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Bonus CG, Hatcher D, Northall T, Montayre J. Using a co-design methodological approach to optimize perioperative nursing care for older adult patients from ethnically diverse backgrounds: a study protocol. Int J Qual Stud Health Well-being 2024; 19:2349438. [PMID: 38709958 PMCID: PMC11075656 DOI: 10.1080/17482631.2024.2349438] [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: 10/24/2023] [Accepted: 04/26/2024] [Indexed: 05/08/2024] Open
Abstract
This article outlines the use of a co-design methodological approach aimed at optimizing perioperative care experiences for ethnically diverse older adults and their family carers. The research involved three phases. In Phase 1, the foundation was established with the formation of a Core Advisory Group comprising key informants, including health consumers. This initial phase focused on forming relationships and conducting a literature review to inform subsequent stages of the research. Phase 2 progressed to data collection, where a qualitative survey on perioperative experiences was conducted. Semi-structured interviews were held with patients, their family carers, and perioperative staff. Phase 3 advanced the co-design process through a workshop involving patients, family carers, perioperative staff, and key stakeholders. Workshop participants collaborated on potential practice changes, proposing strategies for future clinical implementation. While data analysis and reporting for Phases 2 and 3 are forthcoming, the continued involvement of the Core Advisory Group ensures ongoing consensus-building on health consumer needs. This methodology article adopts a prospective stance, with findings to be presented in subsequent scholarly works. Use of this methodology will help to determine how the use of a co-design approach may impact the development of culturally responsive perioperative nursing care for those from ethnically diverse communities.
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Affiliation(s)
- Charmaine G. Bonus
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Blacktown, NSW, Australia
| | - Deborah Hatcher
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Tiffany Northall
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR
- WHO Collaborating Centre for Community Health Services, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR
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McKay S, Meza JI. Culturally contextualized suicide prevention for international students: new opportunities for research and practice. Front Psychol 2024; 15:1418185. [PMID: 39165758 PMCID: PMC11333360 DOI: 10.3389/fpsyg.2024.1418185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
The rising incidence of suicide-related thoughts and behaviors among international students presents a significant public health challenge and growing concern among college campuses. Current intervention strategies often rely on Western-centric and colonized approaches developed and tested with primarily Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. Exclusion and historical underrepresentation of ethnoracially minoritized groups in suicide prevention treatment trials create gaps in advancing our science because they often miss the cultural contextualization crucial for effective prevention and intervention in diverse groups from different countries of origin. To address the limitations of these Western-centric strategies, we explored existing prevention recommendations and approaches through the lens of an expanded version of the newly developed Protective Factors Framework, tailored for non-Western cultural perspectives. We propose significant opportunities for enhancing current practices and point to promising future directions. The primary areas for development include: (1) bolstering community empowerment and ownership, (2) refining mechanisms of change to encompass multicultural viewpoints, and (3) focusing on effective implementation and thorough evaluation for ongoing refinement. This methodology not only shows promise for enhancing international student suicide prevention but also offers insights for broader application in suicide prevention among other culturally diverse populations.
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Affiliation(s)
- Samuel McKay
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jocelyn I. Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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McKay S, Ng C, Kenny B, Armanto R, Lamblin M, Robinson J. Participatory Design in Suicide Prevention: A Qualitative Study of International Students' Experiences of Adapting the LivingWorks safeTALK Programme. Health Expect 2024; 27:e14164. [PMID: 39108064 PMCID: PMC11303664 DOI: 10.1111/hex.14164] [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: 03/25/2024] [Revised: 07/16/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group. METHODS This qualitative study investigated the experiences of international university students studying in Australia who participated in a co-consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co-consultation workshop completed semi-structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis. RESULTS The findings showed that participants found the co-consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language. CONCLUSIONS This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations. PATIENT OR PUBLIC CONTRIBUTION International students were involved in the co-consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.
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Affiliation(s)
- Samuel McKay
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental Health, The University of MelbourneParkvilleVictoriaAustralia
| | | | - Bridget Kenny
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental Health, The University of MelbourneParkvilleVictoriaAustralia
| | | | - Michelle Lamblin
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental Health, The University of MelbourneParkvilleVictoriaAustralia
| | - Jo Robinson
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental Health, The University of MelbourneParkvilleVictoriaAustralia
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McKeon G, Curtis J, Rostami R, Sroba M, Farello A, Morell R, Steel Z, Harris M, Silove D, Parmenter B, Matthews E, Jamaluddin J, Rosenbaum S. Co-designing a Physical Activity Service for Refugees and Asylum Seekers Using an Experience-Based Co-design Framework. J Immigr Minor Health 2024; 26:674-688. [PMID: 38605213 PMCID: PMC11289061 DOI: 10.1007/s10903-024-01587-5] [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] [Accepted: 02/17/2024] [Indexed: 04/13/2024]
Abstract
People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing.
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Affiliation(s)
- Grace McKeon
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
- School of Population Health, University of New South Wales, Sydney, Australia.
| | - Jackie Curtis
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
| | - Reza Rostami
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Monika Sroba
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | | | - Rachel Morell
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
| | - Zachary Steel
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- St. John of God Health Care North Richmond Hospital, North Richmond, NSW, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Derrick Silove
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Belinda Parmenter
- School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Evan Matthews
- Centre for Health Behaviour Research South East Technological University, Waterford, Ireland
| | | | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
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Elliott SA, Bialy L, Scott SD, Hartling L. Exploring methods for creating or adapting knowledge mobilization products for culturally and linguistically diverse audiences: a scoping review. Arch Public Health 2024; 82:111. [PMID: 39034399 PMCID: PMC11265177 DOI: 10.1186/s13690-024-01334-0] [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: 02/12/2024] [Accepted: 06/29/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. METHODS We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations ('surface' and/or 'deep' structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. RESULTS Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. CONCLUSION Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. REGISTRATION Protocol submitted to Open Science Framework on August 16, 2022 ( https://osf.io/9jcw4/ ).
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Liza Bialy
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Shannon D Scott
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Javadizadeh E, Oudshoorn A, Letts L, Barbic S, Shanoff C, Marshall CA. Participatory Research with Persons who Experience Mental Illness in Occupational Therapy: A Scoping Review. Can J Occup Ther 2024; 91:203-221. [PMID: 38240309 PMCID: PMC11088223 DOI: 10.1177/00084174231212760] [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] [Indexed: 05/12/2024]
Abstract
Background. Persons who experience mental illness also face stigma and discrimination that frequently lead to a loss of ability to exercise autonomy and agency in their lives. Purpose. The range and breadth of literature exploring participatory research with persons living with mental illness are unknown in occupational therapy and occupation science. We initiated this study to fill this gap in the existing occupational therapy and occupational science literature. Method. Using the method of Arksey and O'Malley, we have conducted a scoping review to identify the range and breadth of literature. A qualitative content analysis was performed. Findings. A total of 34 articles were included in the narrative synthesis. The content analysis led to three related themes from the included studies: (1) coming together; (2) unique potential of participatory research; and (3) challenges in conducting participatory research. Conclusions. This review highlights that participatory research is well suited to research conducted with persons living with mental illness to support meaningful engagement and minimize stigma throughout the research process. This review can guide future participatory research and practice in occupational therapy and occupational science with persons living with mental illness.
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Affiliation(s)
- Elham Javadizadeh
- Elham Javadizadeh, Health & Rehabilitation Sciences, Elborn College, University of Western Ontario, London, Ontario, Canada.
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Connor E, Blackford K, McCausland K, Lobo R, Crawford G. Searching for choice and control: Western Australian service provider experiences of health, housing and migration. Health Promot Int 2024; 39:daae066. [PMID: 38902981 DOI: 10.1093/heapro/daae066] [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: 06/22/2024] Open
Abstract
This research aimed to inform approaches to increase access to secure housing and improve mental health outcomes for migrants from culturally and linguistically diverse backgrounds (hereafter migrants) who are generally invisible in health and social policy and service provision in Western Australia. We used semi-structured, in-depth interviews (n = 11) and interpretative phenomenological analysis to explore service provider experiences and perspectives of issues impacting service provision and the needs of migrants in this context. Five superordinate themes reveal complex experiences for both service providers and the migrants with whom they work. Findings reflect tensions between contemporary notions of choice and control and a social service system that is difficult to navigate, reflects systemic racism and appears to rely heavily on the non-government sector. Insights have important and practical implications for health promotion policy, practice and research. Recommendations include improvements to housing access, provision, funding and policies; addressing service barriers via staff training and more accessible community resources; and co-design and community outreach approaches.
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Affiliation(s)
- Elizabeth Connor
- School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
| | - Krysten Blackford
- School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
| | - Kahlia McCausland
- School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
| | - Roanna Lobo
- School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
| | - Gemma Crawford
- School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Bentley 6102, Western AustraliaAustralia
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Martinez Escobedo I, Doherty K, Eccleston C. "Infographing" Dementia Prevention: A Co-Design Approach. HEALTH COMMUNICATION 2024:1-10. [PMID: 38726586 DOI: 10.1080/10410236.2024.2350257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Designing effective public health messages is challenging, particularly when communicating complex and relatively new health messages such as dementia risk prevention which are still largely unfamiliar to the public. The accessibility of these messages, especially for individuals who speak English as an additional language, remains uncertain in large scale educational interventions. A key strategy to enhance the communication of evidence-based information is to co-design infographics that optimize the accessibility and impact of visual health messages. This paper reports on the co-design process of infographing dementia prevention messages. Qualitative data were analyzed using reflective thematic analysis to generate three themes reflecting the message design preferences of participants: "all hands on deck," "charting the course," and "get on board." This work supports the crucial need to engage the target audience via co-design when creating visual messages as meaningful and accessible educational tools that will resonate with the intended audience. Doing so may help health communicators navigate the creation of visual messages across diverse health domains and populations.
