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Baba A, Aregbesola A, Caldwell PHY, Elliott SA, Elsman EBM, Fernandes RM, Hartling L, Heath A, Kelly LE, Preston J, Sammy A, Webbe J, Williams K, Woolfall K, Klassen TP, Offringa M. Developments in the Design, Conduct, and Reporting of Child Health Trials. Pediatrics 2024; 154:e2024065799. [PMID: 38832441 DOI: 10.1542/peds.2024-065799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 06/05/2024] Open
Abstract
To identify priority areas to improve the design, conduct, and reporting of pediatric clinical trials, the international expert network, Standards for Research (StaR) in Child Health, was assembled and published the first 6 Standards in Pediatrics in 2012. After a recent review summarizing the 247 publications by StaR Child Health authors that highlight research practices that add value and reduce research "waste," the current review assesses the progress in key child health trial methods areas: consent and recruitment, containing risk of bias, roles of data monitoring committees, appropriate sample size calculations, outcome selection and measurement, and age groups for pediatric trials. Although meaningful change has occurred within the child health research ecosystem, measurable progress is still disappointingly slow. In this context, we identify and review emerging trends that will advance the agenda of increased clinical usefulness of pediatric trials, including patient and public engagement, Bayesian statistical approaches, adaptive designs, and platform trials. We explore how implementation science approaches could be applied to effect measurable improvements in the design, conducted, and reporting of child health research.
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Affiliation(s)
- Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Alex Aregbesola
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Patrina H Y Caldwell
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
| | - Sarah A Elliott
- Cochrane Child Health
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ellen B M Elsman
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Ricardo M Fernandes
- Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Lisa Hartling
- Cochrane Child Health
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Anna Heath
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Statistical Science, University College London, London, United Kingdom
| | - Lauren E Kelly
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pharmacology and Therapeutics, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Canada
| | - Jennifer Preston
- National Institute for Health and Care Research (NIHR) Alder Hey Clinical Research Facility, Liverpool, United Kingdom
| | - Adrian Sammy
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - James Webbe
- Section of Neonatal Medicine, Imperial College London, London, United Kingdom
| | - Katrina Williams
- Department of Paediatrics, Monash University and Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
| | - Kerry Woolfall
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Terry P Klassen
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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Connery A, Salsberg J. Exploring participatory health research and its application to speech and language therapy research practices. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1257-1268. [PMID: 38130139 DOI: 10.1111/1460-6984.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under-represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society. AIMS To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field. METHODS & PROCEDURES This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. MAIN CONTRIBUTION This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field. CONCLUSIONS & IMPLICATIONS Conclusions & Implications: PHR remains an under-represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research-practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production. WHAT THIS PAPER ADDS What is already known on this subject PHR is increasingly attracting the attention of funders, researchers and decision-makers due to a growing body of evidence in support of this collaborative research approach. Despite its potential to bridge the research-practice gap, PHR remains significantly under-represented in the SLT research literature. What this paper adds to the existing knowledge This paper discusses the principles, benefits, challenges and impact evaluation of PHR. A recently developed evaluation framework for supporting the implementation of best engagement practices is examined. A demonstration of how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. What are the potential or actual clinical implications of this work? Speech and language therapists play a key role in PHR, as co-researchers contributing essential context-based knowledge. It is therefore imperative that they understand the principles and practices of this approach in order to maximize their input in future participatory partnerships.
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Affiliation(s)
- Amy Connery
- Department of Clinical Speech & Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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Cross L, Banham D, Melendez-Torres GJ, Ford T, van Sluijs E, Liabo K. Developing inclusive public involvement and engagement activities with secondary school students and educational professionals: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:68. [PMID: 38951878 PMCID: PMC11218269 DOI: 10.1186/s40900-024-00581-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/01/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Public involvement and engagement (PI&E) is increasingly recognised as an important component of research. It can offer valuable insights from those with experiential knowledge to improve research quality, relevance, and reach. Similarly, schools are ever more common sites for health research and, more recently, PI&E. However, 'gold-standard' practice is yet to be established, and activities/approaches remain underreported. As a result, knowledge can remain localised or lost. Diversity and inclusion also remains a challenge. METHODS This protocol has been informed by UK national guidance, evidence-based frameworks and available implementation literature. It describes both rationale and approach to conducting PI&E activities within a secondary school context. Activities are designed to be engaging, safe and accessible to young people with diverse experiences, with scope to be iteratively developed in line with public collaborator preference. DISCUSSION Young people should be architects of their involvement and engagement. Ongoing appraisal and transparency of approaches to PI&E in school settings is crucial. Expected challenges of implementing this protocol include facilitating a safe space for the discussion of sensitive topics, absence and attrition, recruiting students with a diverse range of experiences, and potential knowledge and capacity barriers of both facilitator and contributors. Activities to mitigate these risks are suggested and explored.
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Affiliation(s)
- Lauren Cross
- University of Cambridge (MRC Epidemiology Unit), Cambridge, UK.
| | | | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Crooks J, Flemming K, Shulman C, Casey E, Hudson B. Development of the TIFFIN recommendations for co-producing palliative and end-of-life care research with individuals with lived experience of homelessness: A qualitative study. Palliat Med 2024:2692163241259667. [PMID: 38898648 DOI: 10.1177/02692163241259667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Palliative care for people experiencing homelessness is a complex field. Due to the intricate nuances and heterogeneity in the experience of palliative care for people without secure housing, it is essential that research is informed by people with lived experience of homelessness. However, as homelessness is often associated with loss, trauma and high levels of exposure to death, any co-production of research, particularly in the field of palliative and end-of-life-care, must be trauma-informed. AIM To produce recommendations for co-producing palliative and end-of-life-care research with people with lived experience of homelessness. DESIGN A qualitative study comprising semi-structured interviews and focus groups. Data were analysed using iterative, reflexive thematic analysis. SETTING/PARTICIPANTS Twenty-seven participants were recruited. Sixteen professionals with experience of co-producing research with people with lived experience of homelessness; eleven people with lived experience of homelessness. RESULTS Six key themes were developed: transparency, importance of engagement and rapport, facilitating equitable involvement via person centred approach, financial recognition of involvement, involvement and growth through a trauma-informed approach and navigating institutional resistance and attitudes. Recommendations corresponding to the core themes were developed (TIFFIN recommendations). CONCLUSIONS Co-production of palliative care research with people with lived experience of homelessness is essential, but must be done carefully and sensitively. As a population with high levels of premature morbidity and mortality yet low access to palliative care, the TIFFIN recommendations could help to support the involvement of people with lived experience of homelessness in palliative and end-of-life-care care research.
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Affiliation(s)
| | | | - Caroline Shulman
- Pathway, London, UK
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | | | - Briony Hudson
- Marie Curie, London, UK
- Marie Curie Palliative Care Research Department, University College London, London, UK
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Gafari O, Bahrami-Hessari M, Norton J, Parmar R, Hudson M, Ndegwa L, Agyapong-Badu S, Asante KP, Alwan NA, McDonough S, Tully MA, Calder PC, Barker M, Stokes M. Building trust and increasing inclusion in public health research: co-produced strategies for engaging UK ethnic minority communities in research. Public Health 2024; 233:90-99. [PMID: 38865828 DOI: 10.1016/j.puhe.2024.05.007] [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: 01/29/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 06/14/2024]
Abstract
Patient and public involvement and engagement (PPIE) is essential for improved research outcomes and reduced research waste. To be effective, PPIE should provide opportunities for diverse groups to contribute to all research stages. However, UK ethnic minority communities remain underrepresented in research. This article describes strategies adopted in a public health research project that were effective in building trust and increasing inclusion of ethnic minority communities. The study team of researchers and PPIE partners reflects lessons learnt during the project and describe six main strategies that built meaningful levels of trust and inclusion: 1) early start to recruitment of PPIE partners; 2) relationship-focused engagement; 3) co-production and consultation activities; 4) open communication and iterative feedback; 5) co-production of project closure activities, and; 6) diverse research team. Meaningful outcomes for the community included the involvement of people from ethnic minorities as research participants and PPIE partners, community wellbeing, co-production of public health recommendations co-presented at the UK Houses of Parliament, and consortium-wide impact evidenced by the enrolment of 51 active PPIE partners. PPIE partners reflect on their research involvement, offering advice to researchers and encouraging people from ethnic minority communities to take part in research. An important message from PPIE partners is that involvement should not be restricted to projects specific to ethnic minorities but become a routine part of general population research, recognising ethnic minorities as an integral part of UK society. In conclusion, this article demonstrates that with appropriate strategies, inclusion and diversity can be achieved in public health research. We recommend researchers, practitioners and policy makers adopt these strategies when planning their public health projects.
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Affiliation(s)
- O Gafari
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
| | - M Bahrami-Hessari
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; NIHR Southampton Clinical Research Facility, University of Southampton and University Hospitals Southampton NHS Foundation Trust, UK
| | - J Norton
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - R Parmar
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - M Hudson
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - L Ndegwa
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - S Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - K P Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Ghana
| | - N A Alwan
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S McDonough
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - M A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - P C Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Barker
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Stokes
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
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Engler J, Engler F, Gerber M, Brosse F, Voigt K, Mergenthal K. Establishing a standing patient advisory board in family practice research: A qualitative evaluation from patients' and researchers' perspectives. Health Expect 2024; 27:e14094. [PMID: 38881096 PMCID: PMC11180710 DOI: 10.1111/hex.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/20/2024] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
INTRODUCTION Patient and public involvement is vital for high-quality research. Integrating patients' and providers' perspectives early in research enhances the feasibility and relevance of study results. Within our family practice-based research network ForN, we established a standing patient advisory board (PAB) to include patients with diverse conditions and experiences. In this paper, we aim to describe the establishment and functioning of a standing PAB in family medicine research from patients' and researchers' perspectives. METHODS After each PAB meeting, patients and researchers were asked to name anonymously positive and challenging moments in a feedback form with open questions. Researchers were also asked to reflect on how they implemented the discussion content in their research projects. The responses from both groups were transferred to MAXQDA 2018 and analyzed separately using thematic analysis. RESULTS We analyzed 40 feedback forms from patients and 14 feedback forms from researchers. The dominant theme in the patients' feedback was 'exchange': They positively emphasized the 'exciting and open discussions' and the exchange of perspectives with one another and researchers. The clarity of the researchers' presentations and the research topics were appreciated. Researchers also positively highlighted the open atmosphere of the discussions. Presenting their research to the PAB helped most researchers reflect on their research topics from patients' perspectives and implement changes. However, researchers also mentioned several barriers to the implementation of PAB members' feedback. CONCLUSION The establishment of a standing PAB in family practice research is feasible and productive both from patients' and researchers' perspectives. PATIENT OR PUBLIC CONTRIBUTION This study reports the evaluation of the establishment of a standing PAB in family practice research. Board members are involved in the design of studies, the co-production of interventions and information material, and the interpretation of data.
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Affiliation(s)
- Jennifer Engler
- Institute of General PracticeFaculty of Medicine at Goethe‐Universität Frankfurt am MainFrankfurtGermany
| | - Fabian Engler
- Institute of General PracticeFaculty of Medicine at Goethe‐Universität Frankfurt am MainFrankfurtGermany
| | - Meike Gerber
- Institute of General PracticeFaculty of Medicine at Goethe‐Universität Frankfurt am MainFrankfurtGermany
- Present address:
Researcher, Faculty of Medicine Carl Gustav CarusInstitute for the History of Medicine, Technische Universität DresdenFetscherstraße 74 01307DresdenGermany
| | - Franziska Brosse
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Medical Clinic IIITechnische Universität DresdenDresdenGermany
| | - Karen Voigt
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Medical Clinic IIITechnische Universität DresdenDresdenGermany
| | - Karola Mergenthal
- Institute of General PracticeFaculty of Medicine at Goethe‐Universität Frankfurt am MainFrankfurtGermany
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Hayvon JC. Action against inequalities: a synthesis of social justice & equity, diversity, inclusion frameworks. Int J Equity Health 2024; 23:106. [PMID: 38783319 PMCID: PMC11119020 DOI: 10.1186/s12939-024-02141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/03/2024] [Indexed: 05/25/2024] Open
Abstract
Inequalities in health have long been recognized as interconnected with social, economic, and various other inequalities. The application of social justice and equity, diversity, inclusion (EDI) frameworks may help expand interdisciplinary perspectives in addressing inequalities. This review study conducted an environmental scan for existing syntheses of theories, models, and frameworks (TMFs) relevant to the social justice and EDI. Results from Web of Science, Scopus, PubMed, CINAHL, PsychINFO, and MEDLINE retrieved an existing implementation science framework intently centered upon health inequalities, and draws from a synthesis of postcolonial theory, reflexivity, intersectionality, structural violence, and governance theory. Given this high degree of relevance to the objective of this review, the framework was selected as a basis for expanded synthesis. Subsequent processes sought to identify social justice TMFs which could be integrated into the base framework selected, as well as to refine scope of the study. Based upon considerations of level of evidence and non-tokenistic integration, the following social justice and EDI TMFs were identified: John Rawls' theory of justice; Amartya Sen's Capabilities Approach; Iris Marion Young's theories of justice; Paulo Freire's critical consciousness; and critical race theory (CRT). The focus of the synthesis performed was scoped towards minimizing potential harms arising from actions intending to reduce inequalities. EDI considerations were not collated into a singular construct, but rather extended as a separate component assessing inequitable distribution of risks and benefits given population heterogeneity. Reflexive analysis amended the framework with two key decisions: first, the integration of environmental justice into a single construct, which helps to inform Rawls' and Sen's TMFs; second, a temporal element of sequential-analysis was employed over a unified output. The result of synthesis consists of a three-component framework which: (1) presents sixteen constructs drawn from selected TMFs, to consider various harms or potential reinforcement of existing inequalities; (2) aims to de-invisibilize marginalized groups who are noted to experience inequitable outcomes, and acknowledges the presence of individuals belonging to multiple groups; and (3) synthesizes seven considerations related to equitable dissemination and evaluation as drawn from TMFs, separated for sequential analysis after assessment of harms.
