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Drinkwater J, Farr M, Hickey G, Van Vliet E, Söderholm Werkö S, Klingmann I, Blackburn S. Series: Public engagement with research. Part 3: Sharing power and building trust through partnering with communities in primary care research. Eur J Gen Pract 2024; 30:2328707. [PMID: 38546448 PMCID: PMC10984225 DOI: 10.1080/13814788.2024.2328707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND This article focuses on potential strategies to support primary care researchers in working in partnership with the public and healthcare professionals. Partnership working can potentially to improve the relevance and usefulness of research and ensure better research and health outcomes. DISCUSSION We describe what we mean by partnership working and the importance of reflecting on power and building trusting relationships. To share power in partnership working, it is essential to critically reflect on the multiple dimensions of power, their manifestations, and your own power. Power can influence relationships and therefore, it is essential to build trust with partners. Next, we outline how the context of primary care research and decisions about who you work with and how to work together, are vital considerations that are imbued with power. Lastly, we suggest different ways of working in partnership to address different dimensions of power. We provide examples from primary care research across Europe regarding how to recognise, tackle, and challenge, invisible, hidden and visible power. CONCLUSION We conclude by proposing three calls to actions to encourage researchers working in primary care to consider the multiple dimensions of power and move towards partnership working. First is to use participatory methods to improve the inclusivity of your research. Second is to include patients and the public in decisions about the design, delivery and development of research and its outcomes. Third is to address various systemic and institutional barriers which hinder partnership working.
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Affiliation(s)
- Jessica Drinkwater
- Centre for Primary Care and Health Services Research, University of Manchester, United Kingdom
| | - Michelle Farr
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Gary Hickey
- Agora Digital Centre, School of Healthcare Enterprise and Innovation, University of Southampton, United Kingdom
| | | | - Sophie Söderholm Werkö
- The Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Ingrid Klingmann
- European Forum for Good Clinical Practice (EFGCP), Brussels, Belgium
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, United Kingdom
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Tyack Z, McPhail S, Aarons GA, McGrath K, Barron A, Carter H, Larkins S, Barnett A, Hummell E, Tulleners R, Fisher O, Harvey G, Jones L, Murray K, Abell B. Evaluating the tailored implementation of a multisite care navigation service for mental health in rural and remote Australia (The Bridging Study): protocol for a community-engaged hybrid effectiveness-implementation study. Implement Sci 2024; 19:62. [PMID: 39232820 DOI: 10.1186/s13012-024-01391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 08/18/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND A dramatic decline in mental health of people worldwide in the early COVID-19 pandemic years has not recovered. In rural and remote Australia, access to appropriate and timely mental health services has been identified as a major barrier to people seeking help for mental ill-health. From 2020 to 2021 a care navigation model, Navicare, was co-designed with rural and remote communities in the Greater Whitsunday Region of Central Queensland in Australia. The Exploration, Preparation, Implementation and Sustainment (EPIS) framework was used to design and guide multiple aspects of a multisite study, The Bridging Study, to evaluate the implementation of Navicare in Australia. METHODS A community-engaged hybrid effectiveness-implementation study design will focus on the tailored implementation of Navicare at three new sites as well as monitoring implementation at an existing site established since 2021. Study outcomes assessed will include sustained access as the co-primary outcome (measured using access to Navicare mental health referral services) and Proctor's Implementation Outcomes of feasibility, acceptability, appropriateness, adoption, fidelity, implementation cost, and sustainability. Data collection for the implementation evaluation will include service usage data, community consultations, interviews, and workshops; analysed using mixed methods and guided by EPIS and other implementation frameworks. Pre-post effectiveness and cost-consequence study components are embedded in the implementation and sustainment phases, with comparison to pre-implementation data and value assessed for each EPIS phase using hospital, service, and resource allocation data. A scaling up strategy will be co-developed using a national roundtable forum in the final year of the study. Qualitative exploration of other aspects of the study (e.g., mechanisms of action and stakeholder engagement) will be conducted. DISCUSSION Our study will use tailoring to local sites and a community-engaged approach to drive implementation of a mental health care navigation service in rural and remote Australia, with expected benefits to mental healthcare access. This approach is consistent with policy recommendations nationally and internationally as building blocks for rural health including the World Health Organization Framework for Action on Strengthening Health Systems to Improve Health Outcomes. TRIAL REGISTRATION Prospectively registered on April 2, 2024, on the Australian New Zealand Clinical Trials Registry, no. ACTRN12624000382572. https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386665&isReview=true .
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Affiliation(s)
- Zephanie Tyack
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Steven McPhail
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- Clinical Informatics Directorate, Metro South Health, Brisbane, QLD, Australia
| | - Gregory A Aarons
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, USA
| | - Kelly McGrath
- Health Services Research, Wesley Research Institute, Brisbane, QLD, Australia
| | - Andrew Barron
- Health Services Research, Wesley Research Institute, Brisbane, QLD, Australia
| | - Hannah Carter
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eloise Hummell
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ruth Tulleners
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Olivia Fisher
- Health Services Research, Wesley Research Institute, Brisbane, QLD, Australia
| | - Gillian Harvey
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lee Jones
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- QIMR Berghofer Medical Research Institute, Statistics Unit, Brisbane, QLD, Australia
| | - Kate Murray
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Bridget Abell
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Quintal A, Hotte É, Hébert C, Carreau I, Grenier AD, Berthiaume Y, Racine E. Understanding Rare Disease Experiences Through the Concept of Morally Problematic Situations. HEC Forum 2024; 36:441-478. [PMID: 37515692 DOI: 10.1007/s10730-023-09511-4] [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] [Accepted: 06/30/2023] [Indexed: 07/31/2023]
Abstract
Rare diseases, defined as having a prevalence inferior to 1/2000, are poorly understood scientifically and medically. Appropriate diagnoses and treatments are scarce, adding to the burden of living with chronic medical conditions. The moral significance of rare disease experiences is often overlooked in qualitative studies conducted with adults living with rare diseases. The concept of morally problematic situations arising from pragmatist ethics shows promise in understanding these experiences. The objectives of this study were to (1) acquire an in-depth understanding of morally problematic situations experienced by adults living with rare diseases in the province of Québec and (2) to develop an integrative model of the concept of morally problematic situations. To this end, an online survey targeting this population was developed through a participatory action research project. Respondents provided 90 long testimonies on the most important morally problematic situations they faced, often in healthcare settings. An integrative model was developed based on various qualitative analyses of these testimonies and relevant literature. The integrative model showcases that morally problematic situations have causes (i.e., contextual and relational factors, personal factors, jeopardized valuations), have affective repercussions (i.e., emotions and feelings, internal tensions), prompt action (i.e., through empowerment strategies leading to the evolution of situations), and elicit outcomes (i.e., factual consequences, residual emotions and feelings, positive or negative resolutions). In sum, this study advances understanding of the moral experiences of adults living with rare diseases while proposing a comprehensive conceptual tool to guide future empirical bioethics research on moral experiences.
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Affiliation(s)
- Ariane Quintal
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, 110 Pine Avenue West, Montréal, QC, H2W 1R7, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Élissa Hotte
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, 110 Pine Avenue West, Montréal, QC, H2W 1R7, Canada
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Caroline Hébert
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Isabelle Carreau
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Annie-Danielle Grenier
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Yves Berthiaume
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine, Université de Montréal, Montréal, QC, Canada
| | - Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, 110 Pine Avenue West, Montréal, QC, H2W 1R7, Canada.
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada.
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada.
- Division of Experimental Medicine, and Department of Neurology and Neurosurgery, Department of Medicine, McGill University, Montréal, QC, Canada.