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Affiliation(s)
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania
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Greene Barker T, O'Higgins A, Fonagy P, Gardner F. A systematic review and meta-analysis of the effectiveness of co-designed, in-person, mental health interventions for reducing anxiety and depression symptoms. J Affect Disord 2024; 350:955-973. [PMID: 38199405 DOI: 10.1016/j.jad.2023.12.080] [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: 07/21/2023] [Revised: 12/02/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Co-design is recommended in mental health fields and has been associated with improved intervention efficacy. Despite its growing popularity, syntheses of evidence on the effectiveness of co-designed interventions are scarce, and little is known about their impact on anxiety and depression. METHODS The purpose of this systematic review and meta-analysis was to consolidate evidence on the effectiveness of in-person, co-designed mental health interventions for reducing anxiety and depression symptoms. An exhaustive search was conducted across six electronic databases (PubMed, PsycINFO, Embase, CINAHL, CENTRAL, and ProQuest) and grey literature. Criteria for inclusion comprised studies utilizing randomized or quasi-randomized methods, implementing non-digital/in-person, co-designed interventions for mental health enhancement, and assessing anxiety and/or depression. Intervention impacts were evaluated using random-effects meta-analyses. RESULTS The review identified 20 studies, with only three using the term 'co-design'. Other terminologies included 'co-developed' (n = 2), 'co-produced' (n = 2), and 'CBPR' (n = 11). Seventeen studies exhibited moderate risk of bias, while three demonstrated high risk. Meta-analyses demonstrated a moderate non-significant effect size of 0.5 (95 % CI: -0.8, 1.08; p = 0.08) on depression outcomes, and a small non-significant effect size of 0.12 (95 % CI: -0.1, 0.33; p = 0.23) on anxiety outcomes. LIMITATIONS The majority of studies lacked sufficient statistical power to detect between-group differences. Following GRADE criteria, confidence in estimates was low. CONCLUSIONS Notwithstanding widespread enthusiasm for co-design, the current evidence base is inadequate to confirm the impact of in-person, co-designed mental health interventions on anxiety and depression. More full-scale evaluation trials of higher quality are urgently needed, along with uniform terminology and measurement.
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Affiliation(s)
- Tamsin Greene Barker
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Research Department of Clinical, Educational and Health Psychology, University College London, UK.
| | - Aoife O'Higgins
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Foundations What Works Centre for Children & Families, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Frances Gardner
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK
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D'Aprano A, Hunter SA, Fry R, Savaglio M, Carmody S, Boffa J, Cooke L, Dent A, Docksey A, Douglas J, Dunn A, Halfpenny N, Hewett M, Lipscomb A, Manahan E, Morton B, Mosse H, Ross D, Skouteris H. 'All Aboriginal and Torres Strait Islander children should have access to the ASQ-TRAK': Shared vision of an implementation support model for the ASQ-TRAK developmental screener. Health Promot J Austr 2024; 35:433-443. [PMID: 37431858 DOI: 10.1002/hpja.773] [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: 02/09/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
ISSUE ADDRESSED The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. METHODS The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. RESULTS Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision - all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. CONCLUSIONS This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care. SO WHAT?: Well-implemented developmental screening leads to more Aboriginal and Torres Strait Islander children receiving timely early childhood intervention services, improving developmental trajectories and optimising long-term health and wellbeing.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sue-Anne Hunter
- Sue-Anne Hunter Cultural Consultant, Melbourne, Victoria, Australia
| | - Rebecca Fry
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah Carmody
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Louise Cooke
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Abigail Dent
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Amanda Docksey
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Josie Douglas
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
- Central Land Council, Alice Springs, Northern Territory, Australia
| | - Adam Dunn
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
| | - Nick Halfpenny
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Meg Hewett
- Department of Education, Connected Beginnings Program, Darwin, Northern Territory, Australia
| | - Adrienne Lipscomb
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Esmai Manahan
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Belinda Morton
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Holly Mosse
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
- Uniting, University of Warwick, Melbourne, Victoria, Australia
| | - Dawn Ross
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, UK
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11
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Joyce DW, Kormilitzin A, Hamer-Hunt J, McKee KR, Tomasev N. Defining acceptable data collection and reuse standards for queer artificial intelligence research in mental health: protocol for the online PARQAIR-MH Delphi study. BMJ Open 2024; 14:e079105. [PMID: 38490661 PMCID: PMC10946350 DOI: 10.1136/bmjopen-2023-079105] [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: 09/08/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION For artificial intelligence (AI) to help improve mental healthcare, the design of data-driven technologies needs to be fair, safe, and inclusive. Participatory design can play a critical role in empowering marginalised communities to take an active role in constructing research agendas and outputs. Given the unmet needs of the LGBTQI+ (Lesbian, Gay, Bisexual, Transgender, Queer and Intersex) community in mental healthcare, there is a pressing need for participatory research to include a range of diverse queer perspectives on issues of data collection and use (in routine clinical care as well as for research) as well as AI design. Here we propose a protocol for a Delphi consensus process for the development of PARticipatory Queer AI Research for Mental Health (PARQAIR-MH) practices, aimed at informing digital health practices and policy. METHODS AND ANALYSIS The development of PARQAIR-MH is comprised of four stages. In stage 1, a review of recent literature and fact-finding consultation with stakeholder organisations will be conducted to define a terms-of-reference for stage 2, the Delphi process. Our Delphi process consists of three rounds, where the first two rounds will iterate and identify items to be included in the final Delphi survey for consensus ratings. Stage 3 consists of consensus meetings to review and aggregate the Delphi survey responses, leading to stage 4 where we will produce a reusable toolkit to facilitate participatory development of future bespoke LGBTQI+-adapted data collection, harmonisation, and use for data-driven AI applications specifically in mental healthcare settings. ETHICS AND DISSEMINATION PARQAIR-MH aims to deliver a toolkit that will help to ensure that the specific needs of LGBTQI+ communities are accounted for in mental health applications of data-driven technologies. The study is expected to run from June 2024 through January 2025, with the final outputs delivered in mid-2025. Participants in the Delphi process will be recruited by snowball and opportunistic sampling via professional networks and social media (but not by direct approach to healthcare service users, patients, specific clinical services, or via clinicians' caseloads). Participants will not be required to share personal narratives and experiences of healthcare or treatment for any condition. Before agreeing to participate, people will be given information about the issues considered to be in-scope for the Delphi (eg, developing best practices and methods for collecting and harmonising sensitive characteristics data; developing guidelines for data use/reuse) alongside specific risks of unintended harm from participating that can be reasonably anticipated. Outputs will be made available in open-access peer-reviewed publications, blogs, social media, and on a dedicated project website for future reuse.
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Affiliation(s)
- Dan W Joyce
- Department of Primary Care and Mental Health and the Civic Health Information Laboratory, University of Liverpool, Liverpool, UK
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Cascalheira CJ, Pugh TH, Hong C, Birkett M, Macapagal K, Holloway IW. Developing technology-based interventions for infectious diseases: ethical considerations for young sexual and gender minority people. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1303218. [PMID: 38169805 PMCID: PMC10759218 DOI: 10.3389/frph.2023.1303218] [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: 09/27/2023] [Accepted: 10/20/2023] [Indexed: 01/05/2024] Open
Abstract
Compared to their heterosexual and cisgender peers, young sexual and gender minority (YSGM) people are more likely to contract sexually transmitted infections (STIs; e.g., HIV) and to face adverse consequences of emerging infections, such as COVID-19 and mpox. To reduce these sexual health disparities, technology-based interventions (TBIs) for STIs and emerging infections among YSGM adolescents and young adults have been developed. In this Perspective, we discuss ethical issues, ethical principles, and recommendations in the development and implementation of TBIs to address STIs and emerging infections among YSGM. Our discussion covers: (1) confidentiality, privacy, and data security (e.g., if TBI use is revealed, YSGM are at increased risk of discrimination and family rejection); (2) empowerment and autonomy (e.g., designing TBIs that can still function if YSGM users opt-out of multiple features and data collection requests); (3) evidence-based and quality controlled (e.g., going above and beyond minimum FDA effectiveness standards to protect vulnerable YSGM people); (4) cultural sensitivity and tailoring (e.g., using YSGM-specific models of prevention and intervention); (5) balancing inclusivity vs. group specificity (e.g., honoring YSGM heterogeneity); (6) duty to care (e.g., providing avenues to contact affirming healthcare professionals); (7) equitable access (e.g., prioritizing YSGM people living in low-resource, high-stigma areas); and (8) digital temperance (e.g., being careful with gamification because YSGM experience substantial screen time compared to their peers). We conclude that a community-engaged, YSGM-centered approach to TBI development and implementation is paramount to ethically preventing and treating STIs and emerging infections with innovative technology.
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Affiliation(s)
- Cory J. Cascalheira
- Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Tyler H. Pugh
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Chenglin Hong
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Ian W. Holloway
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
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13
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Gallegos-Rejas VM, Kelly JT, Lucas K, Snoswell CL, Haydon HM, Pager S, Smith AC, Thomas EE. A cross-sectional study exploring equity of access to telehealth in culturally and linguistically diverse communities in a major health service. AUST HEALTH REV 2023; 47:721-728. [PMID: 37983641 DOI: 10.1071/ah23125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023]
Abstract
Objectives The utilisation of telehealth among culturally and linguistically diverse communities in Australia remains unexplored. We aimed to describe telehealth (telephone and videoconference) utilisation within a major health service and identify sociodemographic factors that may contribute to limited telehealth access. Methods A cross-sectional study was performed using service activity data from four metropolitan hospitals in Queensland, Australia. Outpatient department data (January to December 2021) were examined. These data included patients (N = 153 427) of all ages who had an outpatient appointment within 10 speciality services (i.e. Hepatology, Gastroenterology, Immunology and Psychology) that were the most frequent videoconference users. This study measured telehealth utilisation across the four tertiary hospitals and its association with sociodemographic factors. Descriptive statistics and regression analysis were used. Multivariate regression models were adjusted by sex, socioeconomic level and language use. Results Overall, 39% of appointments were delivered through telehealth, with 65% of all reported telehealth services involving a telephone consultation. People who required interpreter services were 66% less likely to use telehealth services (OR adjusted 0.33, 95% CI 0.31-0.36, P P Conclusion There is a gap in Australian telehealth service use for people with culturally diverse backgrounds and limited English proficiency. This study highlights a critical need to determine how people from culturally diverse backgrounds would like to engage with digital care options such as telehealth and the necessary support to enable this.
