, evidence-based, measurement-based treatment. Person(s) with lived experience (PWLE) are regarded as 'experts by experience' in the scope of their first-hand experience with a diagnosis or health condition. Research suggests that including PWLE in a patient's care and treatment has significant contributions to the patient's treatment and overall outcome. However, there is minimal evidence of including PWLE in collaborative care models. This paper describes the inclusion of a PWLE in a research study and collaborative care team for youth with early psychosis. Aims To discuss the active involvement of a PWLE on the research and collaborative care team and to describe the research team's experiences and perspectives to facilitate future collaborations. Method This paper describes the inclusion of a PWLE on our research team. We provide a selective review of the literature on several global initiatives of including PWLE in different facets of the healthcare system. Additionally, we outline multiple challenges of involving PWLE in research and service delivery. Examples are provided on how recruitment and involvement was facilitated, with the guidance of several principles. Lastly, we have included a narrative note from the PWLE included in our study, who is also a contributing author to this paper (AA), where she comments on her experience in the research study. Conclusion Including PWLE in active roles in research studies and collaborative care teams can enhance the experience of the researchers, collaborative care team members, and PWLE. We showcase our method to empower other researchers and service providers to continue to seek guidance from PWLE to provide more comprehensive, collaborative care with better health outcomes for the patient, and a more satisfying care experience for the provider.
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Affiliation(s)
- Lenka Vojtila
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada
| | - Iqra Ashfaq
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada
| | - Augustina Ampofo
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada
| | - Danielle Dawson
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada
| | - Peter Selby
- Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada.
- Addictions Research Program, Centre for Addiction and Mental Health, Toronto, Canada.
- Department of Family and Community Medicine; Department of Psychiatry; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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15
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Ludwig C, Graham ID, Gifford W, Lavoie J, Stacey D. Partnering with frail or seriously ill patients in research: a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:52. [PMID: 32944284 PMCID: PMC7488581 DOI: 10.1186/s40900-020-00225-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/27/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND The expectation to include patients as partners in research has steadily gained momentum. The vulnerability of frail and/or seriously ill patients provides additional complexity and may deter researchers from welcoming individuals from this patient population onto their teams. The aim was to synthesize the evidence on the engagement of frail and/or seriously ill patients as research partners across the research cycle. METHODS A systematic review was conducted using PRISMA guidelines. A search strategy included MEDLINE®, EMBASE®, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from database inception to April, 2019. Eligible studies were peer-reviewed qualitative, quantitative, and mixed methods research reporting on the engagement of frail and/or seriously ill patients as partners on research teams. The Mixed Methods Appraisal Tool was used to appraise study quality. Narrative analysis was conducted. RESULTS Of 8763 citations, 30 were included. Most studies included individuals with cancer on the research team (60%). Barriers included: lack of time and resources (50%), discontinuity in contribution (37%), and concerns for well-being (33%). Facilitators included: trust and mutual respect (60%), structural accessibility (57%), flexibility in timing and methods of engagement (43%), and attention to care and comfort, (33%). Perceived impacts for patients included: renewed personal sense of agency (37%) and emotional/peer support (37%). Impacts for researchers included sensitization to the lived experience of disease (57%) and an increased appreciation of the benefits of patient engagement (23%). Research design, execution, and outcomes, developed with patients, were deemed more suitable, relevant and reflective of patients' priorities. CONCLUSIONS There is emerging evidence to suggest that research partnerships with frail and/or seriously ill patients can be achieved successfully. Patients mostly report benefit from partnering with research teams. Frailty and/or serious illness do present legitimate concerns for their well-being but appear to be successfully mitigated when researchers ensure that the purpose of engagement is well-defined, the timing and methods of engagement are flexible, and the practical and emotional needs of patient partners are addressed throughout the process. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was 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 Medicine, School of Epidemiology and Public Health, Ottawa, Ontario, Canada and Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 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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16
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Roche P, Shimmin C, Hickes S, Khan M, Sherzoi O, Wicklund E, Lavoie JG, Hardie S, Wittmeier KDM, Sibley KM. Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:42. [PMID: 32699647 PMCID: PMC7370500 DOI: 10.1186/s40900-020-00217-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/30/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND Critical stakeholder-identified gaps in current health research engagement strategies include the exclusion of voices traditionally less heard and a lack of consideration for the role of trauma in lived experience. Previous work has advocated for a trauma-informed, intersectional, and critical reflexive approach to patient and public involvement in health research. The Valuing All Voices Framework embodies these theoretical concepts through four key components: trust, self-awareness, empathy, and relationship building. The goal of this framework is to provide the context for research teams to conduct patient engagement through the use of a social justice and health equity lens, to improve safety and inclusivity in health research. The aim of this study was to revise the proposed Valuing All Voices Framework with members of groups whose voices are traditionally less heard in health research. METHODS A qualitative descriptive approach was used to conduct a thematic analysis of participant input on the proposed framework. Methods were co-developed with a patient co-researcher and community organizations. RESULTS Group and individual interviews were held with 18 participants identifying as Inuit; refugee, immigrant, and/or newcomer; and/or as a person with lived experience of a mental health condition. Participants supported the proposed framework and underlying theory. Participant definitions of framework components included characterizations, behaviours, feelings, motivations, and ways to put components into action during engagement. Emphasis was placed on the need for a holistic approach to engagement; focusing on open and honest communication; building trusting relationships that extend beyond the research process; and capacity development for both researchers and patient partners. Participants suggested changes that incorporated some of their definitions; simplified and contextualized proposed component definitions; added a component of "education and communication"; and added a 'how to' section for each component. The framework was revised according to participant suggestions and validated through member checking. CONCLUSIONS The revised Valuing All Voices Framework provides guidance for teams looking to employ trauma-informed approaches, intersectional analysis, and critical reflexive practice in the co-development of meaningful, inclusive, and safe engagement strategies. PLAIN ENGLISH SUMMARY Patient engagement in health research continues to exclude many people who face challenges in accessing healthcare, including (but not limited to) First Nations, Inuit, and Metis people; immigrants, refugees, and newcomers; and people with lived experience of a mental health condition. We proposed a new guide to help researchers engage with patients and members of the public in research decision-making in a meaningful, inclusive, and safe way. We called this the Valuing All Voices Framework, and met with people who identify as members of some of these groups to help define the key parts of the framework (trust; self-awareness; empathy; and relationship building), to tell us what they liked and disliked about the proposed framework, and what needed to be changed. Input from participants was used to change the framework, including clarifying definitions of the key parts, adding another key part called "education and communication", and providing action items so teams can put these key parts into practice.