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Phillip E, Walsh A, Jewitt S, Elnakoury F, Simon J, Conroy RM, Stanistreet D. Exploring community-based participatory research for household and ambient air pollution projects: insights from key informants. BMC Public Health 2024; 24:2233. [PMID: 39152390 PMCID: PMC11330043 DOI: 10.1186/s12889-024-19614-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 07/26/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Despite the extensive use of community-based participatory research (CBPR) in health-related projects, there is limited work on how CBPR processes result in outcomes, especially in household and ambient air pollution (HAAP) research. This study explores the reflections of key informants on factors that shape the implementation and outcomes of CBPR in HAAP projects. METHODS We conducted semi-structured interviews with 13 key stakeholders, including academic researchers, non-governmental organisation administrators, a policymaker, and community members. All interviewees have experience in CBPR projects. Interviews were analysed using framework analysis, and findings were mapped to Wallerstein et al.'s CBPR conceptual model, which consists of four constructs: context, partnership processes, intervention and research, and outcomes. RESULTS The findings are described under two main categories: 'barriers to participation' and 'good practices for effective CBPR design and implementation'. Relevant sub-categories were barriers at the structural, research, community, and individual levels. Suggestions for good practices included respect, cultural humility, trust, effective communication, suitable and affordable interventions such as improved cookstoves, appropriate participatory research tools, and gratuity for the community's time. CONCLUSION Key informants' perspectives identified factors supported by the CBPR model to inform the design and implementation of the CBPR approach. The add-ons to some of the model's factors, such as intra-community dynamics, give value to the informants' knowledge to support community-research partnerships and improve outcomes in HAAP intervention projects. Addressing these factors at the design stage and reporting CBPR evaluation could deepen the understanding of community-research partnerships.
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Affiliation(s)
- Eunice Phillip
- Department of Public Health and Epidemiology, School of Population Health, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland.
| | - Aisling Walsh
- Department of Public Health and Epidemiology, School of Population Health, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland
| | - Sarah Jewitt
- Faculty of Social Sciences, School of Geography, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Farah Elnakoury
- Department of Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland
| | - Joella Simon
- Department of Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland
| | - Ronán M Conroy
- Department of Public Health and Epidemiology, School of Population Health, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland
| | - Debbi Stanistreet
- Department of Public Health and Epidemiology, School of Population Health, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02DH60, Ireland
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Drinkwater J, MacFarlane A, Twiddy M, Meads D, Chadwick RH, Donnelly A, Gleeson P, Hayward N, Kelly M, Mir R, Prestwich G, Rathfelder M, Foy R. Patient influence on general practice service improvement decision making: a participatory research mixed-methods intervention study. Br J Gen Pract 2024; 74:e552-e559. [PMID: 38164535 PMCID: PMC11005925 DOI: 10.3399/bjgp.2023.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Health policy promotes patient participation in decision making about service organisation. In English general practice this happens through contractually required patient participation groups (PPGs). However, there are problems with the enactment of PPGs that have not been systematically addressed. AIM To observe how a co-designed theory-informed intervention can increase representational legitimacy and facilitate power sharing to support PPGs to influence decision making about general practice service improvement. DESIGN AND SETTING Participatory action research to implement the intervention in two general practices in the North of England was undertaken. The intervention combined two different participatory practices: partnership working involving externally facilitated meetings with PPG members and staff; and consultation with the wider patient population using a bespoke discrete choice experiment (DCE). METHOD To illustrate decision making in PPGs, qualitative data are presented from participant observation notes and photographed visual data generated through participatory methods. The DCE results are summarised to illustrate how wider population priorities contributed to overall decision making. Observational data were thematically analysed using normalisation process theory with support from a multi-stakeholder co-research group. RESULTS In both general practices, patients influenced decision making during PPG meetings and through the DCE, resulting in bespoke patient-centred action plans for service improvement. Power asymmetries were addressed through participatory methods, clarification of PPG roles in decision making, and addressing representational legitimacy through wider survey consultation. CONCLUSION Combining participatory practices and facilitated participatory methods enabled patients to influence decision making about general practice service improvement. The policy of mandatory PPGs needs updating to recognise the need to resource participation in a meaningful way.
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Affiliation(s)
- Jessica Drinkwater
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, and honorary research fellow, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Anne MacFarlane
- Participatory Health Research Unit, School of Medicine and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Maureen Twiddy
- Hull York Medical School, Institute of Clinical and Applied Health Research, University of Hull, UK
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ruth H Chadwick
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ailsa Donnelly
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Phil Gleeson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Nick Hayward
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Michael Kelly
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Robina Mir
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Graham Prestwich
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Adams MA, Bevan C, Booker M, Hartley J, Heazell AE, Montgomery E, Sanford N, Treadwell M, Sandall J. Strengthening open disclosure in maternity services in the English NHS: the DISCERN realist evaluation study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-159. [PMID: 39185618 DOI: 10.3310/ytdf8015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Background There is a policy drive in NHS maternity services to improve open disclosure with harmed families and limited information on how better practice can be achieved. Objectives To identify critical factors for improving open disclosure from the perspectives of families, doctors, midwives and services and to produce actionable evidence for service improvement. Design A three-phased, qualitative study using realist methodology. Phase 1: two literature reviews: scoping review of post-2013 NHS policy and realist synthesis of initial programme theories for improvement; an interview study with national stakeholders in NHS maternity safety and families. Phase 2: in-depth ethnographic case studies within three NHS maternity services in England. Phase 3: interpretive forums with study participants. A patient and public involvement strategy underpinned all study phases. Setting National recruitment (study phases 1 and 3); three English maternity services (study phase 2). Participants We completed n = 142 interviews, including 27 with families; 93 hours of ethnographic observations, including 52 service and family meetings over 9 months; and interpretive forums with approximately 69 people, including 11 families. Results The policy review identified a shift from viewing injured families as passive recipients to active contributors of post-incident learning, but a lack of actionable guidance for improving family involvement. The realist synthesis found weak evidence of the effectiveness of open disclosure interventions in the international maternity literature, but some improvements with organisation-wide interventions. Recent evidence was predominantly from the United Kingdom. The research identified and explored five key mechanisms for open disclosure: meaningful acknowledgement of harm; involvement of those affected in reviews/investigations; support for families' own sense-making; psychological safely of skilled clinicians (doctors and midwives); and knowing that improvements to care have happened. The need for each family to make sense of the incident in their own terms is noted. The selective initiatives of some clinicians to be more open with some families is identified. The challenges of an adversarial medicolegal landscape and limited support for meeting incentivised targets is evidenced. Limitations Research was conducted after the pandemic, with exceptional pressure on services. Case-study ethnography was of three higher performing services: generalisation from case-study findings is limited. No observations of Health Safety Investigation Branch investigations were possible without researcher access. Family recruitment did not reflect population diversity with limited representation of non-white families, families with disabilities and other socially marginalised groups and disadvantaged groups. Conclusions We identify the need for service-wide systems to ensure that injured families are positioned at the centre of post-incident events, ensure appropriate training and post-incident care of clinicians, and foster ongoing engagement with families beyond the individual efforts made by some clinicians for some families. The need for legislative revisions to promote openness with families across NHS organisations, and wider changes in organisational family engagement practices, is indicated. Examination of how far the study's findings apply to different English maternity services, and a wider rethinking of how family diversity can be encouraged in maternity services research. Study registration This study is registered as PROSPERO CRD42020164061. The study has been assessed following RAMESES realist guidelines. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research Programme (NIHR award ref: 17/99/85) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 22. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Mary Ann Adams
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Charlotte Bevan
- The Stillbirth and Neonatal Death Charity (SANDS), London, UK
| | | | - Julie Hartley
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | | | - Elsa Montgomery
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Natalie Sanford
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | | | - Jane Sandall
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
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Ladune R, Hayotte M, Vuillemin A, d'Arripe-Longueville F. Development of a Web App to Enhance Physical Activity in People With Cystic Fibrosis: Co-Design and Acceptability Evaluation by Patients and Health Professionals. JMIR Form Res 2024; 8:e54322. [PMID: 39078689 PMCID: PMC11322687 DOI: 10.2196/54322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/16/2024] [Accepted: 05/27/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is a genetic disease affecting the respiratory and digestive systems, with recent treatment advances improving life expectancy. However, many people with CF lack adequate physical activity (PA). PA can enhance lung function and quality of life, but barriers exist. The Cystic Fibrosis Decisional Balance of Physical Activity questionnaire assesses the decisional balance for PA in adults with CF, but it is not optimal for clinical use. A digital app might overcome this limitation by improving the efficiency of administration, interpretation of results, and communication between patients and health care professionals. OBJECTIVE This paper presents the development process and reports on the acceptability of a web app designed to measure and monitor the decisional balance for PA in people with CF. METHODS This study comprised two stages: (1) the co-design of a digital app and (2) the evaluation of its acceptability among health care professionals and people with CF. A participatory approach engaged stakeholders in the app's creation. The app's acceptability, based on factors outlined in the Unified Theory of Acceptance and Use of Technology 2, is vital for its successful adoption. Participants volunteered, gave informed consent, and were aged >18 years and fluent in French. Data collection was performed through qualitative interviews, video presentations, surveys, and individual semistructured interviews, followed by quantitative and qualitative data analyses. RESULTS In total, 11 health care professionals, 6 people with CF, and 5 researchers were involved in the co-design phase. Results of this phase led to the coconstruction of an app named MUCO_BALAD, designed for people with CF aged ≥18 years, health care professionals, and researchers to monitor the decisional balance for PA in people with CF. In the acceptability evaluation phase, the sample included 47 health care professionals, 44 people with CF, and 12 researchers. The analysis revealed that the acceptability measures were positive and that app acceptability did not differ according to user types. Semistructured interviews helped identify positive and negative perceptions of the app and the interface, as well as missing functionalities. CONCLUSIONS This study assessed the acceptability of an app and demonstrated promising qualitative and quantitative results. The digital tool for measuring the decisional balance in PA for people with CF is encouraging for health care professionals, people with CF, and researchers, according to the valuable insights gained from this study.