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Affiliation(s)
- Victor M Gallegos-Rejas
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
| | - Karen Lucas
- Digital Health and Informatics, Metro South Health, Brisbane, Qld, Australia
| | - Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
| | - Sue Pager
- Health Equity and Access Unit, Metro South Health, Brisbane, Qld, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia; and Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
| | - Emma E Thomas
- Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
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14
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Parsons CE, Purves KL, Davies MR, Mundy J, Bristow S, Eley TC, Breen G, Hirsch CR, Young KS. Seeking help for mental health during the COVID-19 pandemic: A longitudinal analysis of adults' experiences with digital technologies and services. PLOS DIGITAL HEALTH 2023; 2:e0000402. [PMID: 38055730 DOI: 10.1371/journal.pdig.0000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
The COVID-19 pandemic brought about dramatic changes in how patients access healthcare from its outset. Lockdown restrictions and remote working led to a proliferation of digital technologies and services, which also impacted mental health provisions. Against the backdrop of new and changing support services, along with an unprecedented emphasis on mental health, relatively little is known about how adults sought out and received support for their mental health during this period. With a sample of 27,574 adults assessed longitudinally online over 12 months of the pandemic in the UK, we analysed reports of help-seeking for mental health, as well as sources of treatment or support and the perceived helpfulness of treatments received. We observed that the proportions of participants who reported seeking help remained relatively consistent throughout the 12-month period (ranging from 12.6% to 17.0%). Online talking therapies were among the most frequently sought sources (15.3%), whereas online self-guided treatments were among the least frequently sought sources (5%). Telephone lines, both NHS and non-governmental, had marked treatment 'gaps'. These treatment gaps, where individuals sought treatment but did not receive it, were especially evident for men and older adults. Our findings underscore online talking therapies as being a widely-sought and helpful source of mental health support. This is important given the current global need for accessible treatment options.
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Affiliation(s)
- Christine E Parsons
- Department of Clinical Medicine, Interacting Minds Center, Aarhus University, Aarhus, Denmark
| | - Kirstin L Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Molly R Davies
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Shannon Bristow
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Colette R Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Katherine S Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
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15
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Hobbs T, Santana De Lima E, Bevington D, Preece C, Allen K, Barna P, Berry V, Booker T, Davies K, Davis G, Deighton J, Freeman L, Fuggle P, Goddard E, Greene Barker T, Harris J, Heather A, Jardiel MF, Joshi K, Keenan M, Kennedy L, Malhotra T, March A, Pilling S, Pitt M, Potter K, Rehill N, Shand J, Surtees R, Fonagy P. Kailo: a systemic approach to addressing the social determinants of young people's mental health and wellbeing at the local level. Wellcome Open Res 2023; 8:524. [PMID: 38798997 PMCID: PMC11126905 DOI: 10.12688/wellcomeopenres.20095.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 05/29/2024] Open
Abstract
The mental health and wellbeing of children and young people is deteriorating. It is increasingly recognised that mental health is a systemic issue, with a wide range of contributing and interacting factors. However, the vast majority of attention and resources are focused on the identification and treatment of mental health disorders, with relatively scant attention on the social determinants of mental health and wellbeing and investment in preventative approaches. Furthermore, there is little attention on how the social determinants manifest or may be influenced at the local level, impeding the design of contextually nuanced preventative approaches. This paper describes a major research and design initiative called Kailo that aims to support the design and implementation of local and contextually nuanced preventative strategies to improve children's and young people's mental health and wellbeing. The Kailo Framework involves structured engagement with a wide range of local partners and stakeholders - including young people, community partners, practitioners and local system leaders - to better understand local systemic influences and support programmes of youth-centred and evidence-informed co-design, prototyping and testing. It is hypothesised that integrating different sources of knowledge, experience, insight and evidence will result in better embedded, more sustainable and more impactful strategies that address the social determinants of young people's mental health and wellbeing at the local level.
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Affiliation(s)
- Tim Hobbs
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | | | | | - Cristina Preece
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | - Kate Allen
- University of Exeter, Exeter, England, EX4 4PY, UK
| | | | - Vashti Berry
- University of Exeter, Exeter, England, EX4 4PY, UK
| | - Thomas Booker
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
| | - Karuna Davies
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
| | - George Davis
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | | | - Leanne Freeman
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | | | - Ellen Goddard
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | - Tamsin Greene Barker
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
| | - Julie Harris
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | - Amy Heather
- University of Exeter, Exeter, England, EX4 4PY, UK
| | | | | | - Megan Keenan
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | - Laura Kennedy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
| | | | - Anna March
- University of Exeter, Exeter, England, EX4 4PY, UK
| | - Steve Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
| | - Martin Pitt
- University of Exeter, Exeter, England, EX4 4PY, UK
| | - Katie Potter
- Dartington Service Design Lab, Buckfastleigh, England, TQ11 0EE, UK
| | | | | | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, England, WC1E 6BT, UK
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16
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Walker SC, Baquero B, Bekemeier B, Parnes M, Arora K. Strategies for enacting health policy codesign: a scoping review and direction for research. Implement Sci 2023; 18:44. [PMID: 37735397 PMCID: PMC10512571 DOI: 10.1186/s13012-023-01295-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Strategies for supporting evidence-informed health policy are a recognized but understudied area of policy dissemination and implementation science. Codesign describes a set of strategies potentially well suited to address the complexity presented by policy formation and implementation. We examine the health policy literature describing the use of codesign in initiatives intended to combine diverse sources of knowledge and evidence in policymaking. METHODS The search included PubMed, MEDLINE, PsychInfo, CINAHL, Web of Science, and Google Scholar in November 2022 and included papers published between 1996 and 2022. Terms included codesign, health, policy, and system terminology. Title and abstracts were reviewed in duplicate and included if efforts informed policy or system-level decision-making. Extracted data followed scoping review guidelines for location, evaluation method, health focus, codesign definition, description, level of health system user input, sectors involved, and reported benefits and challenges. RESULTS From 550 titles, 23 citations describing 32 policy codesign studies were included from multiple continents (Australia/New Zealand, 32%; UK/Europe, 32%; South America, 14%; Africa, 9%; USA/Canada 23%). Document type was primarily case study (77%). The area of health focus was widely distributed. Policy type was more commonly little p policy (47%), followed by big p policy (25%), and service innovations that included policy-enabled funding (25%). Models and frameworks originated from formal design (e.g., human-centered or participatory design (44%), political science (38%), or health service research (16%). Reported outcomes included community mobilization (50%), policy feasibility (41%), improved multisector alignment (31%), and introduction of novel ideas and critical thinking (47%). Studies engaging policy users in full decision-making roles self-reported higher levels of community mobilization and community needs than other types of engagement. DISCUSSION Policy codesign is theoretically promising and is gaining interest among diverse health sectors for addressing the complexity of policy formation and implementation. The maturity of the science is just emerging. We observed trends in the association of codesign strategies and outcomes that suggests a research agenda in this area could provide practical insights for tailoring policy codesign to respond to local contextual factors including values, needs, and resources.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Box 356560, Seattle, USA.
| | - Barbara Baquero
- School of Public Health, University of Washington, 3980 15th Ave, Box 351621, Seattle, NE, USA
| | - Betty Bekemeier
- School of Nursing, University of Washington, Box 357263, Seattle, USA
| | - McKenna Parnes
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Box 356560, Seattle, USA
| | - Kashika Arora
- Seattle Children's Hospital, 6901 Sand Point Way NE, Seattle, WA, 98115, USA
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17
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Rachel Skinner S. Perceived facilitators and barriers to the uptake of the human papillomavirus (HPV) vaccine among adolescents of Arabic-speaking mothers in NSW, Australia: A qualitative study. Vaccine X 2023; 14:100335. [PMID: 37409191 PMCID: PMC10318426 DOI: 10.1016/j.jvacx.2023.100335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
Background Australia has a large immigrant population but there is little data regarding whether human papillomavirus (HPV) vaccination coverage in adolescents varies according to parents' cultural or ethnic background. This work aims to identify facilitators and barriers to HPV vaccination of adolescents as perceived by Arabic-speaking mothers in Western Sydney, South Western Sydney and Wollongong, NSW, Australia. Methods A purposive sampling approach was applied to recruit mothers of adolescents from Arabic speaking backgrounds who had at least one child eligible for the HPV school-based vaccination program. Face-to-face semi-structured well as online interviews were conducted in Arabic between April 2021 and July 2021. The interviews were audio-recorded, transcribed, and translated into English and examined using thematic analysis. Results Sixteen mothers of adolescents from Arabic backgrounds described facilitators and barriers to HPV vaccination. A) Facilitators of HPV vaccination included: knowledge of HPV disease, trust in the school vaccination program, opportunistic recommendations from healthcare workers, information from friends. B) Barriers to accessing HPV vaccination included communication gaps: breakdown in school-parent information flow, lack of access to the Arabic language version of the information sheet, mother - GP communication barriers, mother-child communication gap; and health system gaps: missed opportunities for vaccination. C) Mothers' suggestions to improve HPV vaccination acceptance: to involve religious and cultural leadership, encourage engagement with GPs, and provide school-based education for parents and students. Conclusion Parents could benefit from assistance with HPV vaccination decision making. Interventions via schools, health professionals and religious and cultural organisations could play important roles in HPV vaccination acceptance for Arabic speaking immigrant families and in introducing their adolescent children to this vaccine.
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Affiliation(s)
- Faeza Netfa
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Catherine King
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Harunor Rashid
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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Seale H, Harris-Roxas B, Mustafa K, McDermid P. Communication and engagement of community members from ethnic minorities during COVID-19: a scoping review. BMJ Open 2023; 13:e069552. [PMID: 37344110 DOI: 10.1136/bmjopen-2022-069552] [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: 06/23/2023] Open
Abstract
OBJECTIVES This review examined the factors influencing communication and engagement with ethnic and racial minority groups in Australia during the COVID-19 pandemic. It aimed to answer two main questions: (1) what communication problems people from these communities typically faced during the pandemic? and (2) what strategies and recommendations were suggested to enhance communication and engagement for ethnic and racial minorities during the current COVID-19 pandemic and any similar events in the future? DESIGN Scoping review. DATA SOURCES PubMed, EMBASE, Cochrane Library, PsychINFO and CINAHL. Grey literature was searched within organisations' websites and a Google search of key terms. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included original research, case studies, reports (including government and charity reports), systematic and scoping articles and literature reviews in English, published from January 2020 to August 2022. DATA EXTRACTION AND SYNTHESIS Two researchers independently assessed the literature for eligibility and extracted data from the included literature. The selected papers were analysed and summarised into themes relevant to the research questions. The final review included 38 studies combining published academic papers and grey literature. RESULTS Key themes relating to communication and engagement issues included a lack of trust in authority, a lack of access to information and ineffective communication channels and a lack of timely and culturally responsive materials. To reduce the issues, the papers spoke about the key role of community organisations to provide local support and community leaders as trusted spokespersons. Lastly, key recommendations to reduce inequity and strengthen future pandemic responses focused on the need for collaborations and consultations, increasing the number of bilingual workers and supporting community-led communication efforts. CONCLUSIONS The insights gained from the activities and experiences documented in this review during the COVID-19 pandemic should be incorporated into future decision-making and interventions to enhance communication and engagement strategies.