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Affiliation(s)
- P. Roche
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - C. Shimmin
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - S. Hickes
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - M. Khan
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
| | - O. Sherzoi
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
| | - E. Wicklund
- Canadian Centre on Disability Studies, Unit #10, 226 Osborne Street North, Winnipeg, Manitoba R3C 1V4 Canada
| | - J. G. Lavoie
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
- Ongomiizwin Research, Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, 715 – 727 McDermot Avenue, Winnipeg, Manitoba R3E 3P4 Canada
| | - S. Hardie
- Canadian Centre on Disability Studies, Unit #10, 226 Osborne Street North, Winnipeg, Manitoba R3C 1V4 Canada
| | - K. D. M. Wittmeier
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, Health Sciences Centre, University of Manitoba, CE-208 Children’s Hospital, 840 Sherbrook Street, Winnipeg, Manitoba R3A 1S1 Canada
- Children’s Hospital Research Institute of Manitoba, 656 – 715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4 Canada
| | - K. M. Sibley
- George & Fay Yee Centre for Healthcare Innovation (CHI), 3rd Floor - 753 McDermot Avenue, Winnipeg, Manitoba R3E 0T6 Canada
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 – 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3 Canada
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17
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Vat LE, Warren M, Goold S, Davidge E(B, Porter N, Schuitmaker-Warnaar TJ, Broerse JEW, Etchegary H. Giving patients a voice: a participatory evaluation of patient engagement in Newfoundland and Labrador Health Research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:39. [PMID: 32670610 PMCID: PMC7350650 DOI: 10.1186/s40900-020-00206-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/20/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Efforts to engage patients as partners in health research have grown and thereby the need for feedback and evaluation. In this pilot evaluation study, we aimed to 1) evaluate patient engagement in health research projects in Newfoundland and Labrador, Canada, and 2) learn more about how to best monitor and evaluate patient engagement. This paper presents the results of our participatory evaluation study and the lessons learned. The evaluation of the projects was driven by questions patients wanted answered. METHODS We conducted a formative evaluation of patient engagement in health research projects. Projects spanned a variety of topics, target groups, research designs and methods of patient engagement. Participants included principal investigators (n = 6) and their patient partners (n = 14). Furthermore, graduate students (n = 13) working on their own research projects participated. Participants completed an online survey with closed and open-ended questions about their patient engagement efforts, experiences and preliminary outcomes. Patients were involved as co-investigators in the entire evaluation study. We used qualitative methods to evaluate our participatory process. RESULTS The evaluation study results show that most patients and researchers felt prepared and worked together in various phases of the research process. Both groups felt that the insights and comments of patients influenced research decisions. They believed that patient engagement improved the quality and uptake of research. Students felt less prepared and were less satisfied with their patient engagement experience compared to researchers and their patient partners. Involvement of patient co-investigators in this evaluation resulted in learnings, transparency, validation of findings and increased applicability. Challenges were to select evaluation questions relevant to all stakeholders and to adapt evaluation tools to local needs. CONCLUSIONS Our findings show that researchers, patient partners and students value patient engagement in health research. Capacity building at the supervisor level in academic institutions is needed to better support students. Sufficient time is also needed to permit observable outcomes. Participatory evaluation may increase the relevance and usefulness of information, but it also raises issues such as who defines and designs the content of evaluation tools. A co-creation process is required to develop appropriate monitoring and evaluation strategies.
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Affiliation(s)
- Lidewij Eva Vat
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Memorial University of Newfoundland, St. Johns, Canada
| | - Mike Warren
- NL SUPPORT Patient Advisory Council, Newfoundland and Labrador, Canada
| | - Susan Goold
- NL SUPPORT Patient Advisory Council, Newfoundland and Labrador, Canada
| | | | - Nicole Porter
- Government of Newfoundland and Labrador, St. Johns, Canada
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Martineau JT, Minyaoui A, Boivin A. Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice. BMC Med Ethics 2020; 21:34. [PMID: 32393230 PMCID: PMC7216517 DOI: 10.1186/s12910-020-0460-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards reflecting on and dealing with these issues. METHODS We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. RESULTS We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. CONCLUSIONS We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics.
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Affiliation(s)
- Joé T Martineau
- Department of Management, HEC Montreal, 3000 chemin de la Cote-Ste-Catherine, Montreal, QC, H3T2A7, Canada.
| | | | - Antoine Boivin
- Canada Research Chair in Patient and Public Partnership, CHUM Research Center (CRCHUM) and University of Montreal, Montreal, Canada
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Stuhlfauth S, Knutsen IR, Foss C. Users' and researchers' construction of equity in research collaboration. Health Expect 2020; 23:296-305. [PMID: 31960555 PMCID: PMC7104651 DOI: 10.1111/hex.13026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/26/2019] [Accepted: 12/21/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Equity is described as an ideal in user involvement in research and is mentioned in the health service literature and in several guidelines. However, equity is described as being difficult to obtain and the concept is rarely clarified or concretized. Equity can be socially constructed. OBJECTIVE This study explored users' and researchers' constructions of equity in research processes. DESIGN AND METHOD The study had a qualitative research design. Constructions of equity were analysed through the lens of positioning theory. Two focus group interviews consisting of both users and researchers were conducted. FINDINGS The thirteen users and four researchers considered 'equity' as an important part of user involvement in research. Storylines about norms, responsibility, language, knowledge and usefulness evolved in the discussions. These storylines elucidated unequal access to rights and duties. DISCUSSION AND CONCLUSION Users and researchers constructed equity in user involvement differently, but the difference was masked by an apparent agreement. Users and researchers drew on different storylines. The researchers emphasized the scientific discourse and although users acknowledged this discourse, they attempted to oppose this dominant discourse by drawing on a lay discourse. The identified constructions and negotiations of equity may contribute in new understandings of an equal collaboration in user involvement in research.
