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Mitchell S, Turner N, Fryer K, Beng J, Ogden ME, Watson M, Gardiner C, Bayly J, Sleeman KE, Evans CJ. A framework for more equitable, diverse, and inclusive Patient and Public Involvement for palliative care research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:19. [PMID: 38331966 PMCID: PMC10851547 DOI: 10.1186/s40900-023-00525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/30/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND There are marked inequalities in palliative care provision. Research is needed to understand how such inequalities can be addressed, so that everyone living with advanced illness can receive the care they need, when they need it. Research into inequalities in palliative care should be guided by Patient and Public Involvement (PPI) that includes people from diverse backgrounds, who are less likely to receive specialist services. Multi-disciplinary research partnerships, bringing together primary care (the main providers of palliative care to diverse communities) and specialist palliative care, have the potential to work together in new ways to do research to address inequalities and improve palliative care in practice. This report describes a research partnership between primary care and palliative care that aimed to: (1) create opportunities for more inclusive PPI in palliative care research, (2) co-design new resources to support more equitable, diverse and inclusive PPI for palliative care, (3) propose a new framework for inclusive PPI in palliative care research. METHODS PPI members were recruited via primary care and palliative care research networks from three diverse areas of the UK. A pragmatic, collaborative approach was taken to achieve the partnership aims. Online workshops were carried out to understand barriers to inclusive PPI in palliative care and to co-design resources. Evaluation included a "you said, we did" impact log and a short survey. The approach was informed by good practice principles from previous PPI, and existing theory relating to equity, equality, diversity, and inclusion. RESULTS In total, 16 PPI members were recruited. Most were White British (n = 10), other ethnicities were Asian (n = 4), Black African (n = 1) and British mixed race (n = 1). The research team co-ordinated communication and activities, leading to honest conversations about barriers to inclusive PPI. Resources were co-designed, including a role description for an Equity, Equality, Diversity and Inclusion Champion, a "jargon buster", an animation and an online recipe book ( http://www.re-equipp.co.uk/ ) to inform future PPI. Learning from the partnership has been collated into a new framework to inform more inclusive PPI for future palliative care research. CONCLUSION Collaboration and reciprocal learning across a multi-disciplinary primary care and palliative care research partnership led to the development of new approaches and resources. Research team commitment, shared vision, adequate resource, careful planning, relationship building and evaluation should underpin approaches to increase equality, diversity and inclusivity in future PPI for palliative care research.
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Affiliation(s)
- Sarah Mitchell
- Division of Primary Care, Palliative Care and Public Health, Leeds Institute of Health Sciences, University of Leeds, Clarendon Road, Leeds, UK.
| | - Nicola Turner
- School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Kate Fryer
- Academic Unit of Primary Medical Care, University of Sheffield, Herries Road, Sheffield, UK
| | - Jude Beng
- Academic Unit of Primary Medical Care, University of Sheffield, Herries Road, Sheffield, UK
| | - Margaret E Ogden
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
| | - Melanie Watson
- Health Sciences School, University of Sheffield, 3a Clarkehouse Rd, Sheffield, UK
| | - Clare Gardiner
- Health Sciences School, University of Sheffield, 3a Clarkehouse Rd, Sheffield, UK
| | - Joanne Bayly
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
- St Barnabas Hospices, Worthing, UK
| | - Katherine E Sleeman
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
| | - Catherine J Evans
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
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Nielssen I, Santana M, Pokharel S, Strain K, Kiryanova V, Zelinsky S, Khawaja Z, Khanna P, Rychtera A, Ambasta A. Operationalizing the principles of patient engagement through a Patient Advisory Council: Lessons and recommendations. Health Expect 2024; 27:e13909. [PMID: 37942678 PMCID: PMC10726262 DOI: 10.1111/hex.13909] [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: 01/19/2023] [Revised: 10/13/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Inclusiveness, Support, Mutual Respect and Co-Build are the four pillars of patient engagement according to the Strategy for Patient-Oriented Research (SPOR). The aim of this manuscript is to describe the operationalization of these principles through the creation of a Patient Advisory Council (PAC) for the research study titled 'Re-Purposing the Ordering of Routine laboratory Tests (RePORT)'. METHODS Researchers collaborated with the Alberta SPOR SUPPORT Unit (AbSPORU) Patient Engagement Team to create a diverse PAC. Recruitment was intentional and included multiple perspectives and experiences. PAC meetings were held monthly, and patient research partners received support to function as co-chairs of the PAC. Patient research partners were offered training, support and tailored modalities of compensation to actively engage with the PAC. Regular member check-ins occurred through reflexivity and a formal evaluation of PAC member engagement. RESULTS The PAC included between 9 and 11 patient research partners, principal investigator, research study coordinator, improvement scientist, resident physician and support members from the AbSPORU team. Twelve monthly PAC meetings were held during the first phase of the project. The PAC made course-changing contributions to study design including study objectives, recruitment poster, interview guide and development of codes for thematic analysis. Patient research partners largely felt that their opinions were valued. Diversity in the PAC membership enhanced access to diverse patient participants. Furthermore, support for co-chairs and patient research partner members enabled active engagement in research. In addition, a culture of mutual respect facilitated patient partner engagement, and co-design approaches yielded rich research outputs. CONCLUSIONS Collaboration between research teams and Patient Engagement Teams can promote effective patient engagement through a PAC. Deliberate and flexible strategies are needed to manage the PAC to create an ecology of Inclusiveness, Support, Mutual Respect, and Co-Build for meaningful patient engagement. PATIENT OR PUBLIC CONTRIBUTION Patient research partners were involved in the decision to write this manuscript and collaborated equitably in the conception and development of this manuscript, including providing critical feedback. Patient research partners were active members of the PAC and informed the research project design, participant recruitment strategies, data collection and analysis, and will be involved in the implementation and dissemination of results. They are currently involved in the co-development of a patient engagement strategy using a Human-Centered Design process.