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Affiliation(s)
- Raphaelle Ladune
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
| | - Meggy Hayotte
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
| | - Anne Vuillemin
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
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Drazdowski TK, Castedo de Martell S, Sheidow AJ, Chapman JE, McCart MR. Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults With Polysubstance Use: Protocol for a Feasibility, Acceptability, and Appropriateness Study of Launch. JMIR Res Protoc 2024; 13:e60671. [PMID: 39037768 DOI: 10.2196/60671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Emerging adults (aged 18-26 years) are the most at-risk yet underserved age group among people with substance use disorder, especially rural emerging adults, and polysubstance use is common. Recovery capital is lower among emerging adults than older adults, and evidence-based treatments are typically unavailable or not developmentally tailored, especially in rural areas. Both supportive parents (or parental figures) and peer recovery support services (PRSS) can be leveraged to better support these emerging adults. Previous research indicates parents can be engaged to deliver contingency management (CM), an extensively researched evidence-based intervention for substance use. OBJECTIVE This protocol describes a funded pilot of Launch, a novel, scalable service package that pairs web-based coaching for parents to deliver CM for emerging adults (CM-EA) at home and in-person PRSS with educational and vocational goal setting. Specifically, this protocol describes feasibility, acceptability, and appropriateness testing (implementation-related outcomes) and steps taken to prepare for a future large-scale trial of Launch. METHODS Upon the recruitment of 48 emerging adult and parent pairs from sites serving primarily rural clients, participants will be randomized into 1 of 3 conditions for this randomized controlled trial: virtual parent coaching to deliver CM-EA, in-person PRSS for emerging adults, or both sets of services. Emerging adult eligibility includes polysubstance use, a substance use disorder, and availability of a consenting parent. Emerging adults will be interviewed at baseline and 6 months about substance use, quality of life, recovery capital, parental relationship, and Launch implementation-related outcomes (6-month follow-up only). Parents, peer workers delivering PRSS, and parent CM-EA coaches will be interviewed about implementation-related outcomes at the end of the study period. Peer workers and CM-EA coaches will be asked to complete checklists of services delivered after each session. Finally, payers and providers will be interviewed for additional insights into Launch implementation and to identify key outcomes of Launch. Data analysis for emerging adult outcomes will be primarily descriptive, but parent CM-EA training adherence will be assessed using nested mixed-effects regression models of repeated measures. RESULTS Launch is currently ongoing, with funding received in August 2023, and is expected to end in September 2025, with data analysis and results in December 2026. Participants are expected to begin enrolling in June 2024. CONCLUSIONS While this pilot is limited by the small sample size and restriction to emerging adults with an involved parent, this is mitigated by the study's strengths and is appropriate for the pilot stage. Launch uses an innovative combination of existing strategies to generate better outcomes for emerging adults while remaining scalable. This pilot will provide insights into the feasibility and acceptability of Launch from the perspectives of service recipients, providers, and payers to inform a larger-scale effectiveness trial. TRIAL REGISTRATION ClinicalTrials.gov NCT06414993; https://clinicaltrials.gov/study/NCT06414993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/60671.
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Affiliation(s)
- Tess K Drazdowski
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | | | - Ashli J Sheidow
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | - Jason E Chapman
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
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Zimmerman EB, Rafie C, Wenzel SG, Hosig K, Villani D, Dance J, Lee SS. Addressing opioid misuse through community-engaged strategy development: study protocol of a randomized controlled trial. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:74. [PMID: 39030561 PMCID: PMC11264802 DOI: 10.1186/s40900-024-00612-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/12/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Involving stakeholders in the research process facilitates collaboration, increasing understanding of factors influencing their wellbeing and motivating community action. Currently, there is a need for randomized controlled trials to evaluate the effectiveness of community-engaged research approaches for health, well-being, and engagement outcomes. In this study, we evaluate the effectiveness of both the SEED Method and a modified Delphi method in a participatory project to develop local strategies to address the opioid epidemic in three rural communities. The purpose of this study is to increase the level of evidence for community-engaged research methods through a randomized controlled trial. METHODS Two communities will use the SEED Method and one will use a modified Delphi method. We aim to recruit a total of 144 participants (48 per community). The evaluation team will randomize participants to an intervention group or a control group. In addition, we will collect outcome data from the participatory research team members leading the projects in each county (n = 18) and from additional community members who participate in focus groups (n = 32). The primary outcome for all participants will be the change in self-reported civic engagement as measured by the total score on the Individual Mobilization Scale. DISCUSSION In the context of participatory action to address opioid misuse in rural counties, this study will provide an understanding of the effectiveness of two community engagement methods for increasing civic engagement, as well as the extent to which participants successfully create locally tailored action strategies. The study will also explore how the observed effects differ depending on the participant's role in the project (stakeholder participant, community research team member, or focus group participant), which is an important consideration for participatory research.
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Affiliation(s)
- Emily B Zimmerman
- Center on Society and Health, Virginia Commonwealth University, Richmond, VA, USA.
| | - Carlin Rafie
- Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sophie G Wenzel
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Kathryn Hosig
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Domenique Villani
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jon Dance
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Samantha S Lee
- Center on Society and Health, Virginia Commonwealth University, Richmond, VA, USA
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Bos C, de Weger E, Wildeman I, Pannebakker N, Kemper PF. Implement social prescribing successfully towards embedding: what works, for whom and in which context? A rapid realist review. BMC Public Health 2024; 24:1836. [PMID: 38982399 PMCID: PMC11234751 DOI: 10.1186/s12889-024-18688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/23/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Some clients who access healthcare services experience problems due to the wider determinants of health which cannot be addressed (solely) by the medical sector. Social Prescribing (SP) addresses clients ' wider health needs and is based on linkworkers who support primary care clients in accessing social, community and voluntary care services that support their needs. Previous literature has provided valuable insights about what works (or not) in an early stage of implementing SP. However, there is limited insight into what works for the implementation of SP towards embedding. This study provides guiding principles by which SP can be successfully implemented towards the embedding stage and identifies which contextual factors and mechanisms influence these guiding principles. METHODS A Rapid Realist Review was conducted to examine what works, for whom, why, and in which contexts. A local Dutch reference panel consisting of health and care organisations helped to inform the research questions. Additionally, a workshop was held with the panel, to discuss what the international insights mean for their local contexts. This input helped to further refine the literature review's findings. RESULTS Five guiding principles were identified for successful implementation of SP at the embedding stage: • Create awareness for addressing the wider determinants of health and the role SP services can play; • Ensure health and care professionals build trusting relationships with all involved stakeholders to create a cyclical referral process; • Invest in linkworkers' skills and capacity so that they can act as a bridge between the sectors; • Ensure clients receive appropriate support to improve their self-reliance and increase their community participation; • Invest in the aligning of structures, processes and resources between involved sectors to support the use of SP services. CONCLUSION To embed SP, structural changes on a system level as well as cultural changes are needed. This will require a shift in attitude amongst health and care professionals as well as clients towards the use, role and benefit of SP services in addressing the wider determinants of health. It will also require policymakers and researchers to involve communities and include their perspectives.
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Affiliation(s)
- C Bos
- National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Care and Society, Department of health and Care Nationally, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands.