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Affiliation(s)
- Susanne Stuhlfauth
- Department of Nursing ScienceFaculty of MedicineUniversity of OsloOsloNorway
| | - Ingrid Ruud Knutsen
- Department of Nursing and Health PromotionFaculty of Health ScienceOslo Metropolitan UniversityKjellerNorway
| | - Christina Foss
- Department of Nursing ScienceFaculty of MedicineUniversity of OsloOsloNorway
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20
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[Implementation and participatory design of digital health interventions]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:145-152. [PMID: 31938837 DOI: 10.1007/s00103-019-03079-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are dynamic interactions between (digital) technologies and society. Digital technologies have a (re-)structuring effect on social relationships and social innovations in a variety of ways. Because of these characteristics, technological innovations affect our individual lifestyles and living environments. In particular, the development and implementation of interventions with digital (health) technologies is attracting increasing national and international attention (e.g. telematics GP consultations and app-supported patient education programs).Digital health technologies enable new forms of interaction and knowledge-based reproduction in the field of health. The integration of potential users in the development process of digital health technologies and interventions requires the discussion of new research approaches. The interests, needs, and requirements of users may influence the nonuse of digital health technologies. It is above all the successful implementation, involving potential users, that can have an influence on acceptance and integrative use in the later course of care. The discourse on the participatory development and implementation of interventions with digital health technologies in the field of digital public health presents itself as a complex process characterized by various theoretical approaches and methodological procedures and requiring representation, evaluation, and classification.
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Harrison JD, Auerbach AD, Anderson W, Fagan M, Carnie M, Hanson C, Banta J, Symczak G, Robinson E, Schnipper J, Wong C, Weiss R. Patient stakeholder engagement in research: A narrative review to describe foundational principles and best practice activities. Health Expect 2019; 22:307-316. [PMID: 30761699 PMCID: PMC6543160 DOI: 10.1111/hex.12873] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Health research is evolving to include patient stakeholders (patients, families and caregivers) as active members of research teams. Frameworks describing the conceptual foundations underlying this engagement and strategies detailing best practice activities to facilitate engagement have been published to guide these efforts. OBJECTIVE The aims of this narrative review are to identify, quantify and summarize (a) the conceptual foundational principles of patient stakeholder engagement in research and (b) best practice activities to support these efforts. SEARCH STRATEGY, INCLUSION CRITERIA, DATA EXTRACTION AND SYNTHESIS: We accessed a publicly available repository of systematically identified literature related to patient engagement in research. Two reviewers independently screened articles to identify relevant articles and abstracted data. MAIN RESULTS We identified 990 potentially relevant articles of which 935 (94.4%) were excluded and 55 (5.6%) relevant. The most commonly reported foundational principles were "respect" (n = 25, 45%) and "equitable power between all team members" (n = 21, 38%). Creating "trust between patient stakeholders and researchers" was described in 17 (31%) articles. Twenty-seven (49%) articles emphasized the importance of providing training and education for both patient stakeholder and researchers. Providing financial compensation for patient stakeholders' time and expertise was noted in 19 (35%) articles. Twenty articles (36%) emphasized regular, bidirectional dialogue between patient partners and researchers as important for successful engagement. DISCUSSION AND CONCLUSIONS Engaging patient stakeholders in research as partners presents an opportunity to design, implement and disseminate patient-centred research. This review creates an overarching foundational framework for authentic and sustainable partnerships between patient stakeholders and researchers.
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Affiliation(s)
- James D. Harrison
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | - Andrew D. Auerbach
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | - Wendy Anderson
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | | | - Martha Carnie
- Center for Patients and FamiliesBrigham and Women’s HospitalBostonMassachusetts
| | | | - Jim Banta
- Intensive Care Unit Patient and Family Advisory CouncilUniversity of California San FranciscoSan FranciscoCalifornia
| | - Gina Symczak
- Intensive Care Unit Patient and Family Advisory CouncilUniversity of California San FranciscoSan FranciscoCalifornia
| | - Edmondo Robinson
- Department of MedicineChristiana Care Health SystemWilmingtonDelaware
| | - Jeffrey Schnipper
- Department of MedicineBrigham and Women’s HospitalBostonMassachusetts
| | - Celene Wong
- Center for Patients and FamiliesBrigham and Women’s HospitalBostonMassachusetts
| | - Rachel Weiss
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
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Greenhalgh T, Hinton L, Finlay T, Macfarlane A, Fahy N, Clyde B, Chant A. Frameworks for supporting patient and public involvement in research: Systematic review and co-design pilot. Health Expect 2019; 22:785-801. [PMID: 31012259 PMCID: PMC6737756 DOI: 10.1111/hex.12888] [Citation(s) in RCA: 379] [Impact Index Per Article: 75.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/13/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022] Open
Abstract
Background Numerous frameworks for supporting, evaluating and reporting patient and public involvement in research exist. The literature is diverse and theoretically heterogeneous. Objectives To identify and synthesize published frameworks, consider whether and how these have been used, and apply design principles to improve usability. Search strategy Keyword search of six databases; hand search of eight journals; ancestry and snowball search; requests to experts. Inclusion criteria Published, systematic approaches (frameworks) designed to support, evaluate or report on patient or public involvement in health‐related research. Data extraction and synthesis Data were extracted on provenance; collaborators and sponsors; theoretical basis; lay input; intended user(s) and use(s); topics covered; examples of use; critiques; and updates. We used the Canadian Centre for Excellence on Partnerships with Patients and Public (CEPPP) evaluation tool and hermeneutic methodology to grade and synthesize the frameworks. In five co‐design workshops, we tested evidence‐based resources based on the review findings. Results Our final data set consisted of 65 frameworks, most of which scored highly on the CEPPP tool. They had different provenances, intended purposes, strengths and limitations. We grouped them into five categories: power‐focused; priority‐setting; study‐focused; report‐focused; and partnership‐focused. Frameworks were used mainly by the groups who developed them. The empirical component of our study generated a structured format and evidence‐based facilitator notes for a “build your own framework” co‐design workshop. Conclusion The plethora of frameworks combined with evidence of limited transferability suggests that a single, off‐the‐shelf framework may be less useful than a menu of evidence‐based resources which stakeholders can use to co‐design their own frameworks.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Teresa Finlay
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Nick Fahy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ben Clyde
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alan Chant
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Gaasterland CMW, van der Weide MCJ–, du Prie – Olthof MJ, Donk M, Kaatee MM, Kaczmarek R, Lavery C, Leeson-Beevers K, O’Neill N, Timmis O, van Nederveen V, Vroom E, van der Lee JH. The patient's view on rare disease trial design - a qualitative study. Orphanet J Rare Dis 2019; 14:31. [PMID: 30732630 PMCID: PMC6367834 DOI: 10.1186/s13023-019-1002-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 01/21/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Clinical trials in rare diseases are more challenging than trials in frequent diseases. Small numbers of eligible trial participants, often complicated by heterogeneity among rare disease patients, hamper the design and conduct of a 'classical' Randomized Controlled Trial. Therefore, novel designs are developed by statisticians. However, it is important to be aware of possible design aspects that may jeopardize the feasibility of trial conduct. If the burden of participation is considered out of proportion by patients or parents, recruitment may fail or participants may drop out before trial completion. In order to maximize the chance of success of trials in small populations, it is important to know which aspects of trial design are considered important by patients. RESULTS We have interviewed all ten members of the Patient Think Tank (PTT) of the ASTERIX project, a European research consortium on methodology for clinical trials in small populations. The PTT members are rare disease patient representatives who have completed extensive training in clinical trial methodology. We have analyzed the interviews qualitatively according to Grounded Theory using a thematic analysis, and we structured the topics in four chronologically ordered themes: 1. Involvement in trial design; 2. Opinions on trial design; 3. Trial participation; 4. Phase after the trial. Our main findings are that the PTT-members recommend that patients are involved in trial design from an early stage on, and have influence on the outcomes and measurement instruments that are chosen in the trial, the length of the study, the choice of participants, and the information that is sent to potential participants. Also, according to the PTT-members, patient groups should consider setting up disease registries, placebo groups should be minimized, and more education on clinical trials is advised. CONCLUSIONS Rare disease patient representatives who have been educated about clinical trial methodology think it is important to involve patient representatives in research at an early stage. They can be of advice in trial design in such a way that the ratio of potential benefit and burden of trial participation as well as the chosen outcome measures and in- and exclusion criteria are optimized.