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Affiliation(s)
- Holly Seale
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kinza Mustafa
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Pippa McDermid
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Silvola S, Restelli U, Bonfanti M, Croce D. Co-Design as Enabling Factor for Patient-Centred Healthcare: A Bibliometric Literature Review. CLINICOECONOMICS AND OUTCOMES RESEARCH 2023; 15:333-347. [PMID: 37220481 PMCID: PMC10200122 DOI: 10.2147/ceor.s403243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/21/2023] [Indexed: 05/25/2023] Open
Abstract
Service design and in particular co-design are approaches able to align with the need of healthcare contexts of value-based and patient-centered processing through a participatory design of services. The purpose of this study is to identify the characteristics of co-design and its applicability to the reengineering of healthcare services, as well as to detect the peculiarities of the application of this approach in different geographical contexts. The methodology applied for the review, Systematic Literature Network Analysis (SLNA), combines qualitative and quantitative perspectives. In detail, the analysis applied the paper citation networks and the co-word network analysis to detect the main research trends over time and to identify the most relevant publications. The results of the analysis highlight the backbone of literature on the application of co-design in healthcare as well as the advantages and the critical factors of the approach. Three main literature streams emerged concerning the integration of the approach at meso and micro level, the implementation of co-design at mega and macro level, and the impacts on non-clinical related outcomes. Moreover, the findings underline differences in co-design in terms of impacts and success factors in developed countries and economies in transition or developing countries. The analysis shows the potentially added value of the application of a participatory approach to the design and redesign of healthcare services both at different levels of the healthcare organization and in the contexts of developed countries and economies in transition or developing countries. The evidence also highlights potentialities and critical success factors of the application of co-design in healthcare services redesign.
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Affiliation(s)
- Sofia Silvola
- LIUC - Università Cattaneo, Castellanza, VA, Italy
- Department of Public Health Medicine, School of Health System & Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Umberto Restelli
- LIUC - Università Cattaneo, Castellanza, VA, Italy
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Davide Croce
- LIUC - Università Cattaneo, Castellanza, VA, Italy
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20
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Brijnath B, Navarro Medel C, Antoniades J, Gilbert AS. Culturally Adapting Evidence on Dementia Prevention for Ethnically Diverse Communities: Lessons Learnt from co-design. Clin Gerontol 2023; 46:155-167. [PMID: 35894749 DOI: 10.1080/07317115.2022.2101968] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES 40% of dementia cases can be prevented by addressing 12 lifestyle factors. These risk factors have increased presence in ethnic minorities, yet dementia prevention messages have not reached these communities. This article investigates the experience of co-designing a dementia prevention animated film with 9 ethnic groups in Australia. METHODS Evidence-based recommendations were adapted through an iterative process involving workshops with a stakeholder advisory committee and nine focus groups with 104 participants from the Arabic-, Hindi-, Tamil-, Cantonese-, Mandarin-, Greek-, Italian-, Spanish-, and Vietnamese-speaking communities. Data were analyzed using the Normalization Process Theory. RESULTS Cultural adaptation involves consideration of the mode of delivery, imagery and tone of the resource being developed; ensuring cultural adequacy; anticipating the need of the end-users; and managing linguistic challenges associated with working across multiple languages. CONCLUSIONS Learnings from this co-design process offer valuable insights for researchers and program developers who work with ethnic minority groups. CLINICAL IMPLICATIONS • Adaptation across cultures and languages is a negotiation not a consensus building exercise• Linguistic adaptation requires consideration of the education levels, and linguistic and intergenerational preferences of community members• Co-designing across multiple languages and cultures risks "flattening out" key aspects of cultural specificity.
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Affiliation(s)
- Bianca Brijnath
- Division of Social Gerontology, National Ageing Research Institute
- School of Social Sciences, University of Western Australia
| | | | - Josefine Antoniades
- Division of Social Gerontology, National Ageing Research Institute
- School of Public Health and Preventive Medicine, Monash University
| | - Andrew S Gilbert
- Division of Social Gerontology, National Ageing Research Institute
- Department of Social Inquiry, La Trobe University
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21
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Whitehead L, Talevski J, Fatehi F, Beauchamp A. Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review. J Med Internet Res 2023; 25:e42719. [PMID: 36853742 PMCID: PMC10015358 DOI: 10.2196/42719] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/09/2022] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Health care systems have become increasingly more reliant on patients' ability to navigate the digital world. However, little research has been conducted on why some communities are less able or less likely to successfully engage with digital health technologies (DHTs), particularly among culturally and linguistically diverse (CaLD) populations. OBJECTIVE This systematic review aimed to determine the barriers to and facilitators of interacting with DHTs from the perspectives of CaLD population groups, including racial or ethnic minority groups, immigrants and refugees, and Indigenous or First Nations people. METHODS A systematic review and thematic synthesis of qualitative studies was conducted. Peer-reviewed literature published between January 2011 and June 2022 was searched across 3 electronic databases. Terms for digital health were combined with terms for cultural or linguistic diversity, ethnic minority groups, or Indigenous and First Nations people and terms related to barriers to accessing digital technologies. A qualitative thematic synthesis was conducted to identify descriptive and analytical themes of barriers to and facilitators of interacting with DHTs. Quality appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS Of the 1418 studies identified in the electronic search, a total of 34 (2.4%) were included in this review. Half of the included studies (17/34, 50%) were conducted in the United States. There was considerable variation in terms of the CaLD backgrounds of the participants. In total, 26% (9/34) of the studies focused on Indigenous or First Nations communities, 41% (14/34) were conducted among ethnic minority populations, 15% (5/34) of the studies were conducted among immigrants, and 18% (6/34) were conducted in refugee communities. Of the 34 studies, 21 (62%) described the development or evaluation of a digital health intervention, whereas 13 (38%) studies did not include an intervention but instead focused on elucidating participants' views and behaviors in relation to digital health. From the 34 studies analyzed, 18 descriptive themes were identified, each describing barriers to and facilitators of interacting with DHTs, which were grouped into 7 overarching analytical themes: using technology, design components, language, culture, health and medical, trustworthiness, and interaction with others. CONCLUSIONS This study identified several analytic and descriptive themes influencing access to and uptake of DHTs among CaLD populations, including Indigenous and First Nations groups. We found that cultural factors affected all identified themes to some degree and that cultural and linguistic perspectives should be considered in the design and delivery of DHTs, with this best served through the inclusion of the target communities at all stages of development. This may improve the potential of DHTs to be more acceptable, appropriate, and accessible to population groups currently at risk of not obtaining the full benefits of digital health.
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Affiliation(s)
- Lara Whitehead
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia
| | - Jason Talevski
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia.,Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Australian Institute for Musculoskeletal Science, The University of Melbourne and Western Health, Melbourne, Australia
| | - Farhad Fatehi
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Alison Beauchamp
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia
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22
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Lamahewa K, Griffin S, Seward N, Temmerman M, West J, de Melo M, Raby E, Alonso A, Burnside B, Chissale F, Gheerawo R, Chepchichir EL, Mandlate F, Mahangue D, Mohiddin A, Neagu E, Salisbury TT. Protocol for intervention development to improve adolescent perinatal mental health in Kenya and Mozambique: The INSPIRE project. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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23
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Schiffler T, Kapan A, Gansterer A, Pass T, Lehner L, Gil-Salmeron A, McDermott DT, Grabovac I. Characteristics and Effectiveness of Co-Designed Mental Health Interventions in Primary Care for People Experiencing Homelessness: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:892. [PMID: 36613214 PMCID: PMC9820061 DOI: 10.3390/ijerph20010892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
People experiencing homelessness (PEH) face a disproportionately high prevalence of adverse mental health outcomes compared with the non-homeless population and are known to utilize primary healthcare services less frequently while seeking help in emergency care facilities. Given that primary health services are more efficient and cost-saving, services with a focus on mental health that are co-designed with the participation of users can tackle this problem. Hence, we aimed to synthesize the current evidence of such interventions to assess and summarize the characteristics and effectiveness of co-designed primary mental healthcare services geared towards adult PEH. Out of a total of 10,428 identified records, four articles were found to be eligible to be included in this review. Our findings show that co-designed interventions positively impacted PEH's mental health and housing situation or reduced hospital and emergency department admissions and increased primary care utilization. Therefore, co-designed mental health interventions appear a promising way of providing PEH with continued access to primary mental healthcare. However, as co-designed mental health interventions for PEH can improve overall mental health, quality of life, housing, and acute service utilization, more research is needed.
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Affiliation(s)
- Tobias Schiffler
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Ali Kapan
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Alina Gansterer
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Thomas Pass
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Lisa Lehner
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
- Department of Science & Technology Studies, Cornell University, 303 Morrill Hall, Ithaca, NY 14853, USA
| | - Alejandro Gil-Salmeron
- International Foundation for Integrated Care, Wolfson College, Linton Rd., Oxford OX2 6UD, UK
| | - Daragh T. McDermott
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 4FQ, UK
| | - Igor Grabovac
- Center for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
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24
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Smith J, Rabba AS, Datta P, Dresens E, Wang R, Cong L, Dang N, Hall G, Heyworth M, Lawson W, Lee P, Lilley R, Ma E, Nguyen HTT, Nguyen KV, Nguyen P, Yeow CT, Pellicano E. 'It's really important to be collaborating': Experiences of participatory research for Chinese and Vietnamese parents of autistic children. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2023; 8:23969415231210482. [PMID: 38028582 PMCID: PMC10644728 DOI: 10.1177/23969415231210482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background and aims Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences - and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home-school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home-school partnerships study over time and (2) understand their experiences of being community partners on the home-school partnerships project. Methods Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home-school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home-school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results We found that parents' input fundamentally shaped the broader home-school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home-school partnership study - although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home-school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities.