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Lamb R, Kougiali ZG. Women and shame: narratives of recovery from alcohol dependence. Psychol Health 2024:1-38. [PMID: 38736242 DOI: 10.1080/08870446.2024.2352191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/27/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Existing literature indicates distinct pathways and the key role of shame and stigma into alcohol dependence (AD) and recovery for women. Internationally, there is a paucity of research exploring these factors from women's perspectives. METHODS AND MEASURES Taking a critical realist epistemological position, unstructured life story interviews were analysed via narrative analysis to explore how seven women from the UK, storied shame in their recovery from AD. RESULTS Shame followed a common trajectory across participants' stories, appearing as a reoccurring factor throughout AD and recovery. Participants narrated shame as gendered, contributing to a loss of personal control in defining a valued personal identity. Drinking began as a shame-management strategy but evolved into a source of shame, compounded by fears of being labelled an 'alcoholic woman'. Recovery involved reclaiming the self through de-shaming a shame-based identity and developing a positive, non-drinking identity. By evaluating 'shaming' recovery frameworks, sharing stories and reconstructing their own, participants were able to work through shame, resist pathologising identity labels and internalise esteemed 'sober' identities. CONCLUSION This research provides important insights into the intersection between shame, identity, gender and culture in women's recovery from AD. Implications for clinical practice, future research and policy are considered.
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Affiliation(s)
- Robin Lamb
- Department of Psychology, University of East London, London, UK
| | - Zetta G Kougiali
- School of Psychology, Liverpool John Moores University, Liverpool, UK
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Rao S, Dimitropoulos G, Jardine R, Quickstad J, Satam L, Qureshi M, Bui T, Todorova AA, Tumaneng Y, Suthakaran A, Dalley K, Smith S, Patten SB. Primus Inter PARES: First among equals-practical strategies for young adult PAtient RESearch partners (PARES) by young adult PARES. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:45. [PMID: 38720386 PMCID: PMC11077772 DOI: 10.1186/s40900-024-00576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures. MAIN BODY The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them. CONCLUSION This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose.
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Affiliation(s)
- Sandy Rao
- Faculty of Social Work, University of Calgary, Calgary, Canada.
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada.
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
| | - Rae Jardine
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Julien Quickstad
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Laetitia Satam
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Mohammad Qureshi
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Thyra Bui
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Antoaneta Alexandrova Todorova
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ysabelle Tumaneng
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Abitha Suthakaran
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Kaiden Dalley
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Stacie Smith
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Faculty of Education, Mount Saint Vincent University, Halifax, NS, Canada
| | - Scott B Patten
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Haroutounian S, Holzer KJ, Kerns RD, Veasley C, Dworkin RH, Turk DC, Carman KL, Chambers CT, Cowan P, Edwards RR, Eisenach JC, Farrar JT, Ferguson M, Forsythe LP, Freeman R, Gewandter JS, Gilron I, Goertz C, Grol-Prokopczyk H, Iyengar S, Jordan I, Kamp C, Kleykamp BA, Knowles RL, Langford DJ, Mackey S, Malamut R, Markman J, Martin KR, McNicol E, Patel KV, Rice AS, Rowbotham M, Sandbrink F, Simon LS, Steiner DJ, Vollert J. Patient engagement in designing, conducting, and disseminating clinical pain research: IMMPACT recommended considerations. Pain 2024; 165:1013-1028. [PMID: 38198239 PMCID: PMC11017749 DOI: 10.1097/j.pain.0000000000003121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 01/12/2024]
Abstract
ABSTRACT In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clinical research lifecycle. It is becoming increasingly evident that to develop research that is both meaningful to people who have the targeted condition and is feasible, there are important benefits of involving patients in the planning, conduct, and dissemination of research from its earliest stages. In fact, research funders and regulatory agencies are now explicitly encouraging, and sometimes requiring, that patients are engaged as partners in research. Although this approach has become commonplace in some fields of clinical research, it remains the exception in clinical pain research. As such, the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials convened a meeting with patient partners and international representatives from academia, patient advocacy groups, government regulatory agencies, research funding organizations, academic journals, and the biopharmaceutical industry to develop consensus recommendations for advancing patient engagement in all stages of clinical pain research in an effective and purposeful manner. This article summarizes the results of this meeting and offers considerations for meaningful and authentic engagement of patient partners in clinical pain research, including recommendations for representation, timing, continuous engagement, measurement, reporting, and research dissemination.
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Affiliation(s)
- Simon Haroutounian
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Katherine J. Holzer
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Robert D. Kerns
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT, United States
| | - Christin Veasley
- Chronic Pain Research Alliance, North Kingstown, RI, United States
| | - Robert H. Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Dennis C. Turk
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
| | - Kristin L. Carman
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC, United States
| | - Christine T. Chambers
- Departments of Psychology & Neuroscience and Pediatrics, Dalhousie University, and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Penney Cowan
- American Chronic Pain Association, Rocklin, CA, United States
| | - Robert R. Edwards
- Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, United States
| | - James C. Eisenach
- Departments of Anesthesiology, Physiology and Pharmacology, Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - John T. Farrar
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - McKenzie Ferguson
- Southern Illinois University Edwardsville, School of Pharmacy, Edwardsville, IL, United States
| | - Laura P. Forsythe
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC, United States
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Jennifer S. Gewandter
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Ian Gilron
- Departments of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Christine Goertz
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, United States
| | | | - Smriti Iyengar
- Division of Translational Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Isabel Jordan
- Departments of Psychology & Neuroscience and Pediatrics, Dalhousie University, and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Cornelia Kamp
- Center for Health and Technology/Clinical Materials Services Unit, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Bethea A. Kleykamp
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rachel L. Knowles
- Medical Research Council (part of UK Research and Innovation), London, United Kingdom
| | - Dale J. Langford
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, United States
| | - Sean Mackey
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical Center, Stanford, CA, United States
| | | | - John Markman
- Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Kathryn R. Martin
- Aberdeen Centre for Arthritis and Musculoskeletal Health, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Ewan McNicol
- Massachusetts College of Pharmacy and Health Sciences, Boston, MA, United States
| | - Kushang V. Patel
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
| | - Andrew S.C. Rice
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Michael Rowbotham
- Departments of Anesthesia and Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Friedhelm Sandbrink
- National Pain Management, Opioid Safety, and Prescription Drug Monitoring Program, Specialty Care Program Office, Veterans Health Administration, Washington, DC, United States
| | | | - Deborah J. Steiner
- Global Pain, Pain & Neurodegeneration, Eli Lilly and Company, Indianapolis, IN, United States
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience MCTN, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg, Germany
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Groothuijse JM, van Tol LS, Leeuwen CCMTHV, van Delden JJM, Caljouw MAA, Achterberg WP. Active involvement in scientific research of persons living with dementia and long-term care users: a systematic review of existing methods with a specific focus on good practices, facilitators and barriers of involvement. BMC Geriatr 2024; 24:324. [PMID: 38594644 PMCID: PMC11003093 DOI: 10.1186/s12877-024-04877-7] [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: 02/03/2023] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Active involvement of persons living with dementia (PLWD) and long-term care (LTC) users in research is essential but less developed compared to other patient groups. However, their involvement in research is not only important but also feasible. This study aims to provide an overview of methods, facilitators, and barriers for involving PLWD and LTC users in scientific research. METHODS A systematic literature search across 12 databases in December 2020 identified studies involving PLWD, LTC users, or their carers beyond research subjects and describing methods or models for involvement. Qualitative descriptions of involvement methods underwent a risk of bias assessment using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist 2018. A data collection sheet in Microsoft Excel and thematic analysis were used to synthesize the results. RESULTS The eighteen included studies delineated five core involvement methods spanning all research phases: advisory groups, formal and informal research team meetings, action groups, workshops, and co-conducting interviews. Additionally, two co-research models with PLWD and carers were found, while only two studies detailed LTC user involvement methods. Four distinct involvement roles were identified: consulting and advisory roles, co-analysts, co-researchers, and partners. The review also addressed barriers, facilitators, and good practices in the preparation, execution, and translation phases of research, emphasizing the importance of diversity, bias reduction, and resource allocation. Trust-building, clear roles, ongoing training, and inclusive support were highlighted. CONCLUSIONS Planning enough time for active involvement is important to ensure that researchers have time to build a trusting relationship and meet personal needs and preferences of PLWD, LTC users and carers. Researchers are advised not to presume the meaning of burden and to avoid a deficit perspective. A flexible or emergent design could aid involved persons' ownership of the research process. TRIAL REGISTRATION Prospero 2021: CRD42021253736.
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Affiliation(s)
- Janneke M Groothuijse
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisa S van Tol
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - C C M Toos Hoeksel-van Leeuwen
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands.
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands.
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, the Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
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12
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Postma L, Luchtenberg ML, Verhagen AAE, Maeckelberghe ELM. 'It's Powerful' The impact of involving children and young people in developing paediatric research agendas: A qualitative interview study. Health Expect 2024; 27:e14028. [PMID: 38613790 PMCID: PMC11015888 DOI: 10.1111/hex.14028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 04/15/2024] Open
Abstract
INTRODUCTION There is a growing consensus that children and young people (CYP) should be involved in matters that concern them. Progress is made in involving CYP in developing pediatric research agendas (PRAs), although the impact of their involvement remains unknown. We aimed to evaluate the impact of involving CYP in developing PRAs and assess the extent to which postpatient and public involvement (post-PPI) activities were planned. METHODS We conducted a qualitative study using in-depth interviews to identify and gain an in-depth understanding of the impact of involving CYP in developing PRAs. The transcripts were uploaded to Atlas.ti to be coded and organised. Dutch-language interviews were analysed and interpreted together with vocational education and training (VET) students. These students were aged between 14 and 18 years and were training to become nurses. RESULTS Three CYP and 15 researchers decided to participate. We focused on three categories of impact: agenda-setting impact, individual impact and academic impact. Involving CYP creates a more enriched and clarified agenda. It ensured that both CYP and researchers underwent personal or professional growth and development, it created a connection between the people involved, awareness about the importance of involving CYP and it ensured that the people involved had a positive experience. The participants were unable to indicate the academic impact of their PRAs, but they did understand the key factors for creating it. In addition, the need to measure impact was highlighted, with a particular focus on assessing individual impact. DISCUSSION Our study outlines the diverse subthemes of impact that arise from involving CYP in developing PRAs. Despite the potential of research agendas to amplify CYP voices, only a minority of researchers strategized post-PPI activities ensuring impactful outcomes, prompting the need for thorough evaluation of various impact forms and consistent alignment with the overarching goal of transforming the research field. PATIENT OR PUBLIC CONTRIBUTION We involved VET students in the data analysis and interpretation phase by forming a young person advisory group. The data analysis of the interviews analysed by the VET students revealed four distinct themes: 1. Learnt new knowledge. 2. Learnt to collaborate. 3. Learnt to listen. 4. Assessment of the individual impact.
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Affiliation(s)
- Laura Postma
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Malou L. Luchtenberg
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - A. A. Eduard Verhagen
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Els L. M. Maeckelberghe
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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13
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Mensah-Gourmel J, Bourgain M, Kandalaft C, Chatelin A, Tissier O, Letellier G, Gorter JW, Brochard S, Pons C. Starting from the needs: what are the appropriate sources to co-create innovative solutions for persons with disabilities? Disabil Rehabil Assist Technol 2024; 19:623-632. [PMID: 36036377 DOI: 10.1080/17483107.2022.2114554] [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: 09/01/2021] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Technical solutions could facilitate activities and participation in individuals with disabilities. For the development of solutions, hackathons are a method of interdisciplinary collaboration. For hackathon, the definition of pain points that require solutions is crucial. We aimed to determine engineers' preferences and expectations regarding pain point qualities. METHODS We used a collaborative approach involving individuals with disability, families, and healthcare professionals to determine pain points for use by engineering students during a disability Hackathon. A pain point bank was built using 3 upstream sources: a survey (350 responses, 20 pain points selected), interviews (8 children, 13 pain points), and a multidisciplinary workshop based on design thinking methods (45 people, 32 pain points). A fourth source was 20 adults with disabilities present during the Hackathon. Engineering students rated pain point qualities from each source in a questionnaire that included closed questions relating to predefined criteria: achievability, specificity, relevance and attractiveness and open questions to collect non-predefined quality criteria. RESULTS Pain points from the workshop were most frequently used (48%); followed by on-site discussions with mentors (43%), the survey (38%), and interviews (31%). On-site discussions received the highest quality ratings followed by the workshop, survey, and interviews. Three quality criteria emerged from the responses to open questions: "representative", "empathy", and "real-need". CONCLUSIONS To be actionable by engineers, pain points must relate to real needs, be achievable, specific, relevant and attractive but also representative and arouse empathy. We devised a checklist of qualities along with a toolbox of methods to achieve each. Implications For RehabilitationThe first step of the development of technical solutions for children and individuals with disabilities is the identification of their needs and their adequate formulation to be submitted to technical solutions providers.Daily life needs of individuals with disability were gathered for an engineering hackathon and proposed as pain points to 400 engineering students.To facilitate the development of solutions by engineers, pain points must relate to real needs, be specific, relevant, achievable and attractive; be representative and arouse empathy; a toolbox of needs collection methods is proposed to achieve each of those qualities.Discussions with individuals with disability and health professionals should be provided.