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht , 3584 CS, The Netherlands.
| | - E de Weger
- Vrije universiteit Amsterdam, Athena Instituut, de Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - I Wildeman
- TNO child health, Sylviusweg 71, Leiden, 2333 BE, The Netherlands
| | - N Pannebakker
- TNO child health, Sylviusweg 71, Leiden, 2333 BE, The Netherlands
| | - P F Kemper
- National Institute for Public Health and the Environment (RIVM), Centre for Public Health, Care and Society, Department of health and Care Nationally, P.O. Box 1, Bilthoven, 3720 BA, The Netherlands
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Connery A, Salsberg J. Exploring participatory health research and its application to speech and language therapy research practices. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1257-1268. [PMID: 38130139 DOI: 10.1111/1460-6984.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under-represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society. AIMS To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field. METHODS & PROCEDURES This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. MAIN CONTRIBUTION This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field. CONCLUSIONS & IMPLICATIONS Conclusions & Implications: PHR remains an under-represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research-practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production. WHAT THIS PAPER ADDS What is already known on this subject PHR is increasingly attracting the attention of funders, researchers and decision-makers due to a growing body of evidence in support of this collaborative research approach. Despite its potential to bridge the research-practice gap, PHR remains significantly under-represented in the SLT research literature. What this paper adds to the existing knowledge This paper discusses the principles, benefits, challenges and impact evaluation of PHR. A recently developed evaluation framework for supporting the implementation of best engagement practices is examined. A demonstration of how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. What are the potential or actual clinical implications of this work? Speech and language therapists play a key role in PHR, as co-researchers contributing essential context-based knowledge. It is therefore imperative that they understand the principles and practices of this approach in order to maximize their input in future participatory partnerships.
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Affiliation(s)
- Amy Connery
- Department of Clinical Speech & Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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Yamaguchi S, Zerbo A, Cardoso R, Elsabbagh M, Gitterman A, Glegg S, Gonzalez M, Putterman C, Weiss JA, Shikako K. Realist process evaluation of the knowledge translation programme of a patient-oriented research network. J Eval Clin Pract 2024. [PMID: 38943509 DOI: 10.1111/jep.14056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/02/2024] [Indexed: 07/01/2024]
Abstract
RATIONALE The Knowledge Translation (KT) Programme of a pan-Canadian strategic patient-oriented research network focused on brain-based developmental disabilities aimed to mobilize knowledge relevant to the network members. The programme also promotes and studies integrated Knowledge Translation (iKT) approaches involving different interested parties, such as researchers, patient-partners and decision-makers, in all parts of the knowledge creation process. AIMS AND OBJECTIVES The objective of this study is to advance research programme evaluation methods through a realist evaluation of the process of implementing iKT activities. METHODS Realist process evaluation included: (1) development of initial programme theories (using the partnership synergy theory); (2) data collection and analysis; (3) synthesis and refinement of theories through engagement with literature; and (4) presentation of findings in context-mechanism-outcome (C-M-O) configurations. A range of project documentation records were reviewed for analysis, and three co-leads, a programme coordinator, and a senior research associate were consulted to contextualize the implementation process of relevant KT activities. RESULTS Based on the developed C-M-O configurations, we identified five key mechanisms of generating synergy in the iKT processes: (1) Visible shared leadership that embodies what iKT looks like; (2) Researchers' readiness for iKT; (3) Adaptation and flexible allocation of resources to emerging needs; (4) Power sharing to create practical and creative knowledge; and (5) Collective voice for potential transformative impacts at the policy level. CONCLUSIONS The current realist evaluation demonstrated how partnerships between researchers, patient-partners and other interested parties can synergistically generate new ways of thinking among all interested parties, actionable strategies to integrate users in research, and solutions to disseminate knowledge. In particular, we identified a pivotal role for patient-partners to act as equal decision-maker helps building and maintaining partnerships and consolidating KT strategies.
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Affiliation(s)
- Sakiko Yamaguchi
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Alix Zerbo
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Roberta Cardoso
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Mayada Elsabbagh
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Aryeh Gitterman
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Stephanie Glegg
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Miriam Gonzalez
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Connie Putterman
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Keiko Shikako
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- CHILD-BRIGHT Network, McGill University Health Center Research Institute, Montreal, Quebec, Canada
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Zaforteza-Lallemand C, Blanco-Mavillard I, Pol-Castañeda S, Villafáfila-Gomila CJ, Ferrer-Cruz F, Rodríguez-Calero MÁ. Strategies for knowledge mobilization by advanced practice nurses in three hospitals in Spain: a qualitative study. BMC Nurs 2024; 23:440. [PMID: 38926719 PMCID: PMC11202328 DOI: 10.1186/s12912-024-02095-5] [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: 11/28/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Evidence-based practice, in conjunction with optimum care quality, improves patients' clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations. METHODS An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist. RESULTS Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge. CONCLUSIONS The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made.
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Affiliation(s)
- Concha Zaforteza-Lallemand
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Balearic Islands, 07122, Spain
- Balearic Islands Health Services, Palma, Balearic Islands, 07003, Spain
- CurES Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, 07120, Spain
| | - Ian Blanco-Mavillard
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Balearic Islands, 07122, Spain.
- Healthcare Implementation and Research Unit, Hospital Regional Universitario de Málaga, Avd. de Carlos Haya, 84. Málaga 29010, Málaga, 29010, Spain.
- CurES Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, 07120, Spain.
| | - Sandra Pol-Castañeda
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Balearic Islands, 07122, Spain
- Hospital Son Llàtzer, Palma, Balearic Islands, 07198, Spain
- CurES Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, 07120, Spain
| | - Carlos Javier Villafáfila-Gomila
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Balearic Islands, 07122, Spain
- Balearic Islands Health Services, Palma, Balearic Islands, 07003, Spain
- CurES Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, 07120, Spain
| | | | - Miguel Ángel Rodríguez-Calero
- CurES Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, 07120, Spain
- Quality Department, Torrecárdenas University Hospital, Almería, 04003, Spain
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Buffey AJ, Langley CK, Carson BP, Donnelly AE, Salsberg J. Participatory Approaches in the Context of Research Into Workplace Health Promotion to Improve Physical Activity Levels and Reduce Sedentary Behavior Among Office-Based Workers: Scoping Review. JMIR Public Health Surveill 2024; 10:e50195. [PMID: 38896458 PMCID: PMC11222769 DOI: 10.2196/50195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/06/2023] [Accepted: 02/15/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Participatory research (PR) involves engaging in cocreation with end users and relevant stakeholders throughout the research process, aiming to distribute power equitably between the end users and research team. Engagement and adherence in previous workplace health promotion (WHP) studies have been shown to be lacking. By implementing a PR approach, the insights of end users and stakeholders are sought in the co-design of feasible and acceptable intervention strategies, thereby increasing the relevance of the research. OBJECTIVE This scoping review aims to explore, identify, and map PR techniques and their impact when used in office-based WHP interventions designed to improve physical activity (PA) or reduce sedentary behavior (SB). METHODS The reporting of this scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). A systematic literature search of 5 electronic databases-Web of Science, PubMed, Scopus, Google Scholar, and OpenGrey-was conducted, searching from January 1, 1995, to February 8, 2023. In total, 2 independent reviewers first screened the retrieved articles by title and abstract, and then assessed the full texts based on the inclusion and exclusion criteria. The search strategy and eligibility criteria were developed and guided by an a priori population (office-based working adults), intervention (a PA WHP intervention that took a PR approach), comparison (no comparison required), and outcome (PA or SB) framework. Data were charted and discussed via a narrative synthesis, and a thematic analysis was conducted. The included studies were evaluated regarding the degree of end user engagement throughout the research process and power shared by the researchers, using Arnstein's ladder of citizen participation. RESULTS The search retrieved 376 records, of which 8 (2.1%) met the inclusion criteria. Four key strategies were identified: (1) end user focus groups, (2) management involvement, (3) researcher facilitators, and (4) workplace champions. The degree of engagement and power shared was relatively low, with 25% (2/8) of the studies determined to be nonparticipation studies, 25% (2/8) determined to be tokenistic, and 50% (4/8) determined to provide citizen power. CONCLUSIONS This review provides a foundation of evidence on the current practices when taking a PR approach, highlighting that previous office-based PA WHP studies have been largely tokenistic or nonparticipative, and identified that the end user is only engaged with in the conception and implementation of the WHP studies. However, a positive improvement in PA and reduction in SB were observed in the included studies, which were largely attributed to implementing a PR approach and including the end user in the design of the WHP intervention. Future studies should aim to collaborate with workplaces, building capacity and empowering the workforce by providing citizen control and letting the end users "own" the research for a sustainable WHP intervention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2021-054402.