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Affiliation(s)
- C. M. W. Gaasterland
- Pediatric clinical Research Office, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - M. C. Jansen – van der Weide
- Pediatric clinical Research Office, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - M. J. du Prie – Olthof
- Pediatric clinical Research Office, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - M. Donk
- Department of Cognitive Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M. M. Kaatee
- PSC Patients Europe, Bennebroek, the Netherlands
| | - R. Kaczmarek
- Laboratory of Glycoconjugate Immunochemistry, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
- Polish Hemophilia Society, Warsaw, Poland
| | | | | | - N. O’Neill
- EUPATI Fellow, Bennebroek, the Netherlands
| | | | | | - E. Vroom
- Duchenne Parent Project, Veenendaal, The Netherlands
| | - J. H. van der Lee
- Pediatric clinical Research Office, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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24
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Macdonald GG, Koehn C, Attara G, Stordy A, Allerdings M, Leese J, Li LC, Backman CL. Patient Perspectives on the Challenges and Responsibilities of Living With Chronic Inflammatory Diseases: Qualitative Study. J Particip Med 2018; 10:e10815. [PMID: 33052129 PMCID: PMC7434083 DOI: 10.2196/10815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/28/2018] [Accepted: 09/09/2018] [Indexed: 01/14/2023] Open
Abstract
Background Collectively, chronic inflammatory diseases take a great toll on individuals and society in terms of participation restrictions, quality of life, and economic costs. Although prior qualitative studies have reported patients’ experiences and challenges living with specific diseases, few have compared the consequences of disease management in daily life across different types of inflammatory diseases in studies led by patient partners. Objective The aim of this study was to identify the significant consequences of inflammatory arthritis, psoriasis, and inflammatory bowel diseases on daily life and explore commonalities across diseases. Methods A cross-sectional Web-based survey was designed by patient research partners and distributed by patient awareness organizations via their social media channels and by sharing a link in a newspaper story. One open-ended item asked about burdens and responsibilities experienced in daily life. Informed by narrative traditions in qualitative health research, we applied a thematic content analysis to participants’ written accounts in response to this item. This is an example of a study conceived, conducted, and interpreted with patients as research partners. Results A total of 636 Canadians, with a median age band of 55-64 years, submitted surveys, and 80% of the respondents were women. Moreover, 540 participants provided written substantive responses to the open-ended item. Overall, 4 main narratives were generated: (1) daily life disrupted; (2) socioeconomic vulnerabilities; (3) stresses around visible, invisible, and hiding disabilities; and (4) actions aimed at staying positive. Ways in which participants experienced social stigma, pain and fatigue, balancing responsibilities, and worries about the future appeared throughout all 4 narratives. Conclusions People living with chronic inflammatory diseases affecting joints, skin, and the digestive tract report important gaps between health, social, and economic support systems that create barriers to finding the services they need to sustain their health. Regardless of diagnosis, they report similar experiences navigating the consequences of lifelong conditions, which have implications for policy makers. There is a need for outcome measures in research and service delivery to address patient priorities and for programs to fill gaps created by the artificial administrative separation of health services, social services, and income assistance.
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Affiliation(s)
- Graham George Macdonald
- Arthritis Research Canada, Richmond, BC, Canada.,Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | - Gail Attara
- Canadian Society of Intestinal Research, Vancouver, BC, Canada
| | - Allan Stordy
- Canadian Skin Patient Alliance, Vancouver, BC, Canada
| | - Marilee Allerdings
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, BC, Canada
| | - Jenny Leese
- Arthritis Research Canada, Richmond, BC, Canada.,Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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25
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Hamilton CB, Hoens AM, McQuitty S, McKinnon AM, English K, Backman CL, Azimi T, Khodarahmi N, Li LC. Development and pre-testing of the Patient Engagement In Research Scale (PEIRS) to assess the quality of engagement from a patient perspective. PLoS One 2018; 13:e0206588. [PMID: 30383823 PMCID: PMC6211727 DOI: 10.1371/journal.pone.0206588] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/16/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To develop and examine the content and face validity of the Patient Engagement In Research Scale (PEIRS) for assessing the quality of patient engagement in research projects from a patient partner perspective. METHODS Our team of researchers and patient partners conducted a mixed qualitative and quantitative study in three phases. Participants were English-speaking adult patients (including informal caregivers, family members, and friends) with varying experiences as partners in research projects in Canada. 1) Questionnaire items were generated following thematic analysis of in-depth interviews and published literature. 2) A three-round e-Delphi survey process via email correspondence was undertaken to refine and select the items for a provisional PEIRS. 3) Two rounds of cognitive interviewing elicited participants' understanding and opinions of each item and the structure of the PEIRS. RESULTS One hundred and twenty items were generated from 18 interviews and organized across eight themes of meaningful engagement of patients in health research to form an initial questionnaire. The e-Delphi survey and cognitive interviewing each included 12 participants with a range of self-reported diseases, health-related conditions, and use of healthcare services. The e-Delphi survey yielded a 43-item provisional PEIRS. The PEIRS was then reduced to 37 items organized across seven themes after 1) refinement of problems in its instructions and items, and 2) the combining of two themes into one. CONCLUSIONS We developed a 37-item self-reported questionnaire that has demonstrated preliminary content and face validity for assessing the quality of patient engagement in research.