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Affiliation(s)
- Johanne Mensah-Gourmel
- PMR Department, CHRU Brest, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Université Bretagne Occidentale, Brest, France
| | - Maxime Bourgain
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, Paris, France
- EPF Graduate School of Engineering, Cachan, France
| | | | | | | | - Guy Letellier
- Pediatric Rehabilitation Hospital, ESEAN-APF, Nantes, France
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Sylvain Brochard
- PMR Department, CHRU Brest, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Université Bretagne Occidentale, Brest, France
- Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
| | - Christelle Pons
- PMR Department, CHRU Brest, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Université Bretagne Occidentale, Brest, France
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada
- Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
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Mohamed AA, Shah V, Njeru JW, Wieland ML, Rutten LJF, Prokop LJ, Murad MH. Interventions to Increase Cancer Screening Adherence Among Somali Immigrants in the US and Europe: A Systematic Review. J Immigr Minor Health 2024; 26:385-394. [PMID: 37612453 DOI: 10.1007/s10903-023-01532-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
Cancer screening rates among immigrant and refugee populations in high income countries is significantly lower than native born populations. The objective of this study is to systematically review the effectiveness of interventions to improve screening adherence for breast, cervical and colorectal cancer among Somali immigrants. A literature search was conducted for the years 2000-2021 and eight studies met eligibility criteria. The following intervention components were found to increase adherence to cervical cancer screening: home HPV test, educational workshop for women and education for general practitioners. A patient navigator intervention was found to increase screening for breast cancer. Educational workshops motivated or increased knowledge regarding cancer screening for breast, cervical and colorectal cancer. However, most of the studies had limitations due to methodology with potential for introduction of bias. Therefore, future studies comparing effectiveness of specific intervention components to reduce disparities in cancer screening among Somali immigrants and refugees are encouraged.
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Affiliation(s)
- Ahmed A Mohamed
- Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
| | - Vishal Shah
- Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA
| | - Jane W Njeru
- Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA
| | - Mark L Wieland
- Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA
| | | | | | - M Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, USA
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Pomey MP, Le Roux E, Nadon N, Perron J, Barry A, Bémeur C, Poder TG, Duford F, Laviolette L, Tétrault-Lassonde J, Vialaron C, Escalona MJ, Normandin L, Huard G, Girardin C, Rose C, Malas K, Ouellet D, Vincent C. Telehealth-Delivered Program and Accompanying Patients to Enhance the Clinical Condition of Patients Throughout a Liver Transplant: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e54440. [PMID: 38517464 PMCID: PMC10998179 DOI: 10.2196/54440] [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: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Liver transplantation (LT) is indicated in patients with severe acute or chronic liver failure for which no other therapy is available. With the increasing number of LTs in recent years, liver centers worldwide must manage their patients according to their clinical situation and the expected waiting time for transplantation. The LT clinic at the Centre hospitalier de l'Université de Montréal (CHUM) is developing a new health care model across the entire continuum of pre-, peri-, and posttransplant care that features patient monitoring by an interdisciplinary team, including an accompanying patient; a digital platform to host a clinical plan; a learning program; and data collection from connected objects. OBJECTIVE This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention's cost-effectiveness. METHODS Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study. RESULTS In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited. CONCLUSIONS The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54440.
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Affiliation(s)
- Marie-Pascale Pomey
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
| | - Enora Le Roux
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France
- AP-HP.Nord-Université Paris Cité, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nathalie Nadon
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Jessie Perron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Regroupement cardio-vasculaire, hépatologie et transplantation, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Angèle Barry
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Réseau transplantation et cliniques externes de transplantation et d'hépatologie, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Chantal Bémeur
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thomas G Poder
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada
| | - Fernand Duford
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Louise Laviolette
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Johanne Tétrault-Lassonde
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Cécile Vialaron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Manuel J Escalona
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Normandin
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Geneviève Huard
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Catherine Girardin
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Christopher Rose
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Denis Ouellet
- Direction de la biovigilance et de la biologie médicale, Ministère de la Santé et des Services sociaux du Québec, Montreal, QC, Canada
| | - Catherine Vincent
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
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Liougas MP, Sommerlad A, O'Rourke HM, McGilton KS, Bethell J. Social connection measures for older adults living in long-term care homes: a systematic review protocol. Syst Rev 2024; 13:67. [PMID: 38360642 PMCID: PMC10867987 DOI: 10.1186/s13643-024-02468-6] [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: 08/10/2022] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Various measures have assessed social connection in long-term care (LTC) home residents. However, they use inconsistent terminology, conceptualizations, and operationalizations of social connection. In this systematic review protocol, we propose a study that will characterize measures that assess aspects of LTC home residents' social connection using a unified conceptual model. The objectives are to (1) describe and analyze the measures and (2) evaluate their measurement properties. METHODS A literature search was conducted in MEDLINE ALL (Ovid), Embase Classic and Embase (Ovid), Emcare Nursing (Ovid), APA PsycInfo (Ovid), Scopus, CINAHL Complete (EBSCOhost), AgeLine (EBSCOhost), and Sociological Abstracts (ProQuest). We will include primary research papers with no language limit, published from database inception. We will include studies of a measure of any aspect of social connection in LTC home residents that report at least one measurement property. Independently, two reviewers will screen titles and abstracts, review full-text articles against eligibility criteria, and extract data from included studies. In objective 1, we will analyze identified tools using an adapted framework method. In objective 2, we will evaluate each measure's measurement properties using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. We will engage experts and stakeholders to assist with interpreting results and translating knowledge. DISCUSSION Our findings will inform the social connection in long-term care home residents (SONNET) study's development of a novel, person-centered measure for social connection in LTC home settings. We will present our findings in academic and non-academic forums, including conferences, peer-reviewed journals, and other publications. SYSTEMIC REVIEW REGISTRATION Prospero-"Systematic review of measures of social connection used in long-term care home research." CRD42022303526 .
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Affiliation(s)
- Madalena P Liougas
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON, Canada.
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Hannah M O'Rourke
- College of Health Sciences, Faculty of Nursing, University of Alberta, Alberta, Canada
| | - Katherine S McGilton
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Appelbaum RD, Newcomb A, Joseph K, Hennessy M, Fortin P, Bixby PJ, Prentiss S, McConnell-Hill A, Flayter R, Price MA, Dicker R, Kozar R, Haut ER, Stein DM. Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis. Trauma Surg Acute Care Open 2024; 9:e001274. [PMID: 38347894 PMCID: PMC10860118 DOI: 10.1136/tsaco-2023-001274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Introduction Engaging trauma survivors/caregivers results in research findings that are more relevant to patients' needs and priorities. Although their perspectives increase research significance, there is a lack of understanding about how best to incorporate their insights. We aimed to capture stakeholder perspectives to ensure research is meaningful, respectful, and relevant to the injured patient and their caregivers. Methods A multiphase, inductive exploratory qualitative study was performed, the first phase of which is described here. Virtual focus groups to elicit stakeholder perspectives and preferences were conducted across 19 trauma centers in the USA during 2022. Discussion topics were chosen to identify patients' motivation to join research studies, preferences regarding consent, suggestions for increasing diversity and access, and feelings regarding outcomes, efficacy, and exception from informed consent. The focus groups were audio recorded, transcribed, coded, and analyzed to identify the range of perspectives expressed and any common themes that emerged. Results Ten 90-minute focus groups included patients/caregiver (n=21/1) and researchers (n=14). Data analysis identified common themes emerging across groups. The importance of trust and preexisting relationships with the clinical care team were the most common themes across all groups. Conclusion Our findings reveal common themes in preferences, motivations, and best practices to increase patient/caregiver participation in trauma research. The project's next phases are distribution of a vignette-based survey to establish broad stakeholder consensus; education and dissemination activities to share strategies that increase research engagement and relevance for patients; and the formation of a panel of patients to support future research endeavors. Level of evidence Level IV.
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Affiliation(s)
| | - Anna Newcomb
- Inova Fairfax Medical Center, Falls Church, Virginia, USA
| | | | | | - Princess Fortin
- Health Alliance for Violence Intervention, Boston, Massachusetts, USA
| | - Pam J Bixby
- National Trauma Institute, San Antonio, Texas, USA
| | - Sue Prentiss
- American Trauma Society, Falls Church, Virginia, USA
| | | | | | | | | | - Rosemary Kozar
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
| | | | - Deborah M Stein
- R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
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18
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Parry M, Owadally T, O’Hara A, Nickerson N, Hart D. Community- and Patient-Partner Engagement in Women's Cardiovascular Disease Research: A Rapid Review of the Evidence. CJC Open 2024; 6:485-502. [PMID: 38487065 PMCID: PMC10935688 DOI: 10.1016/j.cjco.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 03/17/2024] Open
Abstract
The primary objective of this rapid review is to describe community-partner and patient-partner engagement in women's cardiovascular disease (CVD) research. Secondary objectives are to: (i) describe the phase of the research in which community and patient partners were engaged; (ii) define the level of engagement at each research phase; and (iii) make recommendations for future engagement of community and/or patient partners in women's CVD research. Rapid review guidelines recommended by the Cochrane Rapid Reviews Methods Group and Tricco et al. were used to search 5 databases using medical subject headings (MeSH) and/or keywords. Participants included women (cis and trans) aged > 18 years who had ischemic heart disease, heart failure, or stroke. A risk of bias assessment was not undertaken. Findings are summarized and/or clustered as community-based participatory research, or patient-oriented and/or patient-partner research. Our search yielded 39,998 titles and abstracts. Of these, 35 were included in a final narrative synthesis, comprising data from 474 community and/or patient partners, including 417 (88%) women. Over 85% of community partners collaborated in the design and/or planning and implementation of women's CVD research; most originated in the US; only one originated in Canada. Most patient-oriented and patient-partner research originated in Canada. However, less than 50% of patient partners collaborated in any phase of research. Sex, gender, race, and ethnicity were rarely reported. Results suggest negligible community and inadequate patient-oriented and/or patient-partner engagement in women's CVD research in Canada. Improved CVD outcomes for women may be achieved with better community- and patient-partner collaboration across all phases of research, genders, race, and ethnicities.
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Affiliation(s)
- Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Tasneem Owadally
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Arland O’Hara
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Donna Hart
- Patient Partner, Milton, Ontario, Canada
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Denninger NE, Brefka S, Skudlik S, Leinert C, Mross T, Meyer G, Sulmann D, Dallmeier D, Denkinger M, Müller M. Development of a complex intervention to prevent delirium in older hospitalized patients by optimizing discharge and transfer processes and involving caregivers: A multi-method study. Int J Nurs Stud 2024; 150:104645. [PMID: 38091654 DOI: 10.1016/j.ijnurstu.2023.104645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Delirium is a common yet challenging condition in older hospitalized patients, associated with various adverse outcomes. Environmental factors, such as room changes, may contribute to the development or severity of delirium. Most previous research has focused on preventing and reducing this condition by addressing risk factors and facilitating reorientation during hospital stay. OBJECTIVE We aimed to systematically develop a complex intervention to prevent delirium in older hospitalized patients by optimizing discharge and transfer processes and involving caregivers during and after these procedures. The intervention combines stakeholder and expert opinions, evidence, and theory. This article provides guidance and inspiration to research groups in developing complex interventions according to the recommendations in the Medical Research Council framework for complex interventions. DESIGN AND METHODS A stepwise multi-method study was conducted. The preparation phase included analysis of the context and current practice via focus groups. Based on these results, an expert workshop was organized, followed by a Delphi survey. Finally, the intervention was modeled and a program theory was developed, including a logic model. RESULTS A complex intervention was developed in an iterative process, involving healthcare professionals, delirium experts, researchers, as well as caregiver and patient representatives. The key intervention component is an 8-point-program, which provides caregivers with recommendations for preventing delirium during the transition phase and in the post-discharge period. Information materials (flyers, handbook, videos, posters, defined "Dos and Don'ts", discharge checklist), training for healthcare professionals, and status analyses are used as implementation strategies. In addition, roles were established for gatekeepers to act as leaders, and champions to serve as knowledge multipliers and trainers for the multi-professional team in the hospitals. CONCLUSIONS This study serves as an example of how to develop a complex intervention. In an additional step, the intervention and implementation strategies will be investigated for feasibility and acceptability in a pilot study with an accompanying process evaluation. TWEETABLE ABSTRACT Delirium prevention can benefit from optimizing discharge and transfer processes and involving caregivers of older patients in these procedures. STUDY REGISTRATION DRKS00017828, German Register of Clinical Studies, date of registration 17.09.2019.