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Affiliation(s)
- Jodie Smith
- Macquarie School of Education, Macquarie University, Sydney, Australia; School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Aspasia Stacey Rabba
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Faculty of Education, School of Educational Psychology and Counselling, Monash University, Melbourne, Australia
| | - Poulomee Datta
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Emma Dresens
- Positive Partnerships, Chatswood, NSW, Australia
| | - Rena Wang
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University,
Melbourne, Australia
| | - Lin Cong
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Ngoc Dang
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, Australia; Reframing Autism,
Sydney, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Curtin University, Curtin Autism Research Group, Perth WA
| | - Patricia Lee
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Positive Partnerships, Forestville, NSW, Australia
- Positive Partnerships, Chatswood, NSW, Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Emily Ma
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University,
Melbourne, Australia
| | - Hau T T Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Kim-Van Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Phuc Nguyen
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Chong Tze Yeow
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia; Department of Clinical, Educational and Health Psychology, University College London, London, UK
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25
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Nyongesa V, Kathono J, Mwaniga S, Yator O, Madeghe B, Kanana S, Amugune B, Anyango N, Nyamai D, Wambua GN, Chorpita B, Kohrt BA, Ahs JW, Idele P, Carvajal L, Kumar M. Cultural and contextual adaptation of mental health measures in Kenya: An adolescent-centered transcultural adaptation of measures study. PLoS One 2022; 17:e0277619. [PMID: 36520943 PMCID: PMC9754261 DOI: 10.1371/journal.pone.0277619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION There is paucity of culturally adapted tools for assessing depression and anxiety in children and adolescents in low-and middle-income countries. This hinders early detection, provision of appropriate and culturally acceptable interventions. In a partnership with the University of Nairobi, Nairobi County, Kenyatta National Hospital, and UNICEF, a rapid cultural adaptation of three adolescent mental health scales was done, i.e., Revised Children's Anxiety and Depression Scale, Patient Health Questionnaire-9 and additional scales in the UNICEF mental health module for adolescents. MATERIALS AND METHODS Using a qualitative approach, we explored adolescent participants' views on cultural acceptability, comprehensibility, relevance, and completeness of specific items in these tools through an adolescent-centered approach to understand their psychosocial needs, focusing on gender and age-differentiated nuances around expression of distress. Forty-two adolescents and 20 caregivers participated in the study carried out in two primary care centers where we conducted cognitive interviews and focused group discussions assessing mental health knowledge, literacy, access to services, community, and family-level stigma. RESULTS We reflect on process and findings of adaptations of the tools, including systematic identification of words adolescents did not understand in English and Kiswahili translations of these scales. Some translated words could not be understood and were not used in routine conversations. Response options were changed to increase comprehensibility; some statements were qualified by adding extra words to avoid ambiguity. Participants suggested alternative words that replaced difficult ones and arrived at culturally adapted tools. DISCUSSION Study noted difficult words, phrases, dynamics in understanding words translated from one language to another, and differences in comprehension in adolescents ages 10-19 years. There is a critical need to consider cultural adaptation of depression and anxiety tools for adolescents. CONCLUSION Results informed a set of culturally adapted scales. The process was community-driven and adhered to the principles of cultural adaptation for assessment tools.
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Affiliation(s)
| | - Joseph Kathono
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Nairobi Metropolitan Services, Nairobi, Kenya
| | - Shillah Mwaniga
- Nairobi Metropolitan Services, Nairobi, Kenya
- Vrije University, Amsterdam, Netherlands
| | - Obadia Yator
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Beatrice Madeghe
- Department of Food and Nutrition Sciences, University of Nairobi, Nairobi, Kenya
| | | | | | - Naomi Anyango
- Department of Mental Health, Ministry of Health, Kenya
| | | | - Grace Nduku Wambua
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bruce Chorpita
- University of California, Los Angeles, United States of America
| | - Brandon A. Kohrt
- Division of Global Mental Health, Department of Psychiatry and Behavioral Science, The George Washington University, Washington, District of Columbia, United States of America
| | - Jill W. Ahs
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Department of Health Care Sciences, Swedish Red Cross University College, Huddinge, Sweden
| | - Priscilla Idele
- UN Secretariat, New York, New York, United States of America
| | - Liliana Carvajal
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York, United States of America
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenyau
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26
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Talevski J, Kulnik ST, Jessup RL, Falls R, Cvetanovska N, Beauchamp A. Use of co-design methodology in the development of cardiovascular disease secondary prevention interventions: A scoping review. Health Expect 2022; 26:16-29. [PMID: 36366855 PMCID: PMC9854329 DOI: 10.1111/hex.13633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/29/2022] [Accepted: 10/02/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION There is growing evidence to support the use of co-design in developing interventions across many disciplines. This scoping review aims to examine how co-design methodology has been used in the development of cardiovascular disease (CVD) secondary prevention interventions within health and community settings. METHODS We searched four academic databases for studies that used the co-design approach to develop their intervention. Studies were included if consumers (adults with CVD) and key stakeholders (e.g. clinicians, service providers) were involved in the co-design process. The review focused on methodology rather than traditional study outcomes; therefore, co-design processes and activities were extracted and evaluated against a selected co-design framework. RESULTS Twenty-two studies were included in this review. Studies were implemented across various settings with consumers and stakeholder groups most frequently consisting of patients and healthcare professionals, respectively. Most studies specifically stated that they used a 'co-design' approach (n = 10); others used terms such as participatory action research (n = 3), user-centred design (n = 3) and community-based participatory research (n = 2). Although there was variability in terminology, co-design processes, and participants, all studies adhered to the key principles of consumer engagement. Predominant co-design activities included semistructured interviews, focus groups, co-design/development workshops and advisory group meetings. Intervention effectiveness was assessed in eight studies showing mixed results. CONCLUSIONS This review provides an overview of how the co-design approach has previously been used in the development of CVD secondary prevention interventions. These findings provide methodological considerations that can guide researchers and healthcare services when implementing co-design to develop feasible and acceptable interventions that can improve outcomes for CVD populations. PATIENT OR PUBLIC CONTRIBUTION No patients, service users, caregivers, people with lived experience or members of the public were involved in this scoping review. This review article was written by academics who have undertaken a significant amount of co-design work with consumers and stakeholders.
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Affiliation(s)
- Jason Talevski
- Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityGeelongVictoriaAustralia,School of Rural HealthMonash UniversityWarragulVictoriaAustralia,Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthSt AlbansVictoriaAustralia
| | - Stefan T. Kulnik
- Ludwig Boltzmann Institute for Digital Health and PreventionSalzburgAustria,Faculty of Health, Social Care and EducationKingston University and St George's University of LondonLondonUK
| | - Rebecca L. Jessup
- School of Rural HealthMonash UniversityWarragulVictoriaAustralia,Academic and Research Collaborative in HealthLa Trobe UniversityBundooraVictoriaAustralia,Allied Health Research, Northern HealthEppingVictoriaAustralia
| | - Roman Falls
- Western Centre for Health Research and Education, Sunshine HospitalSt AlbansVictoriaAustralia
| | - Natali Cvetanovska
- School of Rural HealthMonash UniversityWarragulVictoriaAustralia,Office of Research, Northern HealthEppingVictoriaAustralia
| | - Alison Beauchamp
- School of Rural HealthMonash UniversityWarragulVictoriaAustralia,Australian Institute for Musculoskeletal Science (AIMSS)The University of Melbourne and Western HealthSt AlbansVictoriaAustralia,Victorian Heart InstituteMonash UniversityClaytonVictoriaAustralia
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27
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Tang CY, Lavercombe M, Southcott AM, Taylor NF, Blackstock FC. Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4133-e4143. [PMID: 35352435 DOI: 10.1111/hsc.13807] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Little is known about the extent of cultural and linguistic diversity among people with chronic obstructive pulmonary disease (COPD) in Australia and if ethno-cultural factors influence engagement in pulmonary rehabilitation (PR). We conducted a prospective cohort study to evaluate the extent of cultural and linguistic diversity among people with COPD and identify variables that influence engagement in PR. Patients with COPD attending the respiratory outpatient clinic at a metropolitan health service completed a study-specific questionnaire with results descriptively analysed. Access issues of awareness, referrals, attendance and completion of PR were examined. A multiple regression analysis was conducted to identify variables that influenced engagement in PR. Ninety-seven participants were recruited, of whom 36 (37%) self-identified a culturally and linguistically diverse (CALD) community. While participants from CALD communities had less awareness of PR as compared with the English Australian group (χ2 (df) = 5.3 (1), p = 0.02), there were no significant between-group differences in number of observed referrals (p = 0.30), attendance (p = 0.50) and completions of PR (p = 0.90). Only 11 (11%) out of 97 participants completed PR. Age (p = 0.006) and being from a CALD community (p = 0.03) were independent factors impacting on the awareness of PR while English proficiency (p = 0.04) was an independent factor impacting on referrals to PR. While older age and being from a CALD community were associated with having less awareness in PR, referrals to, attendance and completion rates of PR were similar regardless of ethnicity.
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Affiliation(s)
- Clarice Y Tang
- Physiotherapy Department, Western Health, St Albans, Victoria, Australia
- Physiotherapy, School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Mark Lavercombe
- Department of Respiratory & Sleep Disorders Medicine, Western Health, St Albans, Victoria, Australia
- Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anne M Southcott
- Department of Respiratory & Sleep Disorders Medicine, Western Health, St Albans, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Felicity C Blackstock
- Physiotherapy, School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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28
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Tee S, Üzar-Özçetin YS, Trenoweth S. Achieving culturally competent mental health care: A mixed-methods study drawing on the perspectives of UK nursing students. Perspect Psychiatr Care 2022; 58:1267-1280. [PMID: 34378792 DOI: 10.1111/ppc.12926] [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: 01/31/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to examine the degree of cross-cultural competency among UK mental health student nurses, and the care delivery challenges arising from their internalized cultural assumptions. DESIGN AND METHODS This study adopted a mixed-methods design. Participants were final-year nursing students in the United Kingdom. FINDINGS The results revealed participants had a moderate level of cultural awareness and competency but highlighted many challenges to providing cross-cultural care arising from the meanings, enablers, and values they attributed to culturally competent mental health care. PRACTICE IMPLICATIONS As cultural competency is considered an essential characteristic of effective nursing care, greater attention should be paid to how student nurses assimilate cultural awareness to develop confidence in their day-to-day practice.