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Affiliation(s)
- Clayon B. Hamilton
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Alison M. Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
- BC SUPPORT Unit, Vancouver, BC, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Annette M. McKinnon
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Kelly English
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Catherine L. Backman
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Tara Azimi
- Arthritis Research Canada, Richmond, BC, Canada
| | | | - Linda C. Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
- BC SUPPORT Unit, Vancouver, BC, Canada
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Black A, Strain K, Wallsworth C, Charlton SG, Chang W, McNamee K, Hamilton C. What constitutes meaningful engagement for patients and families as partners on research teams? J Health Serv Res Policy 2018; 23:158-167. [PMID: 29504424 PMCID: PMC6041763 DOI: 10.1177/1355819618762960] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective There is growing emphasis on health care organizations to ensure that lay people are meaningfully engaged as partners on research teams. Our aim was to explore the perspectives of patients, family members and informal caregivers who have been involved on health care research teams in Canada and elicit their recommendations for meaningful engagement. Methods We conducted a qualitative study guided by thematic analysis of transcripts of focus groups and interviews of 19 experienced patient research partners in Canada. Results We identified four main themes: research environment, expectations, support and value, which highlight participants' combined perspectives on important factors to ensure their engagement in research is meaningful. Conclusions Our findings add to the evolving evidence base on the perspectives of lay people involved in health care research and their recommendations for research leaders on meaningful engagement. Our study suggests that research leaders should provide a welcoming research environment, outline appropriate expectations for patient research partners on research teams, support patient research partners' engagement in projects and recognize the value patient research partners bring to health research.
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Affiliation(s)
- Agnes Black
- 1 Director, Research and Knowledge Translation, Professional Practice Office, Providence Health Care, Canada
| | | | | | - Sara-Grey Charlton
- 3 Practice Consultant, Professional Practice Office, Providence Health Care, Canada
| | - Wilma Chang
- 4 Research Assistant, Professional Practice Office, Providence Health Care, Canada
| | - Kate McNamee
- 3 Practice Consultant, Professional Practice Office, Providence Health Care, Canada
| | - Clayon Hamilton
- 5 Post-Doctoral Fellow, Department of Physical Therapy, University of British Columbia, Canada.,6 Post-Doctoral Trainee, Arthritis Research Canada, Canada
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27
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de Wit M, Beurskens A, Piškur B, Stoffers E, Moser A. Preparing researchers for patient and public involvement in scientific research: Development of a hands-on learning approach through action research. Health Expect 2018; 21:752-763. [PMID: 29418053 PMCID: PMC6117481 DOI: 10.1111/hex.12671] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background Acquiring the theoretical and practical knowhow of conducting patient and public involvement (PPI) in research is not part of the traditional curriculum of researchers. Zuyd University of Applied Sciences and Huis voor de Zorg, a regional umbrella patient organization, therefore started a 1.5‐year coaching programme. Objective To establish a community of practice by developing a PPI coaching programme for senior and junior health services researchers of Zuyd University. The context consisted of research projects conducted by the participants. Methods A participatory action research methodology. Data were collected from reports of thematic group meetings and individual sessions with participants, field notes and regular reflection meetings with the project team. Data were analysed by reflexive deliberation. Findings The programme comprised a kick‐off meeting (52 attendees), followed by 7 group meetings with 11 junior and 9 senior researchers. The project team constructed a serious game based on the concept of the participation ladder. Questions and concerns differed for junior and senior researchers, and separate tailored meetings were organized for both groups. Between group meetings, participants received individual assignments. Group meetings were accompanied by individual coaching sessions to provide tailor‐made feedback. The programme concluded with a combined meeting with all stakeholders. Conclusion Building a community of PPI practice through action research facilitates the development of a coaching programme that fosters social learning, empowerment and the development of a shared identity concerning PPI. The role and responsibilities of senior researchers should be distinguished from those of junior researchers.
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Affiliation(s)
- Maarten de Wit
- Stichting Tools patient empowerment, Bussum, the Netherlands
| | - Anna Beurskens
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | | | - Albine Moser
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
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de Wit M, Kirwan JR, Tugwell P, Beaton D, Boers M, Brooks P, Collins S, Conaghan PG, D'Agostino MA, Hofstetter C, Hughes R, Leong A, Lyddiatt A, March L, May J, Montie P, Richards P, Simon LS, Singh JA, Strand V, Voshaar M, Bingham CO, Gossec L. Successful Stepwise Development of Patient Research Partnership: 14 Years' Experience of Actions and Consequences in Outcome Measures in Rheumatology (OMERACT). PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 10:141-152. [PMID: 27704486 PMCID: PMC5362656 DOI: 10.1007/s40271-016-0198-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is increasing interest in making patient participation an integral component of medical research. However, practical guidance on optimizing this engagement in healthcare is scarce. Since 2002, patient involvement has been one of the key features of the Outcome Measures in Rheumatology (OMERACT) international consensus effort. Based on a review of cumulative data from qualitative studies and internal surveys among OMERACT participants, we explored the potential benefits and challenges of involving patient research partners in conferences and working group activities. We supplemented our review with personal experiences and reflections regarding patient participation in the OMERACT process. We found that between 2002 and 2016, 67 patients have attended OMERACT conferences, of whom 28 had sustained involvement; many other patients contributed to OMERACT working groups. Their participation provided face validity to the OMERACT process and expanded the research agenda. Essential facilitators have been the financial commitment to guarantee sustainable involvement of patients at these conferences, procedures for recruitment, selection and support, and dedicated time allocated in the program for patient issues. Current challenges include the representativeness of the patient panel, risk of pseudo-professionalization, and disparity in patients’ and researchers’ perception of involvement. In conclusion, OMERACT has embedded long-term patient involvement in the consensus-building process on the measurement of core health outcomes. This integrative process continues to evolve iteratively. We believe that the practical points raised here can improve participatory research implementation.