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Affiliation(s)
- Natascha-Elisabeth Denninger
- Rosenheim Technical University of Applied Sciences, Centre for Research, Development and Technology Transfer, Rosenheim, Germany; Martin Luther University Halle-Wittenberg, International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Halle (Saale), Germany; Heidelberg University, Medical Faculty Heidelberg, Department of Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg, Germany; University Hospital Heidelberg, Department of Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg, Germany.
| | - Simone Brefka
- Agaplesion Bethesda Hospital Ulm, Research Unit on Ageing, Ulm, Germany; Geriatric Centre Ulm at the Ulm University, Ulm, Germany; Ulm University Hospital, Institute for Geriatric Research at Agaplesion Bethesda Hospital Ulm, Ulm, Germany
| | - Stefanie Skudlik
- Rosenheim Technical University of Applied Sciences, Centre for Research, Development and Technology Transfer, Rosenheim, Germany
| | - Christoph Leinert
- Agaplesion Bethesda Hospital Ulm, Research Unit on Ageing, Ulm, Germany; Geriatric Centre Ulm at the Ulm University, Ulm, Germany; Ulm University Hospital, Institute for Geriatric Research at Agaplesion Bethesda Hospital Ulm, Ulm, Germany
| | - Thomas Mross
- Agaplesion Bethanien Hospital Heidelberg, Centre for Geriatric Medicine, University of Heidelberg, Heidelberg, Germany
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Halle (Saale), Germany
| | | | - Dhayana Dallmeier
- Agaplesion Bethesda Hospital Ulm, Research Unit on Ageing, Ulm, Germany; Geriatric Centre Ulm at the Ulm University, Ulm, Germany; Boston University School of Public Health, Department of Epidemiology, Boston, USA
| | - Michael Denkinger
- Agaplesion Bethesda Hospital Ulm, Research Unit on Ageing, Ulm, Germany; Geriatric Centre Ulm at the Ulm University, Ulm, Germany; Ulm University Hospital, Institute for Geriatric Research at Agaplesion Bethesda Hospital Ulm, Ulm, Germany
| | - Martin Müller
- Rosenheim Technical University of Applied Sciences, Centre for Research, Development and Technology Transfer, Rosenheim, Germany; Heidelberg University, Medical Faculty Heidelberg, Department of Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg, Germany; University Hospital Heidelberg, Department of Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg, Germany
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20
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Dews SA, Daley R, Bansal A, Preston J, Bohm N. The power of language: how to bridge the gap between healthcare research and patients - a scoping review. Curr Med Res Opin 2024; 40:279-291. [PMID: 38131338 DOI: 10.1080/03007995.2023.2295984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The value of patient involvement to the design, conduct, and outcomes of healthcare research is increasingly being recognized. Patient involvement also provides greater patient accessibility and contribution to research. However, the use of inaccessible and technical language when communicating with patients is a barrier to effective patient involvement. METHODS We analyzed peer-reviewed and gray literature on how language is used in communication between healthcare researchers and patients. We used this analysis to generate a set of recommendations for healthcare researchers about using more inclusive and accessible language when involving patients in research. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Review (PRISMA-ScR) checklist. RESULTS Four major themes about the use of language were developed from the literature analysis and were used to develop the set of recommendations. These recommendations include guidance on using standardized terminology and plain language when involving patients in healthcare research. They also discuss the implementation of co-development practices, patient support initiatives, and researcher training, as well as ways to improve emotional awareness and the need for greater equality, diversity, and inclusion. DISCUSSION AND CONCLUSION The use of inclusive, empathetic, and clear language can encourage patients to be involved in research and, once they are involved, make them feel like equal, empowered, and valued partners. Working toward developing processes and guidelines for the use of language that enables an equal partnership between researchers and patients is critical.
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Affiliation(s)
| | - Rachel Daley
- The Positivitree Charity, Wallasey, UK
- Parent and Carers Research Forum, National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Akhil Bansal
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Stanford Existential Risk Initiative, Stanford University, Stanford, CA, USA
| | - Jennifer Preston
- National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Natalie Bohm
- Pfizer Ltd, Tadworth, UK
- Department of Continuing Education, University of Oxford, Oxford, UK
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21
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Zhao N, Cuthel AM, Storms O, Zhang R, Yamarik RL, Hill J, Kaur R, Van Allen K, Flannery M, Chang A, Chung F, Randhawa S, Alvarez IC, Young-Brinn A, Kizzie-Gillett CL, Rosini D, Isaacs ED, Hopkins E, Chan GK, Booker-Vaughns J, Maguire M, Navarro M, Pidatala NR, Dunn P, Williams P, Galvin R, Batra R, Welsh S, Vaughan W, Bouillon-Minois JB, Grudzen CR. Advancing patient-centered research practices in a pragmatic patient-level randomized clinical trial: A thematic analysis of stakeholder engagement in Emergency Medicine Palliative Care Access (EMPallA). RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:10. [PMID: 38263088 PMCID: PMC10807180 DOI: 10.1186/s40900-023-00539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Involving patient and community stakeholders in clinical trials adds value by ensuring research prioritizes patient goals both in conduct of the study and application of the research. The use of stakeholder committees and their impact on the conduct of a multicenter clinical trial have been underreported clinically and academically. The aim of this study is to describe how Study Advisory Committee (SAC) recommendations were implemented throughout the Emergency Medicine Palliative Care Access (EMPallA) trial. EMPallA is a multi-center, pragmatic two-arm randomized controlled trial (RCT) comparing the effectiveness of nurse-led telephonic case management and specialty, outpatient palliative care of older adults with advanced illness. METHODS A SAC consisting of 18 individuals, including patients with palliative care experience, members of healthcare organizations, and payers was convened for the EMPallA trial. The SAC engaged in community-based participatory research and assisted in all aspects from study design to dissemination. The SAC met with the research team quarterly and annually from project inception to dissemination. Using meeting notes and recordings we completed a qualitative thematic analysis using an iterative process to develop themes and subthemes to summarize SAC recommendations throughout the project's duration. RESULTS The SAC convened 16 times between 2017 and 2020. Over the course of the project, the SAC provided 41 unique recommendations. Twenty-six of the 41 (63%) recommendations were adapted into formal Institutional Review Board (IRB) study modifications. Recommendations were coded into four major themes: Scientific, Pragmatic, Resource and Dissemination. A majority of the recommendations were related to either the Scientific (46%) or Pragmatic (29%) themes. Recommendations were not mutually exclusive across three study phases: Preparatory, execution and translational. A vast majority (94%) of the recommendations made were related to the execution phase. Major IRB study modifications were made based on their recommendations including data collection of novel dependent variables and expanding recruitment to Spanish-speaking patients. CONCLUSIONS Our study provides an example of successful integration of a SAC in the conduct of a pragmatic, multi-center RCT. Future trials should engage with SACs in all study phases to ensure trials are relevant, inclusive, patient-focused, and attentive to gaps between health care and patient and family needs. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03325985, 10/30/2017.
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Affiliation(s)
- Nicole Zhao
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Allison M Cuthel
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
| | - Owen Storms
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Raina Zhang
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | | | - Jacob Hill
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
- Department of Wellness and Preventive Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Regina Kaur
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Kaitlyn Van Allen
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Alex Chang
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Frank Chung
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Sumeet Randhawa
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Isabel Castro Alvarez
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Angela Young-Brinn
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Dawn Rosini
- University of Florida Shands Hospital, Gainesville, FL, USA
- The University of Florida College of Medicine, Gainesville, FL, USA
| | - Eric D Isaacs
- Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Martha Navarro
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | | | - Pluscedia Williams
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- The Lundquist Institute/Harbor-UCLA Medical Center, Torrence, CA, USA
| | | | - Romilla Batra
- Senior Care Action Network (SCAN) Health Plan, Long Beach, CA, USA
| | - Sally Welsh
- Hospice and Palliative Nurses Association, Carnegie, PA, USA
| | | | - Jean-Baptiste Bouillon-Minois
- Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
- Emergency Department, University Hospital of Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Corita R Grudzen
- Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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22
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Dahlin-Ivanoff S, Berge I, Barenfeld E, Haak M, Lood Q. Research collaboration with older people as a matter of scientific quality and ethics: a focus group study with researchers in ageing and health. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:6. [PMID: 38200610 PMCID: PMC10782619 DOI: 10.1186/s40900-024-00540-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Society is placing increasing demands on collaboration with actors outside the academia to be involved in the research process, and the responsibility for turning this into reality lies with the researchers. As research collaboration is a way to increase the societal relevance of research and since older people have the right to be actively involved in research that concerns them, this study is addressed to researchers who work with and for older people. The purpose of this article is to explore researchers' experiences of research collaboration with the heterogeneous group of older people, from healthy to frail. METHODS The focus group method was applied based on a qualitative approach that is based on a social constructivist research tradition. It differs from other qualitative methods, such as interviews, in that it encourages interaction between research participants and contributes to shedding light on a collective understanding of the world. A total of 14 researchers participated in four focus groups (three to five participants/group). RESULTS The results provided support for the overall theme: "Good scientific quality and ethics are balanced against the needs and abilities of older people". This means a balance between the researcher and the older people collaborating with them to receive the best possible scientific quality. This is highlighted in the core category "Positioning for research collaboration" with the subcategories "Involvement or not", "Traditional or innovative thinking" and "Selectivity or representativeness", and the core category "Research collaboration - an ethical issue of power" with the subcategories "Research collaboration a risk for freedom of research", "Research collaboration a risk of abuse of power" and "Discriminatory academic power structures create ethical issues". CONCLUSIONS Addressing the balancing act of collaborating with older people in research, the findings contribute with an understanding of the importance of researchers' awareness of social and academic structures to minimise the risk of epistemic injustices in research on ageing and health. We want to highlight the researchers' voice and clarify the role that researchers have in terms of the opportunities for older people to become part of the collective understanding of ageing and health and make their voices heard.
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Affiliation(s)
- Synneve Dahlin-Ivanoff
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
| | - Isak Berge
- Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emmelie Barenfeld
- Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | - Qarin Lood
- Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, Melbourne, Australia
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Gallée J, Tilton-Bolowsky VE, Stark BC. The Communication Success Screener: A Preliminary Investigation of Perceived Communicative Success Across Modalities, Environments, and Demands. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:149-169. [PMID: 37956866 PMCID: PMC11000814 DOI: 10.1044/2023_jslhr-23-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Behavioral intervention targeting speech, language, and communication concerns is an established therapeutic approach for patients with communication concerns across a range of acquired neurogenic disorders. The multidimensional factors that contribute to a person's self-identified communication challenges and strengths in their daily communication needs must be considered to provide functional and person-centered care. While assessments grounded in clinician observation or client self-report exist, there is a direct need for a screening tool that comprehensively evaluates the roles of modality (verbal, text, gesture) and environment (in-person, virtual) on self-reported success across communicative demands. In this study, we describe a preliminary approach to monitoring the progression of receptive and expressive communication skills in people with chronic poststroke aphasia in the context of communication practices of the 21st century, culminating in the development and exploratory implementation of a novel clinical instrument: the Communication Success Screener (COMSS). METHOD Thirty-three participants with aphasia due to stroke were recruited to complete and evaluate the COMSS via an online survey. Quantitative responses and open-ended participant feedback were collected to validate and propose adaptations to the COMSS. Group-level analyses and case presentations were used to highlight COMSS features and outcomes. RESULTS Participant responses to the COMSS questionnaire suggest that this screening tool creates differentiated communicative success profiles based on self-report. Participant feedback also indicated that the COMSS appropriately evaluates self-reported success across modalities of verbal, text, and gesture in the context of in-person and virtual environments. CONCLUSIONS The communication concerns experienced by people with aphasia are often heterogeneous and vary as a function of their daily activities of living, preferred language modalities, and environmental supports. We present preliminary feasibility analyses of the COMSS as a potential tool to support the monitoring of functional change by evaluating self-reported communicative success across form, modality, environment, and task demand. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24521044.
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Affiliation(s)
- Jeanne Gallée
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA
| | | | - Brielle C. Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington
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Conte KP, Laycock A, Bailie J, Walke E, Onnis LA, Feeney L, Langham E, Cunningham F, Matthews V, Bailie R. Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health. Health Res Policy Syst 2024; 22:3. [PMID: 38172892 PMCID: PMC10765661 DOI: 10.1186/s12961-023-01087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Despite that stakeholder participation in evidence synthesis could result in more useful outcomes, there are few examples of processes that actively involve them in synthesis work. Techniques are needed that engage diverse stakeholders as equal partners in knowledge co-production. The aims of this paper are to describe an innovative participatory process of synthesising a large body of academic research products and compare the findings of the participatory process against two traditional approaches to synthesis: a rapid review and a structured review. METHODS First, a rapid synthesis of all research outputs (n = 86) was conducted by researchers with in-depth knowledge of the collaboration's research. Second, a team of researchers and service providers conducted a structured synthesis of seventy-eight peer-reviewed articles and reports generated by the collaboration. Fifty-five publications were brought forward for further synthesis in part three, a facilitated participatory synthesis. Finally, we explored the value added by the participatory method by comparing findings generated across the three synthesis approaches. RESULTS Twelve researchers and 11 service providers/policy partners-8 self-identified as Aboriginal and/or Torres Strait Islander-participated in two facilitated workshops (totalling 4 h). Workshop activities engaged participants in reviewing publication summaries, identifying key findings, and evoked review, discussion and refinement. The process explicitly linked experiential knowledge to citations of academic research, clearly connecting the two knowledge types. In comparing the findings generated across all three methods we found mostly consistencies; the few discrepancies did not contradict but gave deeper insights into statements created by the other methods. The participatory synthesis generated the most, detailed, and unique findings, and contextual insights about the relevance of the key messages for practice. CONCLUSION The participatory synthesis engaged stakeholders with diverse backgrounds and skillsets in synthesising a large body of evidence in a relatively short time. The participatory approach produced findings comparable to traditional synthesis methods while extending knowledge and identifying lessons most relevant for the participants who, ultimately, are the end users of the research. This process will interest other large-scale research collaborations seeking to engage stakeholders in evidence synthesis.
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Affiliation(s)
- Kathleen P Conte
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia.