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Affiliation(s)
- Stephen Tee
- The Business School, Faculty of Health and Social Sciences, Bournemouth University, Dorset, UK
| | | | - Steve Trenoweth
- BU iWell Research Centre, Faculty of Health and Social Sciences, Bournemouth University, Dorset, UK
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29
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MacDermod C, Pettie MA, Carrino EA, Garcia SC, Padalecki S, Finch JE, Sanzari C, Kennedy HL, Pawar PS, Mcgough MM, Iwashita A, Takgbajouah M, Coan D, Szakasits L, Goode RW, Wu Y, Reyes‐Rodríguez ML, Vacuán EMTC, Kennedy MA, Cleland L, Jordan J, Maguire S, Guintivano JD, Giusti‐Rodríguez P, Baker JH, Thornton LM, Bulik CM. Recommendations to encourage participation of individuals from diverse backgrounds in psychiatric genetic studies. Am J Med Genet B Neuropsychiatr Genet 2022; 189:163-173. [PMID: 35785430 PMCID: PMC9542122 DOI: 10.1002/ajmg.b.32906] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/04/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022]
Abstract
We present innovative research practices in psychiatric genetic studies to ensure representation of individuals from diverse ancestry, sex assigned at birth, gender identity, age, body shape and size, and socioeconomic backgrounds. Due to histories of inappropriate and harmful practices against marginalized groups in both psychiatry and genetics, people of certain identities may be hesitant to participate in research studies. Yet their participation is essential to ensure diverse representation, as it is incorrect to assume that the same genetic and environmental factors influence the risk for various psychiatric disorders across all demographic groups. We present approaches developed as part of the Eating Disorders Genetics Initiative (EDGI), a study that required tailored approaches to recruit diverse populations across many countries. Considerations include research priorities and design, recruitment and study branding, transparency, and community investment and ownership. Ensuring representation in participants is costly and funders need to provide adequate support to achieve diversity in recruitment in prime awards, not just as supplemental afterthoughts. The need for diverse samples in genetic studies is critical to minimize the risk of perpetuating health disparities in psychiatry and other health research. Although the EDGI strategies were designed specifically to attract and enroll individuals with eating disorders, our approach is broadly applicable across psychiatry and other fields.
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Affiliation(s)
- Casey MacDermod
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Michaela A. Pettie
- Department of Pathology and Biomedical ScienceUniversity of OtagoChristchurchNew Zealand
| | - Emily A. Carrino
- Department of Psychology and NeuroscienceUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Susana Cruz Garcia
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyUniversity at Albany, State University of New YorkAlbanyNew YorkUSA
| | - Sophie Padalecki
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Elon UniversityElonNorth CarolinaUSA
| | - Jody E. Finch
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyGeorgia State UniversityAtlantaGeorgiaUSA
| | - Christina Sanzari
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyUniversity at Albany, State University of New YorkAlbanyNew YorkUSA
| | - Hannah L. Kennedy
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Pratiksha S. Pawar
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Dr. D. Y. Patil Biotechnology & Bioinformatics InstituteDr. D. Y. Patil VidyapeethPuneIndia
| | | | - Ava Iwashita
- Crystal Springs Uplands SchoolHillsboroughCaliforniaUSA
| | - Mary Takgbajouah
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychologyDePaul UniversityChicagoIllinoisUSA
| | - Danielle Coan
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Social WorkNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Lindsey Szakasits
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychiatryCampbell UniversityBules CreekNorth CarolinaUSA
| | - Rachel W. Goode
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Ya‐Ke Wu
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of NursingUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Eva María Trujillo Chi Vacuán
- Comenzar de Nuevo Eating Disorders Treatment and Research CenterMonterreyMexico,Department of PediatricsSchool of Medicine and Health Sciences Tec SaludMonterreyMexico
| | - Martin A. Kennedy
- Department of Pathology and Biomedical ScienceUniversity of OtagoChristchurchNew Zealand
| | - Lana Cleland
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Jennifer Jordan
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - Sarah Maguire
- Inside Out Institute for Eating DisordersSydneyAustralia,Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Jerry D. Guintivano
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Jessica H. Baker
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
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McCulloch K, Murray K, Cassidy E. Bridging Across the Digital Divide: Identifying the Extent to Which LGBTIQ+ Health Service Websites Engage Culturally and Linguistically Diverse (CALD) Users. JOURNAL OF HOMOSEXUALITY 2022:1-23. [PMID: 35452366 DOI: 10.1080/00918369.2022.2060057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
eHealth is promoted as a viable platform for health service provision, as it can deliver relevant information instantaneously and anonymously, whilst circumventing geographical and discriminatory barriers that can occur in face-to-face settings. Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities stand to benefit greatly from eHealth services, however, the way in which culturally and linguistically diverse (CALD) LGBTIQ+ users are included within eHealth service provision is currently unknown. The current study observed the way in which Australian LGBTIQ+ health service websites are inclusive of CALD users. Quantitative content analysis was performed on 19 Australian LGBTIQ+ health service websites, with a focus on translation of services and materials, English and digital literacy, and CALD specific resources. Results showed limited translated information across all websites, an absence of translation tools embedded in the home page, as well as moderate to high levels of digital and English literacy required, and largely absent CALD specific resources. These results suggest that Australian LGBTIQ+ health service websites are not currently meeting the unique needs of their CALD constituents. Increased availability of translation services, navigation tools, and CALD LGBTIQ+ stakeholder inclusion during website development is recommended to ensure more equitable access for CALD LGBTIQ+ communities.
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Affiliation(s)
- Katherine McCulloch
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kate Murray
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elija Cassidy
- School of Communication, Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
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Sayani A, Manthorne J, Nicholson E, Bloch G, Parsons JA, Hwang SW, Amenu B, Freedman H, Rathbone M, Jeji T, Wathen N, Browne AJ, Varcoe C, Lofters A. Toward equity-oriented cancer care: a Strategy for Patient-Oriented Research (SPOR) protocol to promote equitable access to lung cancer screening. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:11. [PMID: 35382905 PMCID: PMC8980795 DOI: 10.1186/s40900-022-00344-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Screening for lung cancer with low dose CT can facilitate the detection of early-stage lung cancers that are amenable to treatment, reducing mortality related to lung cancer. Individuals are considered eligible for lung cancer screening if they meet specific high-risk criteria, such as age and smoking history. Population groups that are at highest risk of lung cancer, and therefore, the target of lung cancer screening interventions, are also the least likely to participate in lung cancer screening. This can lead to a widening of health inequities. Deliberate effort is needed to both reduce lung cancer risk (through upstream interventions that promote smoking cessation) as well as midstream interventions that promote equitable access to lung cancer screening. METHODS This protocol paper describes an equity-informed patient-oriented research study. Our study aims to promote equitable access to lung cancer screening by partnering with patients to co-design an e-learning module for healthcare providers. The learning module will describe the social context of lung cancer risk and promote access to lung cancer screening by increasing equity at the point of care. We have applied the Generative Co-Design Framework for Healthcare Innovation and detail our study processes in three phases and six steps: Pre-design (establishing a study governance structure); Co-design (identifying research priorities, gathering and interpreting data, co-developing module content); and Post-design (pilot testing the module and developing an implementation plan). DISCUSSION Patient engagement in research can promote the design and delivery of healthcare services that are accessible and acceptable to patients. This is particularly important for lung cancer screening as those at highest risk of developing lung cancer are also those who are least likely to participate in lung cancer screening. By detailing the steps of our participatory co-design journey, we are making visible the processes of our work so that they can be linked to future outcomes and related impact, and inform a wide range of patient co-led processes.
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Affiliation(s)
- Ambreen Sayani
- Transition to Leadership Stream Postdoctoral Fellow at the Women's College Research Institute, Women's College Hospital, Toronto, Canada.
| | | | | | - Gary Bloch
- St. Michael's Hospital and Inner City Health Associates, University of Toronto, Toronto, Canada
- Wellesley Institute, Toronto, Canada
| | - Janet A Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Bikila Amenu
- Research Advisory Council, Lung Cancer Screening Strategy for Patient-Oriented Research Study, Women's College Hospital, Toronto, Canada
| | - Howard Freedman
- Research Advisory Council, Lung Cancer Screening Strategy for Patient-Oriented Research Study, Women's College Hospital, Toronto, Canada
| | - Marlene Rathbone
- Research Advisory Council, Lung Cancer Screening Strategy for Patient-Oriented Research Study, Women's College Hospital, Toronto, Canada
| | - Tara Jeji
- Research Advisory Council, Lung Cancer Screening Strategy for Patient-Oriented Research Study, Women's College Hospital, Toronto, Canada
| | - Nadine Wathen
- Arthur Labatt Family School of Nursing, Centre for Research on Health Equity and Social Inclusion, Western University, London, Canada
| | - Annette J Browne
- University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Colleen Varcoe
- University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, Women's College Hospital Family Practice Health Centre, University of Toronto, Toronto, Canada
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Canada
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Sianko N, Kunkel D. Longitudinal Patterns in Adolescent Intentions to Seek Help for Dating Violence: A Latent Transition Analysis. J Youth Adolesc 2022; 51:673-693. [PMID: 35092550 DOI: 10.1007/s10964-022-01569-6] [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: 10/28/2021] [Accepted: 01/01/2022] [Indexed: 10/19/2022]
Abstract
As a persistent public health problem affecting thousands of adolescents every year, teen dating violence has been studied extensively. However, gaps remain in the knowledge on what adolescents think about seeking help for violence in a dating relationship and how these attitudes might change over time. This study adopts a longitudinal person-oriented approach to explore configurations of help-seeking preferences in a sample of rural adolescents (N at wave 1 = 580, Mage = 13 years, SD = 1.48; 52.7% female; 46.6% African American, 39.4% White, 14% Hispanic and other minorities), surveyed annually for four years, with each assessment approximately 12 months apart. Latent class analyses uncovered variation in adolescents' willingness to disclose dating violence, captured by six groups: (a) Multi-help-seekers (19%), (b) Reluctant help-seekers (15%), (c) Selective help-seekers (16%), (d) Parent confidants (11%), (e) Friends confidants (22%), and (f) Moderate help-seekers (17%). Follow-up analyses revealed that select sociodemographic characteristics (age, gender, and family income) were unevenly distributed among the identified groups, pointing to the need to account for individual and contextual influences in understanding heterogeneity in help-seeking attitudes. Latent transition models further showed that although individual membership in latent classes was generally stable between middle and high school, transitions between help-seeking classes were common as well. The article concludes by discussing these findings in the context of further research and programming to promote help-seeking among developing adolescents, including targeted strategies to address the needs of adolescents who think differently about disclosing dating abuse.