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Affiliation(s)
- Maarten de Wit
- OMERACT Patient Research Partner, Amsterdam, The Netherlands. .,Department of Medical Humanities, VU University Medical Centre/EMGO+ instituut, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - John R Kirwan
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dorcas Beaton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Maarten Boers
- Department of Epidemiology and Biostatistics, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter Brooks
- Centre for Health Policy School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Philip G Conaghan
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Maria-Antonietta D'Agostino
- Department of Rheumatology, Hôpital Ambroise Paré, APHP, Université Versailles Saint Quentin en Yvelines, Boulogne-Billancourt, France
| | | | - Rod Hughes
- Ashford St Peter's Foundation trust Hospital, Chertsey, Surrey, UK
| | - Amye Leong
- OMERACT Patient Research Partner, Santa Barbara, CA, USA.,Healthy Motivations, Santa Barbara, CA, 93108, USA.,Bone and Joint Decade, The Global Alliance for Musculoskeletal Health, Truro, Cornwall, UK
| | - Ann Lyddiatt
- OMERACT Patient Research Partner, Vancouver, BC, Canada
| | - Lyn March
- Institute of Bone and Joint Research, Sydney Medical School and School of Public Health, University of Sydney, Sydney, NSW, Australia.,Department of Rheumatology, Royal North Shore, St. Leonards, NSW, Australia
| | - James May
- OMERACT Patient Research Partner, Seattle, WA, USA
| | - Pamela Montie
- OMERACT Patient Research Partner, Vancouver, BC, Canada.,Arthritis Patient Advisory Board, Arthritis Research Centre Canada, Richmond, BC, Canada
| | - Pamela Richards
- Academic Rheumatology Unit, Bristol Royal Infirmary, University of Bristol, Bristol, BS2 8HW, UK.,OMERACT Patient Research Partner, Bristol, UK
| | | | - Jasvinder A Singh
- Medicine Service, VA Medical Center, Birmingham, AL, USA.,Division of Epidemiology at School of Public Health, Department of Medicine at School of Medicine, University of Alabama, Birmingham, AL, 35294-0022, USA.,Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA
| | - Vibeke Strand
- Division Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marieke Voshaar
- OMERACT Patient Research Partner, Amsterdam, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Paris, France.,Rheumatology Department, Pitie-Salpétrière Hospital, AP-HP, Paris, France
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Amann J, Rubinelli S. Views of Community Managers on Knowledge Co-creation in Online Communities for People With Disabilities: Qualitative Study. J Med Internet Res 2017; 19:e320. [PMID: 29017993 PMCID: PMC5654737 DOI: 10.2196/jmir.7406] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/04/2017] [Accepted: 08/04/2017] [Indexed: 11/29/2022] Open
Abstract
Background The use of online communities to promote end user involvement and co-creation in the product and service innovation process is well documented in the marketing and management literature. Whereas online communities are widely used for health care service provision and peer-to-peer support, only little is known about how they could be integrated into the health care innovation process. Objective The overall objective of this qualitative study was to explore community managers’ views on and experiences with knowledge co-creation in online communities for people with disabilities. Methods A descriptive qualitative research design was used. Data were collected through semi-structured interviews with nine community managers. To complement the interview data, additional information was retrieved from the communities in the form of structural information (number of registered users, number and names of topic areas covered by the forum) and administrative information (terms and conditions and privacy statements, forum rules). Data were analyzed using thematic analysis. Results Our results highlight two main aspects: peer-to-peer knowledge co-creation and types of collaboration with external actors. Although community managers strongly encouraged peer-to-peer knowledge co-creation, our findings indicated that these activities were not common practice in the communities under investigation. In fact, much of what related to co-creation, prototyping, and product development was still perceived to be directed by professionals and experts. Community managers described the role of their respective communities as informing this process rather than a driving force. The role of community members as advisors to researchers, health care professionals, and businesses was discussed in the context of types of collaboration with external actors. According to the community managers, most of the external inquiries related to research projects of students or health care professionals in training, who often joined a community for the sole purpose of recruiting participants for their research. Despite this unilateral form of knowledge co-creation, community managers acknowledged the mere interest of these user groups as beneficial, as long as their interest was not purely financially motivated. Being able to contribute to advancing research, improving products, and informing the planning and design of health care services were described as some of the key motivations to engage with external stakeholders. Conclusions This paper draws attention to the currently under-investigated role of online communities as platforms for collaboration and co-creation between patients, health care professionals, researchers, and businesses. It describes community managers’ views on and experiences with knowledge co-creation and provides recommendations on how these activities can be leveraged to foster knowledge co-creation in health care. Engaging in knowledge co-creation with online health communities may ultimately help to inform the planning and design of products, services, and research activities that better meet the actual needs of those living with a disability.
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Affiliation(s)
- Julia Amann
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne/Nottwil, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne/Nottwil, Switzerland
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Hamilton CB, Hoens AM, Backman CL, McKinnon AM, McQuitty S, English K, Li LC. An empirically based conceptual framework for fostering meaningful patient engagement in research. Health Expect 2017; 21:396-406. [PMID: 28984405 PMCID: PMC5750689 DOI: 10.1111/hex.12635] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 01/15/2023] Open
Abstract
Background Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. Objective To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. Methods We conducted a qualitative secondary analysis of in‐depth interviews with 18 patient research partners from a research centre‐affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Results Participants’ experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. Conclusions The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient‐researcher partnerships are led by researchers with little experience of engaging patients in research.
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Affiliation(s)
- Clayon B Hamilton
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Cananda.,Arthritis Research Canada, Richmond, BC, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Cananda.,Arthritis Research Canada, Richmond, BC, Canada.,BC SUPPORT Unit, Vancouver, BC, Canada.,Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Annette M McKinnon
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Kelly English
- Arthritis Patient Advisory Board, Arthritis Research Canada, Richmond, BC, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Cananda.,Arthritis Research Canada, Richmond, BC, Canada.,BC SUPPORT Unit, Vancouver, BC, Canada
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Hamilton CB, Leese JC, Hoens AM, Li LC. Framework for Advancing the Reporting of Patient Engagement in Rheumatology Research Projects. Curr Rheumatol Rep 2017; 19:38. [PMID: 28631065 PMCID: PMC5750042 DOI: 10.1007/s11926-017-0666-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF REVIEW The term "patient engagement in research" refers to patients and their surrogates undertaking roles in the research process beyond those of study participants. This paper proposes a new framework for describing patient engagement in research, based on analysis of 30 publications related to patient engagement. RECENT FINDINGS Over the past 15 years, patients' perspectives have been instrumental in broadening the scope of rheumatology research and outcome measurement, such as evaluating fatigue in rheumatoid arthritis. Recent reviews, however, highlight low-quality reporting of patient engagement in research. Until we have more detailed information about patient engagement in rheumatology research, our understanding of how patients' perspectives are being integrated into research projects remains limited. When authors follow our guidance on the important components for describing patients' roles and function as "research partners," researchers and other knowledge users will better understand how patients' perspectives were integrated in their research projects.