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Affiliation(s)
- Ingrid Nielssen
- Strategy for Patient Oriented Research (SPOR) Support UnitEdmontonAlbertaCanada
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Maria Santana
- Strategy for Patient Oriented Research (SPOR) Support UnitEdmontonAlbertaCanada
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Surakshya Pokharel
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
- Ward of the 21st Century, Calgary Zone of Alberta Health ServicesUniversity of CalgaryCalgaryCanada
| | - Kimberly Strain
- Strategy for Patient Oriented Research (SPOR) Support UnitEdmontonAlbertaCanada
| | - Veronika Kiryanova
- Strategy for Patient Oriented Research (SPOR) Support UnitEdmontonAlbertaCanada
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Sandra Zelinsky
- Strategy for Patient Oriented Research (SPOR) Support UnitEdmontonAlbertaCanada
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Zoha Khawaja
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
- Ward of the 21st Century, Calgary Zone of Alberta Health ServicesUniversity of CalgaryCalgaryCanada
| | - Prachi Khanna
- Department of Biology, Faculty of ScienceUniversity of British ColumbiaVancouverCanada
| | - Anni Rychtera
- Strategy for Patient Oriented Research (SPOR) Support UnitVancouverBritish ColumbiaCanada
| | - Anshula Ambasta
- Department of Anesthesia, Pharmacology and Therapeutics, Therapeutics InitiativeUniversity of British ColumbiaVancouverCanada
- Department of Medicine, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
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Tivey A, Huddar P, Shotton R, Cheese I, Daniels S, Lorigan P, J Lee R. Patient engagement in melanoma research: from bench to bedside. Future Oncol 2021; 17:3705-3716. [PMID: 34213356 DOI: 10.2217/fon-2020-1165] [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] [Indexed: 11/21/2022] Open
Abstract
Advances in research have transformed the management of melanoma in the past decade. In parallel, patient advocacy has gained traction, and funders are increasingly prioritizing patient and public involvement. Here we discuss the ways in which patients and the public can be engaged in different stages of the research process, from developing, prioritizing and refining the research question to preclinical studies and clinical trials, then finally to ongoing research in the clinic. We discuss the challenges and opportunities that exist at each stage in order to ensure that a representative population of patients and the public contribute to melanoma research both now and in the future.
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Affiliation(s)
- Ann Tivey
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
| | - Prerana Huddar
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
| | - Rohan Shotton
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
| | - Imogen Cheese
- Division of Cancer Sciences, The University of Manchester, Oxford Road, M13 9PL, UK
- Melanoma Patient Conference, Willow Bank, Prince Crescent, Staunton, Gloucestershire, GL19 3RF, UK
| | - Susanna Daniels
- Melanoma Patient Conference, Willow Bank, Prince Crescent, Staunton, Gloucestershire, GL19 3RF, UK
- Patient Author
| | - Paul Lorigan
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
| | - Rebecca J Lee
- The Christie NHS Foundation Trust, Wilmslow Road, M20 4BX, UK
- Melanoma Focus, Queen Anne House, Gonville Place, Cambridge, CB1 1ND, UK
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Melchior I, van der Heijden A, Stoffers E, Suntjens F, Moser A. Patient and public involvement cultures and the perceived impact in the vulnerable context of palliative care: A qualitative study. Health Expect 2021; 24:456-467. [PMID: 33405359 PMCID: PMC8077136 DOI: 10.1111/hex.13186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/27/2020] [Accepted: 12/05/2020] [Indexed: 12/05/2022] Open
Abstract
Background Cultural values are crucial to the practice and impact of patient and public involvement (PPI) in research. Objective To understand different PPI cultures among research teams and the impacts of PPI associated with each culture type. Design A participatory action research design. Setting and participants The setting was 10 palliative care research projects. Seventeen patients and members of the public and 31 researchers participated. Intervention A programme consisting of four components: (1) training and coaching of patients and the public to prepare them for participation in research, (2) tailored coaching of the 10 research teams over 12‐18 months, (3) a community of practice, and (4) a qualitative evaluation. Results We identified three cultures types: relationship cultures, task cultures, and control cultures. We identified four areas of impact: the project aim became more relevant to the target audience, methodological reliability increased, the research products were better able to reach the public, and the awareness increased, associated with behavioural changes, among researchers regarding PPI. Discussion A relationship culture appears to be long‐lasting due to impacting the behaviours of the researchers during future projects. Different cultural types require different types of patients and researcher participants, assigned to different tasks. Conclusions Further research remains necessary to investigate the support required by researchers to enable relationship‐ and task‐oriented PPI cultures. Patient or public contribution Patient advocates and representatives contributed to our research team throughout the entire research process, as well as within the 10 implementation projects.
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Affiliation(s)
- Inge Melchior
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands.,Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Maastricht University, Maastricht, the Netherlands
| | | | - Esther Stoffers
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands
| | - Frits Suntjens
- Zorgbelang Limburg (currently Burgerkracht Limburg), Sittard, the Netherlands
| | - Albine Moser
- Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Maastricht University, Maastricht, the Netherlands
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