- Oregon Health Sciences University-Portland State University School of Public Health, Portland State University, Portland, USA.
| | - Alison Laycock
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
- School of Public Health, The University of Sydney, Camperdown, Australia
| | - Emma Walke
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Leigh-Ann Onnis
- College of Business, Law and Governance, James Cook University, Cairns, Australia
| | - Lynette Feeney
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Erika Langham
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Australia
| | - Frances Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Ross Bailie
- Sydney Medical School, The University of Sydney, Camperdown, Australia
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25
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Kiese-Himmel C. [Participation of Patients in the Development of Clinical Guidelines: A Selective Country Comparison in a Narrative Review]. DAS GESUNDHEITSWESEN 2023; 85:967-974. [PMID: 37327814 PMCID: PMC11248075 DOI: 10.1055/a-2057-0422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
AIM A clinical practice guideline aims to optimize patient care by recommending diagnostic or treatment pathways, based on the best available research and practical experience. Therefore, the needs and preferences of patients and their families should be incorporated. The aim of this study was to examine regulations and standards of patient involvement in guideline development, using a selective comparison of countries. METHOD Information was extracted from publicly available websites and guidelines development manuals for the United Kingdom (UK), the United States, Canada, and Australia. They were compared and discussed in a narrative review. RESULTS In the UK, at least two people from among patients or the public must be involved in all guideline development committees and during all stages of the development process. The US National Academy of Medicine recommends active participation in guideline development groups by patients with disease-specific experience and patient representatives from the public. The Canadian Task Force on Preventive Health Care wants patient preferences to be involved, especially in the development of final guideline recommendations and usability testing. In Australia, guidelines receive the approval or seal of approval of the National Health and Medical Research Council if at least one patient representative can be shown to have been a member of the committee and to have been involved in the entire process of guideline development. CONCLUSION The selective country comparison shows that patient involvement in guideline development and the binding nature of the rules vary considerably, and that there are no uniform standards for involvement. Many issues of involvement are unresolved, and special sensitivity will be needed to bring together the life and experiences of patients/laypersons and the medical system on an equal footing.
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Affiliation(s)
- Christiane Kiese-Himmel
- Medizinische Psychologie und Medizinische Soziologie; Phoniatrisch/Pädaudiologische Psychologie, Georg-August-Universität Göttingen, Universitätsmedizin Göttingen, Germany
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Adus S, Macklin J, Pinto A. Exploring patient perspectives on how they can and should be engaged in the development of artificial intelligence (AI) applications in health care. BMC Health Serv Res 2023; 23:1163. [PMID: 37884940 PMCID: PMC10605984 DOI: 10.1186/s12913-023-10098-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is a rapidly evolving field which will have implications on both individual patient care and the health care system. There are many benefits to the integration of AI into health care, such as predicting acute conditions and enhancing diagnostic capabilities. Despite these benefits potential harms include algorithmic bias, inadequate consent processes, and implications on the patient-provider relationship. One tool to address patients' needs and prevent the negative implications of AI is through patient engagement. As it currently stands, patients have infrequently been involved in AI application development for patient care delivery. Furthermore, we are unaware of any frameworks or recommendations specifically addressing patient engagement within the field of AI in health care. METHODS We conducted four virtual focus groups with thirty patient participants to understand of how patients can and should be meaningfully engaged within the field of AI development in health care. Participants completed an educational module on the fundamentals of AI prior to participating in this study. Focus groups were analyzed using qualitative content analysis. RESULTS We found that participants in our study wanted to be engaged at the problem-identification stages using multiple methods such as surveys and interviews. Participants preferred that recruitment methodologies for patient engagement included both in-person and social media-based approaches with an emphasis on varying language modalities of recruitment to reflect diverse demographics. Patients prioritized the inclusion of underrepresented participant populations, longitudinal relationship building, accessibility, and interdisciplinary involvement of other stakeholders in AI development. We found that AI education is a critical step to enable meaningful patient engagement within this field. We have curated recommendations into a framework for the field to learn from and implement in future development. CONCLUSION Given the novelty and speed at which AI innovation is progressing in health care, patient engagement should be the gold standard for application development. Our proposed recommendations seek to enable patient-centered AI application development in health care. Future research must be conducted to evaluate the effectiveness of patient engagement in AI application development to ensure that both AI application development and patient engagement are done rigorously, efficiently, and meaningfully.
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Affiliation(s)
- Samira Adus
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Jillian Macklin
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada
| | - Andrew Pinto
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada
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Roudini J, Weschke S, Rackoll T, Dirnagl U, Guyatt G, Khankeh H. Systematic scoping review protocol of Stroke Patient and Stakeholder Engagement (SPSE). Syst Rev 2023; 12:180. [PMID: 37777777 PMCID: PMC10542246 DOI: 10.1186/s13643-023-02347-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023] Open
Abstract
This protocol describes a systematic scoping review of Stroke Patient and Stakeholder Engagement (SPSE), concepts, definitions, models, implementation strategies, indicators, or frameworks. The active engagement of patients and other stakeholders is increasingly acknowledged as essential to patient-centered research to answer questions of importance to patients and their caregivers. Stroke is a debilitating, long-lasting burden for individuals, their families, and healthcare professionals. They require rehabilitation services, health care system assistance, and social support. Their difficulties are unique and require the continued involvement of all parties involved. Understanding SPSE in research is fundamental to healthcare planning and extends the role of patients and stakeholders beyond that of the study subject. We will conduct a systematic literature search to identify the types of existing evidence related to SPSE, implementation strategies, indicators, or frameworks related to Patient and Stakeholder Engagement (PSE); clarify key concepts, definitions, and components of SPSE; compile experiences and prerequisites; and identify stroke research internationally. Two independent reviewers will extract data from selected studies onto a customized extraction form that has already been piloted. We integrate existing knowledge to address gaps in the literature on SPSE research by presenting the model, implementation strategies, indicators, and frameworks for stroke patients. We hope that these findings will offer future researchers a clear picture and conceptual model of SPSE.
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Affiliation(s)
- Juliet Roudini
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
| | - Sarah Weschke
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
| | - Torsten Rackoll
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
| | - Ulrich Dirnagl
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
- Department of Experimental Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Hamidreza Khankeh
- Department of Emergency and Disaster Health, University of Social Welfare and Rehabilitation Science, Tehran, Iran.
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
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Bondzi-Simpson A, Ribeiro T, Benipal H, Barabash V, Lofters A, Sutradhar R, Snyder RA, Clarke C, Coburn NG, Hallet J. Integration of the social determinants of health into quality indicators for colorectal cancer surgery: a scoping review protocol. BMJ Open 2023; 13:e075270. [PMID: 37751959 PMCID: PMC10533733 DOI: 10.1136/bmjopen-2023-075270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/22/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Quality monitoring is a critical component of high-performing cancer care systems. Quality indicators (QIs) are standardised, evidence-based measures of healthcare quality that allow healthcare systems to track performance, identify gaps in healthcare delivery and inform areas of priority for strategic planning. Social structures and economic systems that allow for unequal access to power and resources that shape health and health inequities can be described through the social determinants of health (SDoH) framework. Therefore, granular analysis of healthcare quality through SDoH frameworks is required to identify patient subgroups who may experience health inequity. Given the high burden of disease of colorectal cancer (CRC) and well-defined cancer care pathways, CRC is often the first disease site targeted by health systems for quality improvement. The objective of this review is to examine how SDoH have been integrated into QIs for CRC surgery. This review aims to address three primary questions: (1) Have SDoH been integrated into the development, reporting and assessment of CRC surgery QIs? (2) When integrated, what measures and statistical methods have been applied? (3) In which direction do individual SDoH influence QIs outputs? METHODS This review will follow Arksey and O'Malley frameworks for scoping reviews. We will search MEDLINE, EMBASE, HealthSTAR databases for papers that examine QIs for CRC surgery applicable to healthcare systems from database inception until January 2023. Interventional trials, prospective and retrospective observational studies, reviews, case series and qualitative study designs will be included. Two authors will independently review all titles, abstracts and full texts to determine which studies meet the inclusion criteria. ETHICS & DISSEMINATION No ethics approval is required for this review. Results will be disseminated through scientific presentation and relevant conferences targeted for researchers examining healthcare quality and equity in cancer care. REGISTRATION DETAILS osf.io/vfzd3-Open Science Framework.
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Affiliation(s)
- Adom Bondzi-Simpson
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Tiago Ribeiro
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Harsukh Benipal
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Victoria Barabash
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Rebecca A Snyder
- Departments of Surgical Oncology and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Callisia Clarke
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Natalie G Coburn
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Steinert Y, Nimmon L, Buckley H. When I Don't Say … 'Patients'. MEDICAL EDUCATION 2023; 57:792-794. [PMID: 37132341 DOI: 10.1111/medu.15107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
In the latest "When I Say…" paper, Steinert et al. outline the consequences of not saying "patients"
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Affiliation(s)
- Yvonne Steinert
- Institute of Health Sciences Education and Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Laura Nimmon
- Centre for Health Education Scholarship and Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Heather Buckley
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
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Charalambous M, Kountouri A, Schwyter JR, Annoni JM, Kambanaros M. The development of the People with Aphasia and Other Layperson Involvement (PAOLI) framework for guiding patient and public involvement (PPI) in aphasia research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:74. [PMID: 37658465 PMCID: PMC10474738 DOI: 10.1186/s40900-023-00484-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) in aphasia research requires researchers to include people with aphasia as research partners from the beginning of the study. Yet the quality of reporting on the level and type of involvement is poorly documented in the absence of a framework to guide PPI in aphasia research. This study aimed to extract the items and statements relevant for the development of the People with Aphasia and Other Layperson Involvement (PAOLI) framework for designing and implementing PPI in aphasia research, in collaboration with people with aphasia. METHOD The method recommended by the EQUATOR network was followed. This involved: (1) evidence from a scoping review, (2) a thematic analysis of the in-depth interviews, of people with stroke and aphasia, on the topics to be included in the pilot draft, (3) a two round Delphi survey for item/statement selection and (4) an experts' consensus meeting. The research team involved two PPI partners with chronic stroke-induced aphasia. The research process involved co-design and was informed by the Dialogue model. RESULTS Twenty-three panellists, from 13 countries, voted in round one with 87% (20/23) responding in round two. The final PAOLI framework includes the following 17 items (with 66 descriptive statements): establish collaborations, recruit patients, gain informed consent, organize induction meetings, train patient partners, create communication links, engage communication partners, conceptualize topics, establish research priorities, reach consensus, work with co-design methods, develop proposals, assist with dissemination of results, promote implementation of the outcomes, support patient partners and promote self-evaluation, monitor progress and assess impact of the patient involvement. These items were considered by the panellists as the most relevant for the involvement of people with aphasia as research partners. CONCLUSION The PAOLI is the first international consensus framework for guiding patient involvement in aphasia research. Researchers are encouraged to adopt the framework to improve the quality of their research by promoting the meaningful involvement of people with aphasia within the research team from the start.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, Department of Neurology, University of Fribourg, Chemin du Musée 8, 1700, Fribourg, Switzerland.
- The Brain and Neurorehabilitation Lab, Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str, 3036, Limassol, Cyprus.
| | | | - Jürg Rainer Schwyter
- Formerly Professor of English Linguistics, University of Lausanne, Lausanne, Switzerland
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, Department of Neurology, University of Fribourg, Chemin du Musée 8, 1700, Fribourg, Switzerland
| | - Maria Kambanaros
- The Brain and Neurorehabilitation Lab, Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str, 3036, Limassol, Cyprus
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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Dengsø KE, Lindholm ST, Herling SF, Pedersen M, Nørskov KH, Collet MO, Nielsen IH, Christiansen MG, Engedal MS, Moen HW, Piil K, Egerod I, Hørder M, Jarden M. Patient and public involvement in Nordic healthcare research: a scoping review of contemporary practice. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:72. [PMID: 37649111 PMCID: PMC10466765 DOI: 10.1186/s40900-023-00490-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Over the past decades, there has been a growing international interest in user involvement in healthcare research. However, evidence on the management and impact of patient and public involvement in Nordic healthcare research remains limited. OBJECTIVE The aim was to explore and delineate the current state, practice, and impact of patient and public involvement in healthcare research across different areas of healthcare and patient populations in the Nordic countries. METHODS We conducted a scoping review using nine scientific databases and gray literature from 1992-2023. Sources were categorized as empirical or non-empirical. We used the Guidance for Reporting Involvement of Patients and the Public Short Form 2 checklist for reporting of patient and public involvement in healthcare research and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. RESULTS A total of 56 publications were included, consisting of 39 empirical and 17 non-empirical sources. Gray literature varied among countries and institutions encompassing different types of documents. We found an increase in the number of publications on patient and public involvement in Nordic healthcare research. This was evidenced by the growing number of references and institutional initiatives intended at involving the public, indicating the increasing emphasis on patient and public involvement in Nordic healthcare research. The terminology used to describe patient and public involvement varied over time. However, there has been a gradual narrowing down of terms as the concept of PPI has become more integrated into research practices, particularly with the involvement of funding agencies. CONCLUSION The utilization of patient and public involvement in Nordic healthcare research has substantially increased, proliferated, and gained widespread acceptance across diverse healthcare domains. The variety of approaches challenged our scoping review in terms of systematic description and impact. Patient and public involvement was applied in one or more research stages using different methodologies and terms. International agreement on terms and definitions is needed for reliable interpretation of the use of patient and public involvement in Nordic healthcare research.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark.