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Affiliation(s)
- Clayon B Hamilton
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada
| | - Jenny C Leese
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada
| | - Alison M Hoens
- BC SUPPORT Unit, Vancouver, BC, Canada
- Arthritis Patient Advisory Board of Arthritis Research Canada, Richmond, BC, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
- Arthritis Research Canada, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada.
- BC SUPPORT Unit, Vancouver, BC, Canada.
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Abstract
Purpose The purpose of this paper is to outline the development of a training package for service users and carers with an interest in NHS health and social care research. It demonstrates how the developers used their unique experience and expertise as service users and carers to inform their work. Design/methodology/approach Service users and carers, NHS Research and Development Forum working group members, supported by health professionals, identified a need for research training that was tailored to other service user and carer needs. After reviewing existing provision and drawing on their training and support experience, they developed a training package. Sessions from the training package were piloted, which evaluated positively. In trying to achieve programme accreditation and training roll-out beyond the pilots, the group encountered several challenges. Findings The training package development group formed good working relationships and a co-production model that proved sustainable. However, challenges were difficult to overcome owing to external factors and financial constraints. Practical implications Lessons learnt by the team are useful for other service users and carer groups working with health service professionals. Training for service users and carers should be designed to meet their needs; quality and consistency are also important. The relationships between service user and carer groups, and professionals are important to understanding joint working. Recognising and addressing challenges at the outset can help develop strategies to overcome challenges and ensure project success. Originality/value The training package was developed by service users and carers for other service users and carers. Their unique health research experience underpinned the group's values and training development.
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Schipper K, Bakker M, De Wit M, Ket JCF, Abma TA. Strategies for disseminating recommendations or guidelines to patients: a systematic review. Implement Sci 2016; 11:82. [PMID: 27268061 PMCID: PMC4895829 DOI: 10.1186/s13012-016-0447-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 05/25/2016] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this systematic literature review was to assess what dissemination strategies are feasible to inform and educate patients about recommendations (also known as guidelines). Methods The search was performed in February 2016 in PubMed, Ebsco/PsycINFO, Ebsco/CINAHL and Embase. Studies evaluating dissemination strategies, involving patients and/or reaching patients, were included. A hand search and a search in the grey literature, also done in February 2016, were added. Searches were not restricted by language or publication type. Publications that referred to (1) guideline(s) or recommendation(s), (2) dissemination, (3) dissemination with patients/patient organisations and (4) dissemination to patients/patient organisations were included in this article. Criteria 1 AND 2 were mandatory together with criteria 3 OR 4. Results The initial search revealed 3753 unique publications. Forty-seven articles met the inclusion criteria and were selected for detailed review. The hand search and grey literature resulted in four relevant articles. After reading the full text of the 47 articles, 21 were relevant for answering our research question. Most publications had low levels of evidence, 3 or 4 of the Oxford levels of evidence. One article had a level of evidence of 2(b). This article gives an overview of tools and strategies to disseminate recommendations to patients. Key factors of success were a dissemination plan, written at the start of the recommendation development process, involvement of patients in this development process and the use of a combination of traditional and innovative dissemination tools. The lack of strong evidence calls for more research of the effectiveness of different dissemination strategies as well as the barriers for implementing a strategic approach of dissemination. Conclusion Our findings provide the first systematic overview of tools and strategies to disseminate recommendations to patients and patient organisations. Participation of patients in the whole process is one of the most important findings. These findings are relevant to develop, implement and evaluate more (effective) dissemination strategies which can improve health care. Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0447-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Schipper
- Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands. .,Department of Medical Humanities/EMGO+, VU University Medical Center, Post box 7057, 1081 BT, Amsterdam, The Netherlands.
| | - M Bakker
- Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands
| | - M De Wit
- EULAR Standing Committee of People with Arthritis/Rheumatism in Europe, Zurich, Switzerland
| | - J C F Ket
- Medical Library, VU University, Amsterdam, The Netherlands
| | - T A Abma
- Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands
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Fagan MB, Morrison CR, Wong C, Carnie MB, Gabbai-Saldate P. Implementing a pragmatic framework for authentic patient-researcher partnerships in clinical research. J Comp Eff Res 2016; 5:297-308. [PMID: 27144508 DOI: 10.2217/cer-2015-0023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In response to the creation of the Patient-Centered Outcomes Research Institute in 2010, researchers have begun to incorporate patient and family stakeholders into the research process as equal partners, bringing their unique perspectives and experiences to the table. Nonetheless, there is a dearth of literature around how best to engage patients and families and many barriers to doing so effectively. This paper outlines a pragmatic framework of collaborative engagement and partnership between research investigators and patient and family advisors from existing patient and family advisory councils (PFACs) at an academic medical center. This framework includes the role for each party throughout the clinical research process (launch, hypothesis, specific aims, measures/methods, results, interpretations/recommendation and dissemination).
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Affiliation(s)
- Maureen B Fagan
- Center for Patients & Families, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Constance Rc Morrison
- Center for Patients & Families, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Celene Wong
- Center for Patients & Families, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Martha B Carnie
- Center for Patients & Families, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Paulette Gabbai-Saldate
- Department of Medicine, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Patient participation - What is it? ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2016; 110-111:12-5. [PMID: 26875028 DOI: 10.1016/j.zefq.2015.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Taras HL, Kalichman MW, Schulteis G, Dumbauld J, Bell Y, Seligman FF, West KD. Soliciting views of various communities on health research: a prelude to engagement in specific research projects. Health Expect 2015; 18:2753-63. [PMID: 25103450 PMCID: PMC4320671 DOI: 10.1111/hex.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Members of the public are increasingly engaged in health-service and biomedical research and provide input into the content of research, design and data sharing. As there is variation among different communities on how research is perceived, to engage all sectors of the general public research institutions need to customize their approach. OBJECTIVE This paper explores how research institutions and community leaders can partner to determine the best ways to engage different sectors of the public in research. DESIGN Following a literature review, a research institution engaged with four different sectors of the public through their respective representative community-based organizations (CBOs) by interviews with leaders, community member focus groups and a joint project. SETTING San Diego and Imperial Counties, California, United States of America (USA). CONCLUSION Before embarking on more specific research projects, investigators can gain valuable insights about different communities' attitudes to, and understanding of, health services and biomedical research by interacting directly with members of the community, collaborating with community leaders, and jointly identifying steps of engagement tailored to the community.