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Affiliation(s)
- Aidan John Buffey
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Brian P Carson
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alan E Donnelly
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
- Public and Patient Involvement Research Unit, Health Research Institute, University of Limerick, Limerick, Ireland
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Jacobs J, Dougherty A, McCarn B, Saiyed NS, Ignoffo S, Wagener C, Miguel CS, Martinez L. Impact of a multi-disciplinary team-based care model for patients living with diabetes on health outcomes: a mixed-methods study. BMC Health Serv Res 2024; 24:746. [PMID: 38890705 PMCID: PMC11186232 DOI: 10.1186/s12913-024-11062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/30/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Individuals facing socioeconomic hardship experience higher than average rates of chronic disease, such as diabetes, with less access to evidence-based treatment. One solution to address these inequities is a team-based care (TBC) model, defined as one in which at least two providers work collaboratively with a patient and their caregiver(s) to make healthcare decisions. This paper seeks to describe the implementation of a TBC model within a safety-net healthcare setting and determine the extent to which it can be an effective, patient-centered approach to treating individuals with diabetes. METHODS Semi-structured interviews were conducted with staff (n = 15) and patients (n = 18). Clinical data were extracted from the electronic medical record of patients (n = 1,599) seen at a safety-net health system in Chicago, Illinois, United States. The mixed methods study was guided by implementation science and participatory research principles. Staff interviews were 60 min and covered patient care activities, work flow, perceived patient experience, and facilitators/barriers to care coordination. Patient interviews were 60 min and covered satisfaction, attitudes about diabetes management, quality of life, and technology. Patient interviews were co-analyzed by research staff and members of a patient advisory committee. Clinical data were collected at an index visit, two years prior and at one-year follow up (n = 1,599). RESULTS Four themes emerged from the interviews: (1) patients perceived the TBC model to be patient centered and of high quality; (2) technology can be an innovative tool, but barriers exist; (3) diabetes management is a complex process; and (4) staff communication enhances care coordination, but misinterpreting roles reduces care coordination. From pre-enrollment to the follow-up period, we found a statistically significant increase in missed visits, decrease in hemoglobin A1c (HbA1c), decrease in body mass index, and decrease in the percent of patients with high blood pressure. We found that each medical visit during the follow-up period was associated with an HbA1c decrease of 0.26 points. CONCLUSIONS A TBC model is a patient-centered approach to providing care to patients with complex health needs, such as diabetes, patients were satisfied with the care they were receiving, and the model was associated with an improvement in clinical outcomes.
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Affiliation(s)
- Jacquelyn Jacobs
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA.
| | - Alyn Dougherty
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
| | - Banita McCarn
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
| | - Nazia S Saiyed
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
| | - Stacy Ignoffo
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
| | | | - Cindy San Miguel
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
| | - Linda Martinez
- Sinai Urban Health Institute, 1500 South Fairfield Avenue, Chicago, IL, 60608, USA
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Granville-Chapman K, Lee MT, Ritchie-Dunham J. The Development of a New Model of Educational Leadership: Leadership for Teacher Flourishing. HUMANISTIC MANAGEMENT JOURNAL 2024; 9:247-267. [PMID: 39185249 PMCID: PMC11342232 DOI: 10.1007/s41463-024-00181-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/30/2024] [Indexed: 08/27/2024]
Abstract
This paper contributes to a broader movement in which the telos of leadership is flourishing, and the primary role of a leader is to promote the flourishing of their team members through creating a loving environment. In support of this, we propose a new perspective on, and associated model, of educational leadership: 'leadership for teacher flourishing' (LFTF). This model was developed through a literature review and a mixed methods research project across 78 British schools with collaborative and participatory elements which asked how school leaders could improve the flourishing of teachers. The quantitative and qualitative findings suggested that key factors in enabling teachers to flourish, and therefore incorporated into the model 'LFTF', were positive relationships; opportunities for growth; positive impact on subjective wellbeing; and increasing teachers' sense of meaning at work. The ways leaders could impact these factors were reported as: being supportive and compassionate; being trustworthy; giving teachers autonomy; enabling teachers to grow; being appreciative and focusing on strengths; and enabling teachers to do meaningful work. It was also found that not only leaders could influence flourishing; teachers with no formal leadership role could also positively impact teacher flourishing. It is suggested that virtuous dispositions in leaders are required to ensure they are consistent in acting in ways that promote flourishing. We argue that this integration of virtue and a desire to promote flourishing is properly understood as love. The participatory and collaborative phase of the research showed that teachers wanted autonomy in deciding what would help them to flourish. The conclusion sets out the implications of this research for policy on the training and selection of school leaders, to improve not only the flourishing of teachers, but also pupils and communities.
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Affiliation(s)
| | - Matthew T Lee
- Institute for Studies of Religion, Baylor University, One Bear Place #97236, Waco, TX 76798 USA
| | - James Ritchie-Dunham
- McCombs School of Business, University of Texas-Austin, 2110 Speedway, Austin, TX 78712 USA
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Howlett N, Fakoya O, Bontoft C, Simmons I, Miners L, Wagner AP, Brown K. A realist evaluation of community champion and participatory action approaches during the COVID-19 pandemic. Front Public Health 2024; 12:1355944. [PMID: 38939557 PMCID: PMC11208485 DOI: 10.3389/fpubh.2024.1355944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/22/2024] [Indexed: 06/29/2024] Open
Abstract
Background During the COVID-19 pandemic, public health teams tried several approaches to circulate accurate health information and engage with community members to understand what they need from public health services. Two such approaches were community champions and community participatory action research (CPAR). This study evaluates two champion programmes and a CPAR programme in terms of what worked, for whom, and in what contexts, including the funding and resourcing associated with implementation. Methods Between June 2022 and June 2023, a realist evaluation of three distinct case studies (COVID-19 champions, Vaccine Champions, and CPAR programmes) in the city of Southampton in England was conducted in three stages: development of initial programme theories and collection of additional contextual information, including funding and resources associated with delivering each programme; initial programme theory testing; synthesis of final programme theories. Data was collected primarily through semi-structured interviews (n = 29) across programme and training leads, voluntary services, community organisations, volunteers, and local community members, and one focus group with local community members (n = 8). Results The City Council used £642 k from two funding awards to deliver the programmes: COVID-19 Champions £41 k; Vaccine Champions £485 k; and CPAR programmes £115 k. Twenty-eight initial programme theories were generated, which were "tested" to support, refine, or refute context-mechanism-outcome relationships, resulting finally in a set of 22 programme theories across the three programmes. Six demi-regularities were generated, each featuring in multiple programme theories, and providing data on how and why these programmes can work, and in which contexts: (1) building trust through community connections; (2) fostering relationships and collaboration; (3) provision of training and resources; (4) local community knowledge and expertise; (5) community representation and leadership; (6) appropriate communication and information sharing. Conclusion This study provides new knowledge and understanding of the factors affecting the implementation of community champion and CPAR approaches during public health emergencies. These findings suggest that representation and involvement of community members, establishing and building on trust, adequate training and resources, and clear communication from trusted community members and organisations are catalysts for meaningful engagement with communities.Evaluation registration: Research Registry identifier: researchregistry8094.