| | - Sofie Tscherning Lindholm
- Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Suzanne Forsyth Herling
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Maja Pedersen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Marie Oxenbøll Collet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Iben Husted Nielsen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Mette Schaufuss Engedal
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Helga Wallin Moen
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ingrid Egerod
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Mogens Hørder
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
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Etchegary H, Linklater S, Duquette D, Wilkinson G, Francis V, Gionet E, Patey AM, Grimshaw JM. "I think there has to be a mutual respect for there to be value": Evaluating patient engagement in a national clinical trial on de-implementation of low value care. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:70. [PMID: 37633983 PMCID: PMC10463407 DOI: 10.1186/s40900-023-00483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The evaluation of patient engagement in research is understudied and under-reported, making it difficult to know what engagement strategies work best and when. We provide the results of an evaluation of patient engagement in a large Canadian research program focused on the de-implementation of low-value care. We aimed to evaluate the experience and impact of patient engagement in the study. METHODS An online cross-sectional survey was administered using Microsoft Forms to (1) researchers and study staff and (2) patient partners. The survey was developed following iterative reviews by the project's patient partnership council and evaluation committee. Survey content areas included opinions on patient engagement to date, including challenges to engagement and suggestions for improvement. Patient partners also evaluated the partnership council. Descriptive statistics including counts and percentages described Likert scale survey items, while open comments were analyzed using descriptive content analysis. RESULTS The survey response rate was 46% (17/37). There were positive attitudes about the value of patient engagement in this project. There was also a high degree of willingness to be involved with patient engagement in future projects, whether as a patient partner or as a researcher including patients on the research team. Most patient partners felt their contributions to the project were valued by researchers and study research staff. Open comments revealed that a co-design approach and full inclusion on the research team were integral to demonstrating the value of patient partner input. Areas for improvement included more frequent and ongoing communication among all team members, as well as earlier training about patient engagement, particularly addressing role expectations and role clarity. CONCLUSIONS Our data revealed that despite some challenges, team members recognized the value of patient engagement in research and agreed project decisions had been impacted by patient partner input. Ongoing communication was highlighted as an area for improvement, as well as earlier training and ongoing support for all team members, but particularly researchers and study staff. In response to evaluation data, the team has reinstated a quarterly newsletter and plans to use specific patient engagement planning templates across study sites for all project activities. These tools should help make expectations clear for all team members and contribute to a positive patient engagement experience. Findings can inform patient engagement planning and evaluation for other health research projects.
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Affiliation(s)
- Holly Etchegary
- Clinical Epidemiology Program, Faculty of Medicine, Patient Engagement Lead, NL SUPPORT, CIHR-SPOR, Craig L. Dobbin Centre for Genetics, Memorial University, 300 Price Phillip Parkway, Rm 4M210, St. John’s, NL A1B 3V6 Canada
| | - Stefanie Linklater
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - D.’Arcy Duquette
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Gloria Wilkinson
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Vanessa Francis
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Erin Gionet
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Andrea M. Patey
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Jeremy M. Grimshaw
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
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Sagnol G, Haesebaert J, Termoz A, Michel P, Schott AM, Potinet V, Pomey MP, Tazarourte K, Douplat M. Assessing patient partnership among emergency departments in France: a cross-sectional study. BMC Health Serv Res 2023; 23:897. [PMID: 37612727 PMCID: PMC10463322 DOI: 10.1186/s12913-023-09905-7] [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: 01/29/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES This study aims to describe the use of patient partnership, as defined by the Montreal Model, in emergency departments (EDs) in France and report the perception of patient partnership from both the practitioner and patient perspectives. METHODS This cross-sectional study was conducted between July 2020 and October 2020. First, a survey was sent to 146 heads of EDs in both teaching hospitals and non-teaching hospitals in France to assess the current practices in terms of patient partnership in service organization, research, and teaching. The perceived barriers and facilitators of the implementation of such an approach were also recorded. Then, semi-structured telephone interviews were carried out with patients involved in a service re-organization project. RESULTS A total of 48 answers (response rate 32.9%) to the survey were received; 33.3% of respondents involved patients in projects relating to service re-organization, 20.8% involved patients in teaching projects, and 4.2% in research projects. Overall, 60.4% of the respondents were willing to involve patients in re-organization or teaching projects. The main barriers mentioned for establishing patient partnership were difficulties regarding patient recruitment and lack of time. The main advantages mentioned were the improvement in patient/caregiver relationship and new ideas to improve healthcare. When interviewed, patients mentioned the desire to improve healthcare and the necessity to involve people with different profiles and backgrounds. A too important personal commitment was the most frequently raised barrier to their engagement. All the patients recognized their positive role, and more generally, the positive role of patient engagement in service re-organization. CONCLUSION Although this preliminary study indicates a rather positive perception of patient partnership among heads of EDs in France and partner patients, this approach is still not widely applied in practice.
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Affiliation(s)
- Geoffrey Sagnol
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Julie Haesebaert
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Anne Termoz
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
| | - Philipe Michel
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices civils de Lyon, Lyon, 69002 France
| | - Anne-Marie Schott
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Véronique Potinet
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Marie-Pascale Pomey
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC Canada
| | - Karim Tazarourte
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Edouard Herriot, 5 place d’Arsonval, Lyon, F-69003 France
| | - Marion Douplat
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- UMR 7268 ADéS, Aix-Marseille Université / EFS / CNRS, Espace éthique méditerranéen, Hôpital Adultes La Timone, 264 rue Saint Pierre, Marseille cedex 05, France
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Lavery BM, Nelson M, Firican D, Prestley N, Kumru R, Jabs F, O'Loughlin J, Brotto LA. #DebunkingDesire: Sexual Science, Social Media, and Strategy in the Pursuit of Knowledge Dissemination. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:1-17. [PMID: 37566559 DOI: 10.1080/0092623x.2023.2243923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Approximately 1 in 3 women experience low sexual desire. Despite this being a common concern, many women never seek professional help for their difficulties and will instead turn to online resources for information. We sought to address this need for digitally-accessible, evidence-based information on low sexual desire by creating a social media Knowledge Translation (KT) campaign called #DebunkingDesire. Our team led a 10 month social media campaign where our primary outcomes for the campaign were impressions, reach, and engagement. We generated over 300,000 social media impressions; appeared on 11 different podcasts that were listened to/downloaded 154,700 times; hosted and participated in eight online events; and attracted website users from 110 different countries. Over the course of the campaign we compiled lessons learned on what worked for disseminating our key messages and the importance of creating community for this population. These findings point to the utility of using social media as part of KT campaigns in sexual health, and to the importance of collaborating with patient partners and considering social media ads and podcasts to meet reach goals.
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Affiliation(s)
- Brynn M Lavery
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Melissa Nelson
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
| | | | - Nicole Prestley
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
| | - Rayka Kumru
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Faith Jabs
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Julia O'Loughlin
- Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
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Wigginton B, Reeves MM, DiSipio T. Exploring motivations for participating in research among Australian women with advanced gynaecological cancer: a qualitative study. Support Care Cancer 2023; 31:511. [PMID: 37552313 PMCID: PMC10409726 DOI: 10.1007/s00520-023-07979-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/29/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE With global moves to increase research among those living with advanced cancer and legitimise consumers as part of cancer research, this article aims to build an understanding of women's motivations and reasons for participating in gynaecological cancer research. As a secondary aim, we considered the role of qualitative methods in enabling active involvement of consumers in research. METHODS We applied thematic discursive analysis to 18 in-depth interviews with women diagnosed with advanced (stage III-IV) gynaecological cancer living in Australia. RESULTS We found that women viewed research as a vehicle for change in two directions: improving the lives of future generations and improving education and awareness. Underpinning these two framings of research, women spoke about their own role and reasons for participating in this interview study. Women's stories were painted against a backdrop of social and medical silences around gynaecological cancer. It was from such silence that women chose to speak up and position themselves as participating in service for knowledge production. CONCLUSION We learned that trust, reciprocity and relationships are central to women's decisions to participate in cancer research. Legitimising consumers in cancer research requires methods, methodologies and practices that pay careful attention to power, control and representation.
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Affiliation(s)
- B Wigginton
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia
| | - M M Reeves
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia
| | - T DiSipio
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia.
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Aas SN, Distefano MB, Pettersen I, Gravrok B, Nordvoll LY, Bjaastad JF, Grimsgaard S. Patient and public involvement in health research in Norway: a survey among researchers and patient organisations. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:48. [PMID: 37422661 PMCID: PMC10329785 DOI: 10.1186/s40900-023-00458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/20/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Patient and public involvement (PPI) in health research may improve both the relevance and quality of the research. There is however a lack of research investigating the experiences, attitudes and barriers towards PPI in clinical research in Norway. The Norwegian Clinical Research Infrastructure Network therefore conducted a survey among researchers and PPI contributors aiming to investigate experiences with PPI and identify current challenges for successful involvement. METHODS Two survey questionnaires were developed and distributed in October and November 2021. The survey targeting 1185 researchers was distributed from the research administrative system in the Regional Health Trusts. The survey targeting PPI contributors was distributed through Norwegian patient organisations, regional and national competence centers. RESULTS The response rate was 30% among researchers and was unobtainable from PPI contributors due to the survey distribution strategy. PPI was most frequently used in the planning and conduct of the studies, and less utilized in dissemination and implementation of results. Both researchers and user representatives were generally positive to PPI, and agreed that PPI might be more useful in clinical research than in underpinning research. Researchers and PPI contributors who reported that roles and expectations were clarified in advance, were more likely to experience a common understanding of roles and responsibilities in the research project. Both groups pointed to the importance of earmarked funding for PPI activities. There was a demand for a closer collaboration between researchers and patient organisations to develop accessible tools and effective models for PPI in health research. CONCLUSIONS Surveys among clinical researchers and PPI contributors indicate overall positive attitudes towards PPI in clinical research. However, more resources, such as budget, time, and accessible tools, are needed. Clarifying roles and expectations, and creating new PPI models under resource constraints can enhance its effectiveness. PPI is underutilized in disseminating and implementing research results, presenting an opportunity for improving healthcare outcomes.
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Affiliation(s)
- Sigve Nyvik Aas
- Clinical Research Unit, St. Olavs Hospital, Trondheim, Norway.
| | - Marita Borg Distefano
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Ingvild Pettersen
- Clinical Research Department, University Hospital of North Norway, Tromsø, Norway
| | - Berit Gravrok
- Clinical Research Department, University Hospital of North Norway, Tromsø, Norway
| | - Laila Yvonne Nordvoll
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | | | - Sameline Grimsgaard
- Clinical Research Department, University Hospital of North Norway, Tromsø, Norway
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Martin EG, Rasiah J, Claassen CS, Waywitka J, Merritt AM, Pringsheim TM, Shearer KA, Tsang VWL, Stevens KE, Sheehan-Klassen CE, Suddaby P, Orr SL. Engaging youth and parents in clinical pediatric research: A case-based example. Paediatr Child Health 2023; 28:235-240. [PMID: 37287482 PMCID: PMC10243992 DOI: 10.1093/pch/pxac111] [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: 12/09/2021] [Accepted: 10/24/2022] [Indexed: 04/02/2024] Open
Abstract
Background Youth and parent engagement is a key component of clinical research. There are many ways to actively and meaningfully engage youth and parents as integral members of research teams, for example, through ad-hoc committees, advisory councils, or as co-leads on projects. When youth and parents are actively and meaningfully engaged in research projects, they share knowledge from their lived experiences to improve the quality and relevance of research. Methods We describe a case-based example of engaging youth and parent research partners when co-designing a questionnaire to assess preferences for pediatric headache treatments, from both a researcher and youth/parent perspective. We also summarize best practices in patient and family engagement from the literature and pertinent guidelines to assist researchers with integrating patient and family engagement into their studies. Results As researchers, we felt that the integration of a youth and parent engagement plan into our study significantly altered and strengthened questionnaire content validity. We encountered challenges throughout the process and detailed these experiences to help educate others about challenge mitigation and best practices in youth and parent engagement. As youth and parent partners, we felt that engaging in the process of questionnaire development was an exciting and empowering opportunity, and that our feedback was valued and integrated. Conclusions By sharing our experience, we hope to catalyze thought and discussion around the importance of youth and parent engagement in pediatric research, with the goal of stimulating more appropriate, relevant, and high-quality pediatric research and clinical care in the future.
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Affiliation(s)
- Elise G Martin
- Alberta Children’s Hospital, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jananee Rasiah
- Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | - Tamara M Pringsheim
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Edmonton, Alberta, Canada
| | | | - Vivian W L Tsang
- KidsCan Young Person’s Research Advisory Group, Ottawa, Ontario, Canada
| | | | | | - Perle Suddaby
- KidsCan Young Person’s Research Advisory Group, Ottawa, Ontario, Canada
| | - Serena L Orr
- Alberta Children’s Hospital, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Colomer‐Lahiguera S, Steimer M, Ellis U, Eicher M, Tompson M, Corbière T, Haase KR. Patient and public involvement in cancer research: A scoping review. Cancer Med 2023; 12:15530-15543. [PMID: 37329180 PMCID: PMC10417078 DOI: 10.1002/cam4.6200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) in research emphasizes the importance of doing research with, rather than for people with lived health/illness experience(s). The purpose of this scoping review is to investigate the breadth and depth of scientific literature on PPI in cancer research and to identify how is PPI applied and reported in cancer research. METHODS We searched MEDLINE, Embase, CINAHL, and PsycInfo up to March 2022. All titles/abstracts and full-text results were screened by two reviewers. Data were analyzed and are presented in both narrative and tabular format. RESULTS We screened 22,009 titles/abstract, reviewed 375 full-text articles, of which 101 studies were included in this review. 66 papers applied PPI; 35 used co-design methodologies. PPI in cancer research in published research has increased steadily since 2015 and often includes those with a past diagnosis of cancer or relatives/informal caregivers. The most common applied methods were workshops or interviews. PPI was generally used at the level of consultation/advisor and occurred mainly in early stages of research. Costs related to PPI were mentioned in 25 papers and four papers described training provided for PPI. CONCLUSIONS Results of our review demonstrate the nature and extent of PPI expansion in cancer research. Researchers and research organizations entering the fray of PPI should consider planning and reporting elements such as the stage, level, and role type of PPI, as well as methods and strategies put in place to assure diversity. Furthermore, a thorough evaluation of whether all these elements meet the stated PPI purpose will help to grasp its impact on research outcomes. PATIENT OR PUBLIC CONTRIBUTION Two patients participated in the stakeholder consultation as part of the scoping review methodology, contributed to the discussion on refining the results, and critically reviewed the manuscript. Both are co-authors of this manuscript.