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Affiliation(s)
- Howard L. Taras
- Clinical & Translational Research InstituteUniversity of California‐San DiegoLa JollaCAUSA
| | | | - Gery Schulteis
- Research & DevelopmentVA San Diego Healthcare SystemDepartment of AnesthesiologyUniversity of California‐San DiegoLa JollaCAUSA
| | - Jill Dumbauld
- Clinical & Translational Research InstituteUniversity of California‐San DiegoLa JollaCAUSA
| | - Yvonne Bell
- Clinicas de Salud del Pueblo, Inc.BrawleyCAUSA
| | | | - Kathy D. West
- Epilepsy Foundation of San Diego CountySan DiegoCAUSA
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de Wit MPT, Kvien TK, Gossec L. Patient participation as an integral part of patient-reported outcomes development ensures the representation of the patient voice: a case study from the field of rheumatology. RMD Open 2015; 1:e000129. [PMID: 26509075 PMCID: PMC4613173 DOI: 10.1136/rmdopen-2015-000129] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/29/2015] [Accepted: 07/03/2015] [Indexed: 01/24/2023] Open
Abstract
Introduction Patient-reported outcomes (PROs) are important instruments to evaluate healthcare interventions, both in clinical practice and clinical research. Objective To describe how representation of the perspective of people with psoriatic arthritis was obtained through active participation on different levels in the development of PROs. Methods This case study focuses on the methods of involving patients in the elaboration and validation of the Psoriatic Arthritis Impact of Disease (PsAID) score. We used the concept of the participation ladder and the European League Against Rheumatism (EULAR) recommendations for the involvement of patient representatives in scientific projects to analyse the variety of ways patients participated in this process. Results Two patient experts were part of the steering group. 12 patient research partners, coming from 12 different European countries, participated in identifying domains, formulating items for the questionnaire and determining the number of items, the recall period and the questionnaire format. They also helped with the translation of the items into different European languages. Then, 139 patients took part in ranking and prioritising the domains for importance; 65 patients were involved in cognitive debriefing interviews; 499 new patients were recruited for the validation study. Challenges of patient participation in PRO development, such as the representation of patients, are discussed. Conclusions Making patient participation an integral part of the PRO development and validation process is an important requisite for outcome research. The variety of patient contributions at different phases in this case study resulted in an instrument with high face validity.
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Affiliation(s)
- M P T de Wit
- Department of Medical Humanities , VU University , Amsterdam , The Netherlands
| | - T K Kvien
- Department of Rheumatology , Diakonhjemmet Hospital , Oslo , Norway
| | - L Gossec
- Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS) , Paris , France ; Department of Rheumatology , AP-HP, Pitié Salpêtrière Hospital , Paris , France
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38
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Cheung PP, de Wit M, Bingham CO, Kirwan JR, Leong A, March LM, Montie P, Scholte-Voshaar M, Gossec L. Recommendations for the Involvement of Patient Research Partners (PRP) in OMERACT Working Groups. A Report from the OMERACT 2014 Working Group on PRP. J Rheumatol 2015; 43:187-93. [DOI: 10.3899/jrheum.141011] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective.Patient participation in research is increasing; however, practical guidelines to enhance this participation are lacking. Specifically within the Outcome Measures in Rheumatology (OMERACT) organization, although patients have participated in OMERACT meetings since 2002, consensus about the procedures for involving patients in working groups has not been formalized. The objective is to develop a set of recommendations regarding patient research partner (PRP) involvement in research working groups.Methods.We conducted a systematic literature review on recommendations/guidelines of PRP involvement in research; elaborated a structured consensus process involving multiple participants to develop a set of recommendations; and sought endorsement of recommendations by OMERACT.Results.In the 18 articles included in the literature review, there was general agreement on the broad concepts for recommendations covering PRP involvement in research although they were heterogeneous in detail. Most considered PRP involvement in all phases of research with early engagement, training, and support important, but details on the content were scarce. This review informed a larger consensus-building process regarding PRP inclusion in OMERACT research. Three overarching principles and 8 recommendations were developed, discussed, and refined at OMERACT 2014. The guiding principles were endorsed during the OMERACT plenary session.Conclusion.These recommendations for PRP involvement in OMERACT research reinforce the importance of patient participation throughout the research process as integral members. Although the applicability of the recommendations in other research contexts should be assessed, the generalizability is expected to be high. Future research should evaluate their implementation and their effect on outcome development.
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Gooberman-Hill R, Burston A, Clark E, Johnson E, Nolan S, Wells V, Betts L. Involving patients in research: considering good practice. Musculoskeletal Care 2014; 11:187-90. [PMID: 24311367 PMCID: PMC3918577 DOI: 10.1002/msc.1060] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Abma TA, Pittens CACM, Visse M, Elberse JE, Broerse JEW. Patient involvement in research programming and implementation: A responsive evaluation of the Dialogue Model for research agenda setting. Health Expect 2014; 18:2449-64. [PMID: 24889933 DOI: 10.1111/hex.12213] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Dialogue Model for research agenda-setting, involving multiple stakeholders including patients, was developed and validated in the Netherlands. However, there is little insight into whether and how patient involvement is sustained during the programming and implementation of research agendas. AIM To understand how the Dialogue Model can be optimised by focusing on programming and implementation, in order to stimulate the inclusion of (the perspectives of) patients in research. METHODS A responsive evaluation of the programming and implementation phases of nine agenda-setting projects that had used the Dialogue Model for agenda-setting was conducted. Fifty-four semi-structured interviews were held with different stakeholders (patients, researchers, funding agencies). Three focus groups with patients, funding agencies and researchers (16 participants) were organized to validate the findings. RESULTS Patient involvement in programming and implementation of the research agendas was limited. This was partly related to poor programming and implementation, partly to pitfalls in earlier phases of the agenda-setting. Optimization of the Dialogue Model is possible by attending to the nature of the agenda and its intended use in earlier phases. Attention should also be given to the ambassadors and intended users of agenda topics. Support is needed during programming and implementation to organize patient involvement and adapt organizational structures like review procedures. In all phases the attitude to patient involvement, stakeholder participation, especially of researchers, and formal and informal relationships between parties need to be addressed to build a strong relationship with a shared goal. CONCLUSION Patient involvement in agenda-setting is not automatically followed by patient involvement in programming and implementation. More attention should be paid, in earlier stages, to the attitude and engagement of researchers and funding agencies.
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Affiliation(s)
- Tineke A Abma
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Carina A C M Pittens
- Faculty of Earth and Life Science, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Merel Visse
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Janneke E Elberse
- Faculty of Earth and Life Science, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Jacqueline E W Broerse
- Faculty of Earth and Life Science, Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University, Amsterdam, The Netherlands
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41
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A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 2014; 73:1012-9. [DOI: 10.1136/annrheumdis-2014-205207] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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