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Affiliation(s)
- Neil Howlett
- Department of Psychology, Sport, and Geography, University of Hertfordshire, Hatfield, United Kingdom
| | - Olujoke Fakoya
- Department of Psychology, Sport, and Geography, University of Hertfordshire, Hatfield, United Kingdom
| | - Charis Bontoft
- Department of Psychology, Sport, and Geography, University of Hertfordshire, Hatfield, United Kingdom
| | - Isobel Simmons
- Department of Psychology, Sport, and Geography, University of Hertfordshire, Hatfield, United Kingdom
| | - Lisa Miners
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Adam P. Wagner
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Katherine Brown
- Department of Psychology, Sport, and Geography, University of Hertfordshire, Hatfield, United Kingdom
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Tran NT, Ali M, Azmat SK, Seuc A, Olaolorun FM, Awan MA, Morhason-Bello I, Thom EM, Martin J, Abubakar HD, Uzma Q, Kiarie J. Strengthening contraceptive counselling services to empower clients and meet their needs: protocol for a two-stage, multiphase complex intervention in Pakistan and Nigeria. BMJ Open 2024; 14:e081967. [PMID: 38839392 PMCID: PMC11163613 DOI: 10.1136/bmjopen-2023-081967] [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: 11/10/2023] [Accepted: 05/13/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND High-quality contraceptive counselling can accelerate global efforts to reduce the unmet need for and suboptimal use of modern contraceptives. This study aims to identify a package of interventions designed to strengthen in Pakistan and Nigeria and determine their effectiveness in increasing client-level decision-making, autonomy and meeting of contraceptive needs. METHODS A multisite, two-stage and five-phase intervention design will start with a pre-formative, formative, design, experimental and reflective phase. The pre-formative phase will map potential study sites and establish the sampling frame. The two-part formative phase will first use participatory approaches to identify clients' perspectives, including young couples and providers, to ensure research contextualisation and address each interest group's needs and priorities followed by clinical observations of client-provider encounters to document routine care. The design workshop in the third phase will result in the development of a package of contraceptive counselling interventions. In the fourth experimental phase, a multi-intervention, three-arm, single-blinded, parallel cluster randomised-controlled trial will compare routine care (arm 1) with the contraceptive counselling package (arm 2) and the same package combined with wider methods availability (arm 3). The study aims to enrol a total of 7920 participants. The reflective phase aims to identify implementation barriers and enablers. The outcomes are clients' level of decision-making autonomy and use of modern contraceptives. ETHICS AND DISSEMINATION Ethical approval for this study was obtained from the WHO Scientific and Ethics Review Committee (Protocol ID Pakistan: ERC 006232 and Nigeria ERC: 006523). Each study site is required and has obtained the necessary ethical and regulatory approvals that are required in each specific country. Findings will be presented at local, national and international conferences and disseminated by peer-review publications. TRIAL REGISTRATION NUMBER NCT06081842.
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Affiliation(s)
- Nguyen Toan Tran
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Moazzam Ali
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Syed Khurram Azmat
- APPNA-Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Armando Seuc
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Muhammad Ali Awan
- APPNA-Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Imran Morhason-Bello
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo, Nigeria
| | | | - Josepth Martin
- World Health Organization Country Office, Abuja, Nigeria
| | | | - Qudsia Uzma
- World Health Organization Country Office, Islamabad, Pakistan
| | - James Kiarie
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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19
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Ataman R, Ahmed S, Berta W, Thomas A. Sustainability of an outcome measure in outpatient stroke rehabilitation: A realist evaluation. J Eval Clin Pract 2024; 30:559-574. [PMID: 38361260 DOI: 10.1111/jep.13972] [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: 10/13/2023] [Accepted: 12/31/2023] [Indexed: 02/17/2024]
Abstract
RATIONALE Only half of newly implemented evidence-based practices are sustained. Though poor sustainment can lead to negative consequences for clinical teams, organizations and patients, the causal explanations of sustainment are largely unknown. AIMS AND OBJECTIVES We aimed to ascertain how (mechanisms) and in what circumstances (context) a newly implemented outcome measure in rehabilitation was sustained or not (outcome). METHODOLOGY Informed by an integrated knowledge translation approach, we conducted a realist evaluation using a mixed method, embedded single case study design with data collection up to 18 months following the implementation of the Mayo-Portland Adaptability Inventory - version 4 (MPAI-4), a rehabilitation outcome measure. Quantitative data (survey and patient charts) was analysed using descriptive statistics, then integrated with qualitative data (interviews with 10 key informants) and analysed using inductive and deductive retroduction. We integrated the data to develop a case description and ultimately, to refine the programme theory to better understand the sustainability of the MPAI-4. RESULTS We linked context, mechanisms and outcomes, and also emphasized sustainability strategies in 18 explanations of how sustainability works. These explanations provide evidence for four overarching patterns: (1) implementation and sustainability phases are interconnected, (2) outcomes build on each other recursively, with patient benefits as the keystone outcome, (3) sustainment is achieved to varying levels across different sustainability outcomes [e.g., high level (e.g., rate of MPAI-4 scoring: 77.7%) to low level (e.g., rate of MPAI-4 application to clinical decision-making: 3.7%)] and (4) the work of sustaining the MPAI-4 is shared amongst different stakeholders. CONCLUSION Implementation teams can draw from this programme theory to improve the sustainment of outcomes measures while researchers could continue to refine the theory. Continued investigation of sustainability, including diverse and continuous sustainability outcomes, is needed to understand how to maintain improvements in quality of care and patient outcomes.
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Affiliation(s)
- Rebecca Ataman
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Constance Lethbridge Rehabilitation Center, CIUSSS Centre-Ouest de l'Îile de Montreal, Montreal, Quebec, Canada
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | - Whitney Berta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
- Institute of Health Sciences Education, McGill University, Montréal, Québec, Canada
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20
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Gonella S, Di Giulio P, Riva-Rovedda F, Stella L, Rivolta MM, Malinverni E, Paleologo M, Di Vella G, Dimonte V. Supporting health and social care professionals in serious illness conversations: Development, validation, and preliminary evaluation of an educational booklet. PLoS One 2024; 19:e0304180. [PMID: 38820471 PMCID: PMC11142603 DOI: 10.1371/journal.pone.0304180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/08/2024] [Indexed: 06/02/2024] Open
Abstract
Serious illness conversations aim to align the care process with the goals and preferences of adult patients suffering from any advanced disease. They represent a challenge for healthcare professionals and require specific skills. Conversation guides consistent with task-centered instructional strategies may be particularly helpful to improve the quality of communication. This study aims to develop, validate, and preliminarily evaluate an educational booklet to support Italian social and healthcare professionals in serious illness conversations. A three-step approach, including development, validation, and evaluation, was followed. A co-creation process with meaningful stakeholders led to the development of the booklet, validated by 15 experts on clarity, completeness, coherence, and relevance. It underwent testing on readability (Gulpease index, 0 = lowest-100 = maximum) and design (Baker Able Leaflet Design criteria, 0 = worst to 32 = best). Twenty-two professionals with different scope of practice and care settings evaluated acceptability (acceptable if score ≥30), usefulness, feasibility to use (1 = not at all to 10 = extremely), and perceived acquired knowledge (1 = not at all to 5 = extremely). After four rounds of adjustments, the booklet scored 97% for relevance, 60 for readability, and 25/32 for design. In all, 18 (81.8%), 19 (86.4%) and 17 (77.3%) professionals deemed the booklet acceptable, moderate to highly useful, and feasible to use, respectively; 18/22 perceived gain in knowledge and all would recommend it to colleagues. The booklet has good readability, excellent design, high content validity, and a high degree of perceived usefulness and acquired knowledge. The booklet is tailored to users' priorities, mirrors their most frequent daily practice challenges, and offers 1-minute, 2-minute and 5-minute solutions for each scenario. The co-creation process ensured the development of an educational resource that could be useful regardless of the scope of practice and the care setting to support professionals in serious illness conversations.
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Affiliation(s)
- Silvia Gonella
- City of Health and Science University Hospital Turin, Turin, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | | | - Luigi Stella
- Fondazione Assistenza e Ricerca Oncologica (F.A.R.O.), Turin, Italy
| | | | | | - Mario Paleologo
- City of Health and Science University Hospital Turin, Turin, Italy
| | - Giancarlo Di Vella
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Valerio Dimonte
- City of Health and Science University Hospital Turin, Turin, Italy
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
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21
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Khanpoor H, Amerzadeh M, Alizadeh A, Khosravizadeh O, Rafiei S. Developing a community-responsive research model in the healthcare system: a mixed-method study. BMC Med Res Methodol 2024; 24:119. [PMID: 38796452 PMCID: PMC11128113 DOI: 10.1186/s12874-024-02250-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Responsiveness to the population's non-clinical needs encompasses various dimensions, including responsive research and an educational outreach plan at the community level. This study aims to develop a community-responsive research model in the healthcare system to ensure the connection between community-identified health priorities and research funds, as well as capacity-building efforts. METHODS A mixed-methods research study was conducted in three main phases, including a comprehensive literature review, a qualitative analysis of an expert panel's points of view, and the developing of a model using the Equation Modeling (SEM) technique. R software version 3.2.4 was used to conduct statistical analysis, considering a significance level of 0.05. RESULTS Based on the literature review, 41 responsiveness components were identified from sixteen relevant studies conducted between 2000 and 2022. Ten sub-themes in four major themes, including planning, implementation, monitoring and evaluation, and action, were identified through qualitative content analysis. Standardized coefficients revealed that components such as dissemination of results to all stakeholders, research prioritization aligned with community needs, commitment to implement research findings, and collaborative learning had statistically significant effects on the community-responsive research model. CONCLUSION It is essential to identify community health priorities by following a community-focused, priority-setting process based on the principles of community engagement to develop a community-responsive research model. Afterward, dissemination of research findings to all stakeholders, commitment to apply the obtained results in the real world, and promotion of shared learning among research partners have been proven to facilitate collaborative investigation and mutual understanding between the community and academic partners.