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Affiliation(s)
- Sara Colomer‐Lahiguera
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | - Matthieu Steimer
- Master of Advanced Studies in Public Health studentInstitute of Global Health, Geneva UniversityGenevaSwitzerland
| | - Ursula Ellis
- Woodward LibraryUniversity of British ColumbiaVancouverCanada
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | | | - Tourane Corbière
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
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Vinnicombe S, Bianchim MS, Noyes J. A review of reviews exploring patient and public involvement in population health research and development of tools containing best practice guidance. BMC Public Health 2023; 23:1271. [PMID: 37391764 PMCID: PMC10311710 DOI: 10.1186/s12889-023-15937-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/19/2023] [Indexed: 07/02/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) is increasingly seen as something that is integral to research and of importance to research funders. There is general recognition that PPI is the right thing to do for both moral and practical reasons. The aim of this review of reviews is to examine how PPI can be done 'properly' by looking at the evidence that exists from published reviews and assessing it against the UK Standards for Public Involvement in Research, as well as examining the specific features of population health research that can make PPI more challenging. METHODS A review of reviews and development of best practice guidance was carried out following the 5-stage Framework Synthesis method. RESULTS In total 31 reviews were included. There is a lack of current research or clarity around Governance and Impact when findings are mapped against UK Standards for Public Involvement in Research. It was also clear that there is little knowledge around PPI with under-represented groups. There are gaps in knowledge about how to ensure key specific attributes of population health research are addressed for PPI team members - particularly around how to deal with complexity and the data-driven nature of the research. Four tools were produced for researchers and PPI members to further improve their PPI activity within population health research and health research more generally, including a framework of recommended actions to address PPI in population health research, and guidance on integrating PPI based on the UK Standards for Public Involvement in Research. CONCLUSIONS Facilitating PPI in population health research is challenging due to the nature of this type of research and there is far less evidence on how to do PPI well in this context. The tools can help researchers identify key aspects of PPI that can be integrated when designing PPI within projects. Findings also highlight specific areas where more research or discussion is needed.
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Affiliation(s)
- Soo Vinnicombe
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Mayara S Bianchim
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK.
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Burgher T, Shepherd V, Nollett C. Effective approaches to public involvement in care home research: a systematic review and narrative synthesis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:38. [PMID: 37268986 PMCID: PMC10234794 DOI: 10.1186/s40900-023-00453-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/26/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Public involvement (often referred to as patient and public involvement or PPI) integrates the voices of the public in health and care research. However, groups such as care home residents are often excluded from involvement opportunities due to the complexities of involving people with additional care and communication needs. Despite a range of approaches being used, there is little understanding about how best to incorporate their experiences, and those of other care home stakeholders, into the design and conduct of research. OBJECTIVE A systematic review was conducted to identify PPI methods that better meet the specific needs of care home stakeholders. This was undertaken by (1) outlining effective PPI approaches used in care home research and the key stakeholders involved; (2) describing the role of PPI in different care home contexts and (3) identifying stakeholders' experiences and attitudes towards PPI in care homes. METHODS Databases CINAHL, Embase, MEDLINE, PsycINFO and Scopus were searched for English language papers from inception to November 2021. A narrative synthesis approach was utilised to organise the extracted data into five themes. RESULTS The search initially yielded 2314 articles (following de-duplication), with 27 meeting the inclusion criteria. Articles reported a range of input from stakeholders (including residents, staff, relatives and community stakeholders), with the impact of PPI varying according to the type of care establishment and research context. The experiences and reflections of stakeholders' about their involvement in care home research varied, with some studies offering first-hand accounts compared with summaries from researchers. Some articles explicitly evaluated the effectiveness of the PPI approach using specific outcome measures whilst others indirectly described the impact of their approach. Five themes were identified as characterising an effective PPI approach: (1) valuing stakeholders' perspectives, (2) awareness of the multi-faceted research context, (3) ensuring inclusivity and transparency, (4) maintaining flexibility and adaptability and (5) utilising resources and wider support. CONCLUSION Effective PPI in care home research requires researchers to create person-centred opportunities to adequately involve groups with physical and cognitive impairments. The findings led to the creation of evidence-based practical recommendations to support future involvement opportunities and help researchers develop strategies for inclusive opportunities for involvement. SYSTEMATIC REVIEW REGISTRATION The review was prospectively registered on PROPSERO (CRD42021293353).
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Affiliation(s)
| | - Victoria Shepherd
- Centre for Trials Research, Cardiff University, 4Th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Claire Nollett
- Centre for Trials Research, Cardiff University, 4Th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
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Cook DJ, Swinton M, Krewulak KD, Fiest K, Dionne J, Debigare S, Guyatt G, Taneja S, Alhazzani W, Burns KEA, Marshall JC, Muscedere J, Gouskos A, Finfer S, Deane AM, Myburgh J, Rochwerg B, Ball I, Mele T, Niven D, English S, Verhovsek M, Vanstone M. What counts as patient-important upper gastrointestinal bleeding in the ICU? A mixed-methods study protocol of patient and family perspectives. BMJ Open 2023; 13:e070966. [PMID: 37208143 DOI: 10.1136/bmjopen-2022-070966] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
INTRODUCTION Clinically important upper gastrointestinal bleeding is conventionally defined as bleeding accompanied by haemodynamic changes, requiring red blood cell transfusions or other invasive interventions. However, it is unclear if this clinical definition reflects patient values and preferences. This protocol describes a study to elicit views from patients and families regarding features, tests, and treatments for upper gastrointestinal bleeding that are important to them. METHODS AND ANALYSIS This is a sequential mixed-methods qualitative-dominant multi-centre study with an instrument-building aim. We developed orientation tools and educational materials in partnership with patients and family members, including a slide deck and executive summary. We will invite intensive care unit (ICU) survivors and family members of former ICU patients to participate. Following a virtual interactive presentation, participants will share their perspectives in an interview or focus group. Qualitative data will be analysed using inductive qualitative content analysis, wherein codes will be derived directly from the data rather than using preconceived categories. Concurrent data collection and analysis will occur. Quantitative data will include self-reported demographic characteristics. This study will synthesise the values and perspectives of patients and family members to create a new trial outcome for a randomised trial of stress ulcer prophylaxis. This study is planned for May 2022 to August 2023. The pilot work was completed in Spring 2021. ETHICS AND DISSEMINATION This study has ethics approval from McMaster University and the University of Calgary. Findings will be disseminated via manuscript and through incorporation as a secondary trial outcome on stress ulcer prophylaxis. TRIAL REGISTRATION NUMBER NCT05506150.
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Affiliation(s)
- Deborah J Cook
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Marilyn Swinton
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Karla D Krewulak
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kirsten Fiest
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Joanna Dionne
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sylvie Debigare
- Patient and Family Partnership Committee, Canadian Critical Care Trials Group, Montreal, Quebec, Canada
| | - Gordon Guyatt
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Shipra Taneja
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Waleed Alhazzani
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John C Marshall
- Surgery and Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John Muscedere
- Critical Care Medicine, Kingston Health Sciences Center, Queens University, Kingston, Ontario, Canada
| | - Audrey Gouskos
- Patient and Family Advisory Committee and Steering Committee Representative, Toronto, Ontario, Canada
| | - Simon Finfer
- Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Adam M Deane
- Critical Care, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - John Myburgh
- Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bram Rochwerg
- Medicine, McMaster University, Hamilton, Ontario, Canada
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ian Ball
- Medicine and Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Tina Mele
- Surgery and Critical Care Medicine, Western University, London, Ontario, Canada
| | - Daniel Niven
- Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Shane English
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Carlini J, Muir R, McLaren-Kennedy A, Grealish L. Researcher Perceptions of Involving Consumers in Health Research in Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105758. [PMID: 37239487 DOI: 10.3390/ijerph20105758] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
There is growing recognition internationally of the importance of involving consumers, patients, and the public in research. This is being driven by political mandates for policies, funding, and governance that demand genuine and meaningful engagement with consumers. There are many potential benefits to involving consumers in research, including an increased relevance to patient needs, improved quality and outcomes, and enhanced public confidence in research. However, the current literature highlights that efforts to incorporate their contributions are often tokenistic and there is a limited understanding of the psychological factors that can impact researcher attitudes, intentions, and behaviours when working with consumers in research. To address this gap, this study conducted 25 semi-structured interviews with health researchers in Australia using the qualitative case study method. The study aim was to explore the underlying influences on researcher behaviour when involving consumers in health research. The results identified several factors that influence researchers' behaviour, including better quality research, emotional connection and the humanisation of research, and a shift in research culture and expectations as major drivers. However, beliefs that consumers would hinder research and must be protected from risks, paternalism, and a lack of researcher skills and resources were identified as major barriers. This article presents a theory of planned behaviour for consumer involvement in the health research model. The model offers a valuable tool for policymakers and practitioners to understand the factors that influence researcher behaviours. It can also serve as a framework for future research in this area.
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Affiliation(s)
- Joan Carlini
- Department of Marketing, Griffith University, Nathan, QLD 4111, Australia
- Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia
| | - Rachel Muir
- Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia
- School of Nursing & Midwifery, Griffith University, Nathan, QLD 4111, Australia
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, QLD 4215, Australia
| | | | - Laurie Grealish
- Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia
- School of Nursing & Midwifery, Griffith University, Nathan, QLD 4111, Australia
- Nursing & Midwifery Education and Research, Gold Coast Health, Southport, QLD 4227, Australia
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Verret M, Fergusson DA, Nicholls SG, Graham M, Zivkovic F, Lê M, Geist A, Lam NH, Graham ID, Turgeon AF, McIsaac DI, Lalu MM. Engaging patients in anesthesiology research: a rewarding frontier. Can J Anaesth 2023; 70:817-823. [PMID: 36959493 PMCID: PMC10241667 DOI: 10.1007/s12630-023-02432-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 03/25/2023] Open
Affiliation(s)
- Michael Verret
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
- Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), CHU de Québec - Université Laval Research Center, Quebec City, QC, Canada.
- Department of Anesthesiology and Critical Care Medicine, Université Laval, Quebec City, QC, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Megan Graham
- Patient partner, The Ottawa Hospital, Ottawa, ON, Canada
| | - Fiona Zivkovic
- Patient partner, The Ottawa Hospital, Ottawa, ON, Canada
| | - Maxime Lê
- Patient partner, The Ottawa Hospital, Ottawa, ON, Canada
| | - Allison Geist
- Patient partner, The Ottawa Hospital, Ottawa, ON, Canada
| | - Nhat Hung Lam
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Alexis F Turgeon
- Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), CHU de Québec - Université Laval Research Center, Quebec City, QC, Canada
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec City, QC, Canada
| | - Daniel I McIsaac
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Manoj M Lalu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, ON, Canada
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Landlust AM, Koza SA, Carbin M, Walinga M, Robert S, Cooke J, Vyshka K. Parental perspectives on Phelan-McDermid syndrome: Results of a worldwide survey. Eur J Med Genet 2023; 66:104771. [PMID: 37120079 DOI: 10.1016/j.ejmg.2023.104771] [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: 02/02/2023] [Revised: 04/07/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023]
Abstract
Phelan-McDermid syndrome (PMS) is a rare neurodevelopmental disorder characterised by hypotonia, speech problems, intellectual disability and mental health issues like regression, autism and mood disorders. In the development, implementation and dissemination of a new clinical guideline for a rare genetic disorder like PMS, the parental experienced perspective is essential. As information from literature is scarce and often conflicting the European Phelan-McDermid syndrome guideline consortium created a multi-lingual survey for parents of individuals with PMS to collect their lived experiences with care needs, genotypes, somatic issues, mental health issues and parental stress. In total, we analysed 587 completed surveys from 35 countries worldwide. Based on parental reporting, PMS appeared to be caused by a deletion of chromosome 22q13.3 in 78% (379/486) of individuals and by a variant in the SHANK3 gene in 22% (107/486) of the individuals. Parents reported a wide variety of developmental, neurological, and other clinical issues in individuals with PMS. The most frequently experienced issues were related to speech and communication, learning disabilities/intellectual disability, and behaviour. While most reported issues were present across all age groups and genotypes, the prevalence of epilepsy, lymphoedema, and mental health issues do appear to vary with age. Developmental regression also appeared to begin earlier in this cohort than described in literature. Individuals with PMS due to a 22q13.3 deletion had a higher rate of kidney issues and lymphoedema compared to individuals with SHANK3 variants. Parental stress was high, with specific contributing factors being child and context related in accordance with the PMS phenotype. The survey results led to various validated recommendations in the European PMS guideline including an age specific surveillance scheme, specific genetic counselling, structured healthcare evaluations on sleep and communication and a focus on family well-being.