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Affiliation(s)
- Natallia Sianko
- Department of Sociology, Anthropology & Criminal Justice, Clemson University, Clemson, SC, USA.
| | - Deborah Kunkel
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA
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Elliott SA, Wright KS, Scott SD, Mohamed M, Farah A, Hartling L. Adapting child health knowledge translation tools for Somali parents: a qualitative study exploring process considerations and stakeholder engagement (Preprint). JMIR Form Res 2022; 6:e36354. [PMID: 35377330 PMCID: PMC9016500 DOI: 10.2196/36354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kelsey S Wright
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Muna Mohamed
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Asha Farah
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Porche MV, Folk JB, Tolou-Shams M, Fortuna LR. Researchers' Perspectives on Digital Mental Health Intervention Co-Design With Marginalized Community Stakeholder Youth and Families. Front Psychiatry 2022; 13:867460. [PMID: 35530032 PMCID: PMC9072625 DOI: 10.3389/fpsyt.2022.867460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/28/2022] [Indexed: 01/07/2023] Open
Abstract
Co-design of digital mental health technology with youth and families is a relatively new but growing approach to intervention development. In this perspective article, researchers used collaborative reflexivity through duoethnography methodology to reflect and report on experiences and lessons learned conducting co-designed projects with marginalized youth and families. Researchers engaged in written reflective dialogue regarding projects designed to co-develop technology-based apps and computer programs to support mental health of youth and their families. Reflections described the barriers and challenges for sharing responsibilities with stakeholders who have extensive lived experience but limited exposure to research. Researchers shared insights about their own intersectionality and positionality from marginalized to privileged, relative to co-design participants, and what it means to share authority, authentic partnership, and responsibility in the research process. Cultural understanding may diverge, even between acculturated minority researchers and matched minority stakeholders. While there are a variety of approaches that researchers might refer to as co-design, it is important to be intentional in the implementation of these processes so that collaborations with stakeholder youth and families are neither disingenuous nor exploitative. Implications for equitable and meaningful engagement of marginalized communities in co-design projects for youth mental health are discussed.
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Affiliation(s)
- Michelle V Porche
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Lisa R Fortuna
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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35
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Gan DZQ, McGillivray L, Larsen ME, Christensen H, Torok M. Technology-supported strategies for promoting user engagement with digital mental health interventions: A systematic review. Digit Health 2022; 8:20552076221098268. [PMID: 35677785 PMCID: PMC9168921 DOI: 10.1177/20552076221098268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/12/2022] [Indexed: 01/12/2023] Open
Abstract
Background Although digital mental health interventions (DMHIs) offer a potential
solution for increasing access to mental health treatment, their integration
into real-world settings has been slow. A key reason for this is poor user
engagement. A growing number of studies evaluating strategies for promoting
engagement with DMHIs means that a review of the literature is now
warranted. This systematic review is the first to synthesise evidence on
technology-supported strategies for promoting engagement with DMHIs. Methods MEDLINE, EmbASE, PsycINFO and PubMed databases were searched from 1 January
1995 to 1 October 2021. Experimental or quasi-experimental studies examining
the effect of technology-supported engagement strategies deployed alongside
DMHIs were included, as were secondary analyses of such studies. Title and
abstract screening, full-text coding and quality assessment were performed
independently by two authors. Narrative synthesis was used to summarise
findings from the included studies. Results 24 studies (10,266 participants) were included. Engagement strategies ranged
from reminders, coaching, personalised information and peer support. Most
strategies were disseminated once a week, usually via email or telephone.
There was some empirical support for the efficacy of technology-based
strategies towards promoting engagement. However, findings were mixed
regardless of strategy type or study aim. Conclusions Technology-supported strategies appear to increase engagement with DMHIs;
however, their efficacy varies widely by strategy type. Future research
should involve end-users in the development and evaluation of these
strategies to develop a more cohesive set of strategies that are acceptable
and effective for target audiences, and explore the mechanism(s) through
which such strategies promote engagement.
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Affiliation(s)
- Daniel Z Q Gan
- Black Dog Institute, University of New South Wales, Australia
| | | | - Mark E Larsen
- Black Dog Institute, University of New South Wales, Australia
| | | | - Michelle Torok
- Black Dog Institute, University of New South Wales, Australia
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36
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Tindall RM, Ferris M, Townsend M, Boschert G, Moylan S. A first-hand experience of co-design in mental health service design: Opportunities, challenges, and lessons. Int J Ment Health Nurs 2021; 30:1693-1702. [PMID: 34390117 DOI: 10.1111/inm.12925] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022]
Abstract
In an era of mental health service reform, co-design is emerging as a leading framework to guide the design and implementation of new services. Co-design uses the expertise of clinicians, those with lived experiences of services (both consumers and carers) and provocateurs (curious questioners) to understand a 'problem' and develop innovative strategies to address it. It relies on the creation of a safe environment where power imbalances are acknowledged and mitigated, and decisions are made collaboratively. Understanding how to do this effectively within the mental health sphere, where experiences of uneven power distribution and trauma are common, can feel overwhelming. Building a shared understanding of the opportunities and limitations within co-design is also important to establish its place within broader mental health reform. This paper uses an experiential approach to reflect on a co-design process, offering an opportunity to learn from a specific example. Factors that enhanced co-design included formal, remunerated roles, the allocation of time to establish and maintain an intimate, trusting team culture, and the capacity for all team members to be vulnerable. Equally important, strategies needed to be employed to mitigate the challenges inherent within the process, including the impact of power differences, a push to make fast-paced decisions, and a sense of cynicism remaining from previous projects or experiences. When these factors are attended to, the process of co-design can be dynamic, innovative, and transformational for the people participating in it, the project and the mental health sector.
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37
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Sylvie G, Farré Coma J, Ota G, Aoife L, Anna S, Johanne S, Tiago M. Co-designing an Integrated Care Network With People Living With Parkinson's Disease: From Patients' Narratives to Trajectory Analysis. QUALITATIVE HEALTH RESEARCH 2021; 31:2585-2601. [PMID: 34629008 PMCID: PMC8649812 DOI: 10.1177/10497323211042605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
An integrated care model for people living with Parkinson's disease (PD) offers the promise of meeting complex care needs in a person-centered way that addresses fragmentation and improves quality of life. The purpose of our research was to co-design a care delivery model that supports both social and medical care from the perspective of patients and care partners. In the first step of our co-design approach, participants from five countries were invited to share their experiences of living with PD during a narrative interview. A qualitative analysis of these narrative interviews based on the Corbin and Strauss model was done to map out patients' trajectories. Three typical trajectories were identified: (a) the "unpredictable" trajectory, (b) the "situated" trajectory, and (c) the "demanding" trajectory. Based on the analysis of these trajectories, we were able to integrate various patient experiences into the design of an integrated care network.
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Affiliation(s)
- Grosjean Sylvie
- University of Ottawa, Ottawa, Ontario, Canada
- Grosjean Sylvie, University of Ottawa, 55 Laurier east, Desmanarais Building, 11112, Ottawa, Ontario, Canada K1N 6N5.
| | | | - Gal Ota
- Department of Neurology and Centre of Clinical Neuroscience, General University Hospital, Charles University, Prague, Czech Republic
| | - Laffan Aoife
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Stuempel Johanne
- University of Cologne, Cologne Centre for Ethics, Rights, Economics, and Social Sciences of Health (ceres), Cologne, Germany
| | - Mestre Tiago
- Parkinson’s Disease and Movement Disorders Clinic, Division of Neurology, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
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38
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Saad A, Bruno D, Camara B, D'Agostino J, Bolea-Alamanac B. Self-directed Technology-Based Therapeutic Methods for Adult Patients Receiving Mental Health Services: Systematic Review. JMIR Ment Health 2021; 8:e27404. [PMID: 34842556 PMCID: PMC8665378 DOI: 10.2196/27404] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 07/26/2021] [Accepted: 08/12/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Technological interventions used to treat illnesses and promote health are grouped under the umbrella term of digital therapeutics. The use of digital therapeutics is becoming increasingly common in mental health. Although many technologies are currently being implemented, research supporting their usability, efficacy, and risk requires further examination, especially for those interventions that can be used without support. OBJECTIVE This review aims to identify the evidence-based, self-directed, technology-based methods of care that can be used in adult patients after they are discharged from mental health services. The interventions reviewed are automated with no human input required (either at the patient's or at the technology's end), so the patients can implement them without any support. METHODS A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PROSPERO (International Prospective Register of Systematic Reviews) guidelines in 3 databases: PubMed, Web of Science, and OVID. The inclusion criteria were self-directed, automated, and technology-based interventions related to mental health, primarily for adults, having a solid evaluation process. The interventions had to be self-directed, in that the participants could use the technology without any external guidance. RESULTS We identified 36 papers that met the inclusion criteria: 26 randomized controlled trials, 9 nonrandomized controlled trial quantitative studies, and 1 qualitative study. The technologies used included websites, automated text messaging, phone apps, videos, computer software, and integrated voice response. There were 22 studies focused on internet-based cognitive behavioral therapies as a therapeutic paradigm compared with the waitlist, web-based human-delivered therapy, and other interventions. Among these studies, 14 used paradigms other than the internet-based cognitive behavioral therapy. Of the 8 studies comparing guided and unguided digital care, 3 showed no differences, 3 favored guided interventions, and 2 favored unguided interventions. The research also showed that dropout rates were as high as 80%, citing potential problems with the acceptability of the suggested technologies. CONCLUSIONS There is limited research on the efficacy and suitability of self-directed technology-based care options for mental health. Digital technologies have the potential to bridge the gap between ambulatory care and independent living. However, these interventions may need to be developed collaboratively with the users to encourage their acceptability and to avoid high dropout rates.