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Affiliation(s)
- Hooman Khanpoor
- Student Research Committee, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ahad Alizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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22
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Brown K, Lucassen MFG, Núñez-García A, Rimes KA, Wallace LM, Samra R. A Web-Based Intervention to Support the Mental Well-Being of Sexual and Gender Minority Young People: Mixed Methods Co-Design of Oneself. JMIR Form Res 2024; 8:e54586. [PMID: 38772025 DOI: 10.2196/54586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Sexual and gender minority youth are at greater risk of compromised mental health than their heterosexual and cisgender peers. This is considered to be due to an increased burden of stigma, discrimination, or bullying resulting in a heightened experience of daily stress. Given the increasing digital accessibility and a strong preference for web-based support among sexual and gender minority youth, digital interventions are a key means to provide support to maintain their well-being. OBJECTIVE This paper aims to explicate the co-design processes and underpinning logic of Oneself, a bespoke web-based intervention for sexual and gender minority youth. METHODS This study followed a 6-stage process set out by Hagen et al (identify, define, position, concept, create, and use), incorporating a systematic scoping review of existing evidence, focus groups with 4 stakeholder groups (ie, sexual and gender minority youth, professionals who directly support them, parents, and UK public health service commissioners), a series of co-design workshops and web-based consultations with sexual and gender minority youth, the appointment of a digital development company, and young adult sexual and gender minority contributors to create content grounded in authentic experiences. RESULTS Oneself features a welcome and home page, including a free accessible to all animation explaining the importance of using appropriate pronouns and the opportunity to create a user account and log-in to access further free content. Creating an account provides an opportunity (for the user and the research team) to record engagement, assess users' well-being, and track progress through the available content. There are three sections of content in Oneself focused on the priority topics identified through co-design: (1) coming out and doing so safely; (2) managing school, including homophobic, biphobic, or transphobic bullying or similar; and (3) dealing with parents and families, especially unsupportive family members, including parents or caregivers. Oneself's content focuses on identifying these as topic areas and providing potential resources to assist sexual and gender minority youth in coping with these areas. For instance, Oneself drew on therapeutic concepts such as cognitive reframing, stress reduction, and problem-solving techniques. There is also a section containing relaxation exercises, a section with links to other recommended support and resources, and a downloads section with more detailed techniques and strategies for improving well-being. CONCLUSIONS This study contributes to research by opening up the black box of intervention development. It shows how Oneself is underpinned by a logic that can support future development and evaluation and includes diverse co-designers. More interactive techniques to support well-being would be beneficial for further development. Additional content specific to a wider range of intersecting identities (such as care-experienced Asian sexual and gender minority youth from a minority faith background) would also be beneficial in future Oneself developments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/31036.
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Affiliation(s)
- Katherine Brown
- Centre for Research in Psychology and Sports Science, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Mathijs F G Lucassen
- School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Alicia Núñez-García
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
| | - Katharine A Rimes
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom
| | - Louise M Wallace
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
| | - Rajvinder Samra
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, United Kingdom
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23
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de Weger E, Drewes H, Luijkx K, Baan C. Tracking the Development of Community Engagement Over Time: Realist Qualitative Study. J Particip Med 2024; 16:e47500. [PMID: 38748458 PMCID: PMC11137424 DOI: 10.2196/47500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/30/2023] [Accepted: 11/12/2023] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND A growing interest in engaging communities in the development of health care services and communities has not automatically led to progress or consensus as to how to engage communities successfully, despite the evidence base showing how to leverage enablers and alleviate barriers. OBJECTIVE To bridge the gap between the evidence base and which community engagement (CE) approaches have actually been applied in practice over time, this study aims to investigate how CE approaches have changed over the past 4 years in 6 different regions in the Netherlands and citizens' and professionals' experiences underlying these changes. METHODS For the last stage of a multiple case study following the development of CE approaches in 6 different regions in the Netherlands, a realist qualitative case study was conducted. To investigate how CE approaches had changed over the past 4 years, data from the entire 4 years of the study were used, including documents, interview transcripts, and observations. To examine citizens' and professionals' experiences underlying these changes, new interviews were conducted. The latest interview results were discussed with a panel to ensure the results had face validity. RESULTS The regions had implemented different types of CE approaches over the past 4 years and were adapting these approaches over time. Many of the (remaining) approaches may be operating on a smaller scale. The study identified the following overarching themes along which CE had been adapted: fewer region-wide approaches and more community-focused approaches, more focus on building relationships with (already engaged) citizens and community-led initiatives, and more focus on practical and tangible health promotion and social cohesion activities and less focus on complex "abstract" programs. The study identified a further 4 overarching themes highlighting citizens' and professionals' experiences underlying these changes in the CE approaches: a lack of engagement environment, need for facilitative leadership from organizations, need for a clear and shared vision underscoring the importance of CE, and misalignment between citizens' and professionals' perspectives and motivations for CE. All participants had experienced the engagement environment as insufficient. To support CE, professionals experienced the need to develop and receive more facilitative leadership and to develop approaches better equipped to involve citizens in the decision-making process. Citizens experienced the need to better align citizens' and professionals' motivations and aims for CE approaches and to receive longer-term financial support for their community-led initiatives. CONCLUSIONS This study suggests that CE has not yet been embedded within organizational cultures. This has arguably meant that the (remaining) CE approaches are operating on a smaller scale. To enable the further development of CE approaches, an investment in the engagement environment and a shared vision is required. Only then could CE within the regions move beyond the more seemingly smaller-scale CE approaches.
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Affiliation(s)
- Esther de Weger
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Katrien Luijkx
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - Caroline Baan
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
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24
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Ramanadhan S, Alemán R, Bradley CD, Cruz JL, Safaeinili N, Simonds V, Aveling EL. Using Participatory Implementation Science to Advance Health Equity. Annu Rev Public Health 2024; 45:47-67. [PMID: 38109515 PMCID: PMC11251496 DOI: 10.1146/annurev-publhealth-060722-024251] [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: 12/20/2023]
Abstract
Participatory approaches to implementation science (IS) offer an inclusive, collaborative, and iterative perspective on implementing and sustaining evidence-based interventions (EBIs) to advance health equity. This review provides guidance on the principles and practice of participatory IS, which enables academic researchers, community members, implementers, and other actors to collaboratively integrate practice-, community-, and research-based evidence into public health and health care services. With a foundational focus on supporting academics in coproducing knowledge and action, participatory IS seeks to improve health, reduce inequity, and create transformational change. The three main sections of this review provide (a) a rationale for participatory approaches to research in implementation science, (b) a framework for integrating participatory approaches in research utilizing IS theory and methods, and (c) critical considerations for optimizing the practice and impact of participatory IS. Ultimately, participatory approaches can move IS activities beyond efforts to make EBIs work within harmful systems toward transformative solutions that reshape these systems to center equity.