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Affiliation(s)
- Annemiek M Landlust
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, the Netherlands.
| | - Sylvia A Koza
- University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, the Netherlands
| | - Maya Carbin
- Phelan-McDermid Association, the Netherlands
| | - Margreet Walinga
- University of Groningen, University Medical Centre Groningen, Department of Genetics, Groningen, the Netherlands
| | - Sandra Robert
- (Swiss Representative of) Phelan-McDermid-Gesellschaft e.V. Geschäftsstelle Universitätsklinikum Ulm, Sekretariat Neurologie, Ulm, Germany
| | - Jennifer Cooke
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - Klea Vyshka
- ERN ITHACA Guideline Working Group, ERN ITHACA Project Management & Legal Office, Clinical Genetics Department, Robert Debré University Hospital, Paris, France
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Connelly D, Hay M, Garnett A, Hung L, Yous ML, Furlan-Craievich C, Snelgrove S, Babcock M, Ripley J, Snobelen N, Gao H, Zhuang R, Hamilton P, Sturdy-Smith C, O’Connell M. Video Conferencing With Residents and Families for Care Planning During COVID-19: Experiences in Canadian Long-Term Care. THE GERONTOLOGIST 2023; 63:478-489. [PMID: 36201219 PMCID: PMC9619647 DOI: 10.1093/geront/gnac154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Government-mandated health and safety restrictions to mitigate the effects of coronavirus disease 2019 (COVID-19) intensified challenges in caring for older adults in long-term care (LTC) without family/care partners. This article describes the experiences of a multidisciplinary research team in implementing an evidence-based intervention for family-centered, team-based, virtual care planning-PIECESTM approach-into clinical practice. We highlight challenges and considerations for implementation science to support care practices for older adults in LTC, their families, and the workforce. RESEARCH DESIGN AND METHODS A qualitative descriptive design was used. Data included meetings with LTC directors and Registered Practical Nurses (i.e., licensed nurse who graduated with a 2-year diploma program that allows them to provide basic nursing care); one-on-one interviews with family/care partners, residents, Registered Practical Nurses, and PIECES mentors; and reflections of the academic team. The Consolidated Framework for Implementation Research provided sensitizing constructs for deductive coding, while an inductive approach also allowed themes to emerge. RESULTS Findings highlighted how aspects related to planning, engagement, execution, reflection, and evaluation influenced the implementation process from the perspectives of stakeholders. Involving expert partners on the research team to bridge research and practice, developing relationships from a distance, empowering frontline champions, and adapting to challenging circumstances led to shared commitments for intervention success. DISCUSSION AND IMPLICATIONS Lessons learned include the significance of stakeholder involvement throughout all research activities, the importance of clarity around expectations of all team members, and the consequence of readiness for implementation with respect to circumstances (e.g., COVID-19) and capacity for change.
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Affiliation(s)
- Denise Connelly
- Address correspondence to: Denise Connelly, BScPT, MSc, PhD, School of Physical Therapy, The University of Western Ontario, Room 1000, Elborn College, London ON, N6A 3K7, Canada. E-mail:
| | - Melissa Hay
- School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada
| | - Anna Garnett
- Arthur Labatt Family School of Nursing, The University of Western Ontario, London, Ontario, Canada
| | - Lillian Hung
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Shannon Snelgrove
- APANS Health Service―Copper Terrace Long Term Care Home, Chatham, Ontario, Canada
| | | | - Jacqueline Ripley
- APANS Health Service―Copper Terrace Long Term Care Home, Chatham, Ontario, Canada
| | - Nancy Snobelen
- Registered Practical Nurses Association of Ontario (WeRPN), Toronto, Ontario, Canada
| | - Harrison Gao
- Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada
| | - Ruthie Zhuang
- Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada
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Lood Q, Hermansen Østby R, Hultqvist S, Edvardsson D, Dahlin-Ivanoff S. Uncovering hidden abilities for participation in research through photo-elicitation interviews: a view on participatory research with people living in residential care facilities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:9. [PMID: 36934278 PMCID: PMC10024515 DOI: 10.1186/s40900-023-00422-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Participatory research has been described to improve the relevance of research findings for the society in terms of quality of healthcare services and other public benefits. Nevertheless, there is limited guidance on how to conduct participatory research, and especially in relation to persons living in residential care facilities. To make the voices of this group heard, we therefore take a stance in the democratic approach to participatory research, and we have applied the theoretical framework Model of Human Occupation (MoHO) on participation to evaluate photo-elicitation interviews as a participatory research method with this group. METHODS A total of 13 persons living in two residential care facilities were involved in the study and asked to take photographs of their everyday life over one week. They were then invited to an individual interview to narrate the meaning of the photographs and to describe how they experienced the photo-elicitation method. The interviews were analysed in the six steps of theoretically driven reflexive thematic analysis. RESULTS The findings are described in the theme 'Uncovering hidden abilities for participation in research' that describes how photo elicitation interviews facilitated the older persons' participation in research. This is illustrated by four sub-themes: 'Bridging the ageing body', 'Altering habituation to everyday life', 'Empowering storytelling', and 'Negotiating the institutional culture'. CONCLUSIONS Our study findings support further application and evaluation of photo-elicitation interviews as a method for participatory research in residential care facilities. The major finding is how photo-elicitation interviews were used to reduce the impact of the institutional culture on the older persons' participation in research. The method is, however, not without limitations and we encourage researchers to study the dynamic relationship between physical, social, and cultural aspects of residential care facilities in relation to the use of photo-elicitation interviews with the persons living there.
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Affiliation(s)
- Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health –AgeCap, University of Gothenburg, Box 455, 40530 Gothenburg, Sweden
- School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, GS Building, Office 327, Bundoora, 3083 Australia
| | - Roar Hermansen Østby
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health –AgeCap, University of Gothenburg, Box 455, 40530 Gothenburg, Sweden
| | - Sara Hultqvist
- Faculty of Social Science, Department of Social Work, Linnaeus University, 351 95 Växjö, Sweden
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, Faculty of Health Sciences, La Trobe University, GS Building, Office 327, Bundoora, 3083 Australia
- Centre for Person‑Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Synneve Dahlin-Ivanoff
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, Vån 3 SU/Sahlgrenska, 413 45 Gothenburg, Sweden
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47
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Ribeiro T, Mahar A, Jerath A, Bondzi-Simpson A, Barabash V, Barr AA, Wright FC, Kosyachkova E, Deleemans J, Coburn NG, Hallet J. Novel patient-centred outcome in cancer care, days at home: a scoping review protocol. BMJ Open 2023; 13:e071201. [PMID: 36931670 PMCID: PMC10030791 DOI: 10.1136/bmjopen-2022-071201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION Patient-centred care is valued by patients and providers. As management of cancer becomes increasingly complex, the value of providing care that incorporates an individual's values and preferences along with demographic and tumour factors is increasingly important. To improve care, patients with cancer need easily accessible information on the outcomes important to them. The patient-centred outcome, days at home (DAH), is based on a construct that measures the time a patient spends alive and out of hospitals and healthcare institutions. DAH is accurately measured from various data sources and has shown construct validity with many patient-centred outcomes. There is significant heterogeneity in terms used and definitions for DAH in cancer care. This scoping review aims to consolidate information on the outcome DAH in cancer care and to review definitions and terms used to date to guide future use of DAH as a patient-centred care, research and policy tool. METHODS AND ANALYSIS This scoping review protocol has been designed with joint guidance from the JBI Manual for Evidence Synthesis and the expanded framework from Arksey and O'Malley. We will systematically search MEDLINE, Embase and Scopus for studies measuring DAH, or equivalent, in the context of active adult cancer care. Broad inclusion criteria have been developed, given the recent introduction of DAH into cancer literature. Editorials, opinion pieces, case reports, abstracts, dissertations, protocols, reviews, narrative studies and grey literature will be excluded. Two authors will independently perform full-text selection. Data will be extracted, charted and summarised both qualitatively and quantitively. ETHICS AND DISSEMINATION No ethics approval is required for this scoping review. Results will be disseminated through scientific publication and presentation at relevant conferences.
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Affiliation(s)
- Tiago Ribeiro
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Alyson Mahar
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Angela Jerath
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Adom Bondzi-Simpson
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Victoria Barabash
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Austin A Barr
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Frances C Wright
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada
| | | | - Julie Deleemans
- Department of Oncology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Natalie G Coburn
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada
| | - Julie Hallet
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, Ontario, Canada
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Schladen MM, Kuo HH, Tran T, Ofonedu A, Hoang H, Jett R, Gu M, Liu K, Mohammed K, Mohammed Y, Lum PS, Koumpouros Y. Evolution of a System to Monitor Infant Neuromotor Development in the Home: Lessons from COVID-19. Healthcare (Basel) 2023; 11:healthcare11060784. [PMID: 36981440 PMCID: PMC10048217 DOI: 10.3390/healthcare11060784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
In the nine months leading up to COVID-19, our biomedical engineering research group was in the very early stages of development and in-home testing of HUGS, the Hand Use and Grasp Sensor (HUGS) system. HUGS was conceived as a tool to allay parents' anxiety by empowering them to monitor their infants' neuromotor development at home. System focus was on the evolving patterns of hand grasp and general upper extremity movement, over time, in the naturalistic environment of the home, through analysis of data captured from force-sensor-embedded toys and 3D video as the baby played. By the end of March, 2020, as the COVID-19 pandemic accelerated and global lockdown ensued, home visits were no longer possible and HUGS system testing ground to an abrupt halt. In the spring of 2021, still under lockdown, we were able to resume recruitment and in-home testing with HUGS-2, a system whose key requirement was that it be contactless. Participating families managed the set up and use of HUGS-2, supported by a detailed library of video materials and virtual interaction with the HUGS team for training and troubleshooting over Zoom. Like the positive/negative poles of experience reported by new parents under the isolation mandated to combat the pandemic, HUGS research was both impeded and accelerated by having to rely solely on distance interactions to support parents, troubleshoot equipment, and securely transmit data. The objective of this current report is to chronicle the evolution of HUGS. We describe a system whose design and development straddle the pre- and post-pandemic worlds of family-centered health technology design. We identify and classify the clinical approaches to infant screening that predominated in the pre-COVID-19 milieu and describe how these procedural frameworks relate to the family-centered conceptualization of HUGS. We describe how working exclusively through the proxy of parents revealed the family's priorities and goals for child interaction and surfaced HUGS design shortcomings that were not evident in researcher-managed, in-home testing prior to the pandemic.
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Affiliation(s)
- Manon Maitland Schladen
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Hsin-Hung Kuo
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Tan Tran
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Achuna Ofonedu
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Hanh Hoang
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Robert Jett
- Department of Mechanical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Megan Gu
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Kimberly Liu
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Kai'lyn Mohammed
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Yas'lyn Mohammed
- Department of Biomedical Engineering, The Catholic University of America, Washington, DC 20064, USA
| | - Peter S Lum
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC 20064, USA
| | - Yiannis Koumpouros
- Department of Public and Community Health, University of West Attica, 12243 Aigaleo, Greece
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49
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Schuster ALR, Hampel H, Paskett ED, Bridges JFP. Rethinking Patient Engagement in Cancer Research. THE PATIENT 2023; 16:89-93. [PMID: 36301439 PMCID: PMC9911482 DOI: 10.1007/s40271-022-00604-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Anne L R Schuster
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Lincoln Tower, 1800 Cannon Drive, Columbus, OH, USA.
| | - Heather Hampel
- Division of Clinical Cancer Genomics, City of Hope National Medical Center, Duarte, CA, USA.,Division of Human Genetics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - John F P Bridges
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Lincoln Tower, 1800 Cannon Drive, Columbus, OH, USA
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50
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Patient Engagement in Health Research: Perspectives from Patient Participants. Curr Oncol 2023; 30:2770-2780. [PMID: 36975423 PMCID: PMC10047022 DOI: 10.3390/curroncol30030210] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/10/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Background and purpose: Over the past decade, patient engagement (PE) has emerged as an important way to help improve the relevance, quality, and impact of health research. However, there is limited consensus on how best to meaningfully engage patients in the research process. The goal of this article is to share our experiences and insights as members of a Patient Advisory Committee (PAC) on a large, multidisciplinary cancer research study that has spanned six years. We hope by sharing our reflections of the PAC experiences, we can highlight successes, challenges, and lessons learned to help guide PE in future health research. To the best of our knowledge, few publications describing PE experiences in health research teams have been written by patients, survivors, or family caregivers themselves. Methods: A qualitative approach was used to gather reflections from members of the Patient Advisory Committee regarding their experiences in participating in a research study over six years. Each member completed an online survey and engaged in a group discussion based on the emergent themes from the survey responses. Results: Our reflections about experiences as a PAC on a large, pan-Canadian research study include three overarching topics (1) what worked well; (2) areas for improvement; and (3) reflections on our overall contribution and impact. Overall, we found the experience positive and experienced personal satisfaction but there were areas where future improvements could be made. These areas include earlier engagement and training in the research process, more frequent communication between the patient committee and the research team, and on-going monitoring regarding the nature of the patient engagement. Conclusions: Engaging individuals who have experienced the types of events which are the focus of a research study can contribute to the overall relevance of the project. However, intentional efforts are necessary to ensure satisfactory involvement.
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