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Affiliation(s)
- Anthony Saad
- Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada
| | - Deanna Bruno
- Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Bettina Camara
- Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Blanca Bolea-Alamanac
- Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Chauhan A, Leefe J, Shé ÉN, Harrison R. Optimising co-design with ethnic minority consumers. Int J Equity Health 2021; 20:240. [PMID: 34736455 PMCID: PMC8567634 DOI: 10.1186/s12939-021-01579-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/25/2021] [Indexed: 12/19/2022] Open
Abstract
Co-design as a participatory method aims to improve health service design and implementation. It is being used more frequently by researchers and practitioners in various health and social care settings. Co-design has the potential for achieving positive outcomes for the end users involved in the process; however, involvement of diverse ethnic minority population in the process remains limited. While the need to engage with diverse voices is identified, there is less information available on how to achieve meaningful engagement with these groups. Ethnic minorities are super-diverse population and the diversity between and within these groups need consideration for optimising their participation in co-design. Based on our experience of working with diverse ethnic minority groups towards the co-design of consumer engagement strategies to improve patient safety in cancer services as part of the two nationally-funded research projects in Australia, we outline reflections and practical techniques to optimise co-design with people from diverse ethnic backgrounds. We identify three key aspects of the co-design process pertinent to the involvement of this population; 1) starting at the pre-commencement stage to ensure diverse, seldom heard consumers are invited to and included in co-design work, 2) considering logistics and adequate resources to provide appropriate support to address needs before, during and beyond the co-design process, and 3) supporting and enabling a diversity of contributions via the co-design process.
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Affiliation(s)
- Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation (AIHI), Macquarie University, North Ryde, NSW, 2109, Australia.
| | - Jessica Leefe
- System Transformation Evaluation and Patient Experience, Agency for Clinical Innovation (ACI), NSW Health, St Leonards, NSW, 2065, Australia
| | - Éidín Ní Shé
- School of Population Health, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation (AIHI), Macquarie University, North Ryde, NSW, 2109, Australia
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40
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Elliott SA, Wright KS, Scott SD, Hartling L. Perspectives from French and Filipino parents on the adaptation of child health knowledge translation tools: a qualitative exploration (Preprint). JMIR Form Res 2021; 6:e33156. [PMID: 35333185 PMCID: PMC8994152 DOI: 10.2196/33156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 01/23/2023] Open
Abstract
Background A number of evidence-based knowledge translation (KT) tools for parents of children with acute health conditions have been developed. These tools were created and tested with parental input and disseminated to groups proficient in English. Therefore, it is unclear whether they are useful for populations that are more diverse. To enhance the reach of our current and future KT tools, language translation and cultural adaptations may promote relevance for previously underserved knowledge users. Objective This study aims to explore and understand considerations for the cultural and linguistic adaptation of a KT tool in French and Filipino communities. Methods A KT tool (whiteboard animation video) describing the signs and symptoms of croup was originally developed in English to provide parents with evidence-based information couched within a narrative reflecting parents’ experiences with the condition. This KT tool was adapted (linguistics and imagery) for French- and Tagalog-speaking parents and caregivers through feedback from key stakeholders. The videos were presented to the respective language speakers for usability testing and discussion. Participants were asked to view the KT tool, complete a usability survey, and participate in semistructured interviews. Audio recordings from the interviews were transcribed verbatim, translated into English, and analyzed for relevant themes by using thematic analysis. Results French- (n=13) and Tagalog-speaking (n=13) parents completed the usability survey and were interviewed. Although analyzed separately, both data sets produced similar findings, with key themes relating to understanding, relatability, and accessibility. Both the French and Tagalog groups reported that the video and other KT tools were useful in their adapted forms. Participants in both groups cautioned against using verbatim vocabulary and suggested that cultural competency and understanding of health languages were essential for high-quality translations. Parents also discussed their preference for videos with diverse visual representations of families, home environments, and health care workers, as such videos represent their communities more broadly. Conclusions French and Filipino parents appreciated having KT tools in their first language; however, they were also supportive of the use of English KT products. Their suggestions for improving the relatability and communication of health messages are important considerations for the development and adaptation of future KT products. Understanding the needs of the intended end users is a crucial first step in producing relevant tools for health evidence dissemination.
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kelsey S Wright
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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41
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Harrison R, Raman M, Walpola RL, Chauhan A, Sansom-Daly UM. Preparing for partnerships in cancer care: an explorative analysis of the role of family-based caregivers. BMC Health Serv Res 2021; 21:620. [PMID: 34187469 PMCID: PMC8240189 DOI: 10.1186/s12913-021-06611-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Family-based 'informal' caregivers are critical to enable sustainable cancer care that produces optimal health outcomes but also gives rise to psychological burdens on caregivers. Evidence of psychosocial support for caregivers does not currently address the impacts of their role in providing clinical and health-related care for their loved ones. The present study sought to address this gap including with those from priority populations. METHODS Qualitative data was collected using focus group and interview methods. We purposively sampled caregivers identified as having a high burden of responsibility for providing clinical care including those from ethnic minority backgrounds, parental caregivers and those living rurally. Transcripts were subject to thematic analysis utilising a team-based approach. RESULTS Family-based caregivers included spouses (11), parents (7), children (1), siblings (1). Ten participants were from ethnic minority backgrounds and five participants were from regional or rural locations. Four resulting inter-related themes were; 1) Dual burden of providing clinical care and managing personal emotional distress; 2) Navigating healthcare partnership dynamics; 3) Developing a caregiving skillset, and 4) Unique supportive needs and barriers to access. These data provide evidence of the unique challenge of providing clinical care as part of family-based caregiving for a loved one with cancer, and the absence of support for caregivers to take up this role. CONCLUSION Our findings highlight the substantial contribution of family-based caregivers to the provision of cancer care in contemporary health systems. Inadequate support for caregivers is apparent with regard to their role in providing clinical aspects of care such as medication administration and management. Support programs to prepare caregivers to provide clinical care while building capacity to manage their stressors and emotions through this challenging period may be valuable towards sustainable, person-centred care.
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Affiliation(s)
- Reema Harrison
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
- School of Population Health, UNSW Sydney, Sydney, Australia.
| | - Madhav Raman
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ramesh Lahiru Walpola
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ashfaq Chauhan
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ursula M Sansom-Daly
- School of Women's and Children's Health, UNSW Sydney, Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, Australia
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Yadav UN, Lloyd J, Baral KP, Bhatta N, Mehata S, Harris M. Evaluating the feasibility and acceptability of a co-design approach to developing an integrated model of care for people with multi-morbid COPD in rural Nepal: a qualitative study. BMJ Open 2021; 11:e045175. [PMID: 33472791 PMCID: PMC7818838 DOI: 10.1136/bmjopen-2020-045175] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To understand the feasibility and acceptability of a co-design approach to developing an integrated model of healthcare for people with multi-morbid chronic obstructive pulmonary disease (COPD) in rural Nepal. SETTINGS A rural setting of Nepal. PARTICIPANTS Data collection included five video recordings, five key informant interviews and observation notes from a final co-design workshop that involved a total of 68 stakeholders: persons with COPD and their family members; healthcare providers, including respiratory physicians; local community leaders; representatives from local, provincial and federal government; academics; and representatives from non-government organisations. PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility and acceptability of using a co-design approach to develop an integrated model of care for people with multi-morbid COPD in rural Nepal. RESULTS Our qualitative evaluation of the Hasso Plattner's co-design process found that all stakeholders (including people with COPD/community members, primary care practitioners and local government/senior health officials) were actively engaged in and significantly contributed to the process of co-design. Four main themes were identified which determined the feasibility and acceptability of the resulting integrated model of care: engagement of stakeholders, factors contributing to the co-design, consequences of the co-design process, and challenges and opportunities learnt by the researchers and participants in the co-design process. Based on the relationship between the four main themes emerging from this research, we developed an evaluation framework to guide the co-design of a health service innovation. CONCLUSION Our study demonstrated the feasibility and acceptability of the Hasso Plattner's co-design process. Our findings suggest that this co-design approach can be useful and acceptable to local communities and government agencies. It enabled the meaningful contribution of a diverse group of stakeholders in the design and delivery of health services in low-income and middle-income countries.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
- Center for Research, Policy and Implementation, Biratnagar, Nepal
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Close JB, Bornemann J, Piggin M, Jayacodi S, Luan LX, Carhart-Harris R, Spriggs MJ. Co-design of Guidance for Patient and Public Involvement in Psychedelic Research. Front Psychiatry 2021; 12:727496. [PMID: 34658961 PMCID: PMC8514741 DOI: 10.3389/fpsyt.2021.727496] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/06/2021] [Indexed: 01/17/2023] Open
Abstract
Within the context of scientific research, patient and public involvement (PPI) is defined as research performed "with" or "by" patients and members of the public, rather than "to," "about", or "for" them. When carried out systematically and thoughtfully, PPI has the potential to strengthen the quality and impact of research by fostering accountability, transparency, and relevance. There exist numerous guidelines, frameworks and tools for supporting PPI, however, these do not account for the unique challenges faced in psychedelic research. This paper describes the co-design of guidance intended to help build, evaluate and improve PPI in psychedelic research. A steering group was formed to design and run a co-design workshop alongside public collaborators. Insights from this workshop were analyzed and refined into a comprehensive and readily usable guide for planning PPI specific to the field of psychedelic research. Core values emerging from the process focused on the essential importance of trust, learning, purpose and inclusivity. It is hoped that this guidance will be a starting point for incorporating PPI in future psychedelic research, so that it can grow and adapt as this burgeoning field of research progresses.
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Affiliation(s)
- James B Close
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Julia Bornemann
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Maria Piggin
- Patient Experience Research Centre, Imperial College London, London, United Kingdom
| | - Sandra Jayacodi
- Imperial Biomedical Research Centre Public Panel, London, United Kingdom
| | - Lisa Xiaolu Luan
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Meg Jo Spriggs
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
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