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Affiliation(s)
- Shoba Ramanadhan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA;
| | - Rosa Alemán
- American Civil Liberties Union-Massachusetts, Boston, Massachusetts, USA
| | - Cory D Bradley
- Center for Dissemination and Implementation Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jennifer L Cruz
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA;
| | - Nadia Safaeinili
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Vanessa Simonds
- College of Education, Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Emma-Louise Aveling
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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25
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Mauricio AM, Garcia Y, Merelas S, Cioffi CC, McWhirter EH, Budd EL, Mueller MV, De Anda S, Rodriguez E, Leve LD. Community Partner Perceptions of Equitable Implementation Practices for a Promotores de Salud Intervention: A Qualitative Assessment. Am J Public Health 2024; 114:S377-S383. [PMID: 38776501 PMCID: PMC11111374 DOI: 10.2105/ajph.2024.307686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/25/2024]
Abstract
We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between August and October 2021. Results highlighted community partner perceptions of practices congruent (e.g., communication that built trust and dismantled power dynamics, a shared mission) and incongruent (e.g., intervention-community misalignment, research driven decision-making) with equitable implementation in the development, implementation, and evaluation of a promotores de salud intervention to increase COVID-19 testing and preventive behaviors among Latinx communities in Oregon. (Am J Public Health. 2024;114(S5):S377-S383. https://doi.org/10.2105/AJPH.2024.307686).
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Affiliation(s)
- Anne Marie Mauricio
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Yahaira Garcia
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Sophia Merelas
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Camille C Cioffi
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Ellen Hawley McWhirter
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Elizabeth L Budd
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Maryanne V Mueller
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Stephanie De Anda
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Elaine Rodriguez
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Leslie D Leve
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
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McGowan LJ, John DA, Kenny RPW, Joyes EC, Adams EA, Shabaninejad H, Richmond C, Beyer FR, Landes D, Watt RG, Sniehotta FF, Paisi M, Bambra C, Craig D, Kaner E, Ramsay SE. Improving oral health and related health behaviours (substance use, smoking, diet) in people with severe and multiple disadvantage: A systematic review of effectiveness and cost-effectiveness of interventions. PLoS One 2024; 19:e0298885. [PMID: 38635524 PMCID: PMC11025870 DOI: 10.1371/journal.pone.0298885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/31/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND People experiencing homelessness co-occurring with substance use or offending ('severe and multiple disadvantage' SMD) often have high levels of poor oral health and related health behaviours (particularly, substance use, smoking, poor diet). This systematic review aimed to assess the effectiveness and cost-effectiveness of interventions in adults experiencing SMD to improve oral health and related health behaviours. METHODS AND FINDINGS From inception to February 2023, five bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus) and grey literature were searched. Two researchers independently screened the search results. Randomized controlled trials (RCTs), comparative studies and economic evaluations were included that reported outcomes on oral health and the related health behaviours. Risk of bias was assessed and results narratively synthesized. Meta-analyses were performed where appropriate. This review was registered with PROSPERO (reg. no: CRD42020202416). Thirty-eight studies were included (published between 1991 and 2023) with 34 studies reporting about effectiveness. Most studies reported on substance use (n = 30). Interventions with a combination of housing support with substance use and mental health support such as contingent work therapy appeared to show some reduction in substance use in SMD groups. However, meta-analyses showed no statistically significant results. Most studies had short periods of follow-up and high attrition rates. Only one study reported on oral health; none reported on diet. Three RCTs reported on smoking, of which one comprising nicotine replacement with contingency management showed improved smoking abstinence at 4 weeks compared to control. Five studies with economic evaluations provided some evidence that interventions such as Housing First and enhanced support could be cost-effective in reducing substance use. CONCLUSION This review found that services such as housing combined with other healthcare services could be effective in improving health behaviours, particularly substance use, among SMD groups. Gaps in evidence also remain on oral health improvement, smoking, and diet. High quality studies on effectiveness with adequate power and retention are needed to address these significant health challenges in SMD populations.
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Affiliation(s)
- Laura J. McGowan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Deepti A. John
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ryan P. W. Kenny
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma C. Joyes
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma A. Adams
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Hosein Shabaninejad
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Catherine Richmond
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fiona R. Beyer
- Evidence Synthesis Group and Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - David Landes
- NHS England & Improvement, Newcastle Upon Tyne, United Kingdom
| | - Richard G. Watt
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Falko F. Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle Upon Tyne, United Kingdom
- Department of Public Health, Social and Preventive Medicine, Centre for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Martha Paisi
- Faculty of Medicine and Dentistry, Peninsula Dental School, University of Plymouth, Plymouth, United Kingdom
| | - Claire Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sheena E. Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Hubeishy MH, Rossen CB, Dannapfel P, Thomas K, Jensen TS, Maribo T, Rolving N. Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study. Implement Sci Commun 2024; 5:33. [PMID: 38570830 PMCID: PMC10993475 DOI: 10.1186/s43058-024-00568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/09/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Low back pain is still the leading cause of disability and societal burden, with 619 million prevalent cases worldwide in 2020. Most countries produce clinical guidelines to support healthcare professionals in evidence-based care regarding low back pain. However, several studies have identified relatively poor uptake of guidelines. Tailored strategies to facilitate the implementation of guidelines have been argued to increase uptake. This study aimed to develop a contextually tailored implementation programme to enhance evidence-based low back pain care among Danish physiotherapists and chiropractors in primary care. METHODS A theory-driven implementation programme development study was conducted using the Behaviour Change Wheel, with high healthcare professional involvement. Data collection included four workshops with seven physiotherapists and six chiropractors from primary care clinics. The development process consisted of [1] establishing a theoretical frame, [2] involving participants, [3] understanding the behaviour, [4] designing the implementation programme, and [5] final implementation programme. RESULTS The target behaviours selected (guideline recommendations) for the implementation programme were (i) screening of psychosocial risk factors and (ii) offering patient education. The barriers and facilitators for the selected behaviours were described and linked to intervention functions and behavioural techniques. Finally, the implementation programme comprised five strategies: webinars, e-learning videos, communication exercises, peer learning, and group dialogue meetings. In addition, the programme consisted of implementation support: champions, a physical material folder, a weekly email reminder, a specially designed website and a visit from an implementation consultant. An essential element of the overall programme was that it was designed as a step-by-step implementation process consisting of 16 h of education and training distributed over 16 weeks. CONCLUSIONS A programme for implementing low back pain guideline recommendations was developed based on behaviour change theory and four co-design workshops involving healthcare professionals to overcome the contextually identified barriers. A theory-driven approach involving healthcare professionals was useful in identifying relevant target behaviours and tailoring the programme to consider contextual barriers and facilitators for implementation. The effectiveness of the final implementation programme will be evaluated in the project's next phase. TRIAL REGISTRATION Central Denmark Region, Registered November 11, 2021, act no. 1-16-02-93-19.
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Affiliation(s)
- Maja Husted Hubeishy
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Hospital in Central Denmark Region, Falkevej 1-3, 8600, Silkeborg, Denmark.
- Department of Public Health, Aarhus University, Aarhus, Denmark.
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.
| | - Camilla Blach Rossen
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Hospital in Central Denmark Region, Falkevej 1-3, 8600, Silkeborg, Denmark
| | - Petra Dannapfel
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tue Secher Jensen
- Diagnostic Centre - Imaging Section, Silkeborg Regional Hospital, Silkeborg, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
| | - Nanna Rolving
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
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Hosseinabadi ZA, Raeisi AR, Amiresmaili M, Amini-Rarani M, Shaarbafchizadeh N. Developing a model of public health system strengthening during pandemic of new emerging respiratory diseases for Iran: A protocol study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:117. [PMID: 38726094 PMCID: PMC11081461 DOI: 10.4103/jehp.jehp_1320_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/25/2023] [Indexed: 05/12/2024]
Abstract
The objective of this article is to propose a protocol for developing a model for strengthening the public health system in Iran. Currently, there is no clearly articulated model for strengthening public health systems during the pandemic of new emerging respiratory diseases in Iran. The protocol described here aims to: (1) identify components for strengthening public health systems, during the pandemic of new emerging respiratory diseases worldwide, (2) identify components for strengthening Iran's public health system, and (3) design a model for strengthening the public health system in Iran during the pandemic of new emerging respiratory diseases. The protocol proposes three phases. In the first phase, a realistic review will be conducted to identify components for strengthening public health systems worldwide based on six building block framework. In the second phase, a qualitative study will be used to identify components for strengthening public health systems in Iran during the pandemic of new emerging respiratory diseases. In the third phase, an initial model will be designed, and the Delphi technique will be used to finalize the model. Due to fragility and the significant strain that public health systems experienced during the pandemic, it is imperative to introduce a model that strengthens public health systems through some initiatives and strategies and explains the mechanisms by which they operate. A realist review and qualitative study will provide the evidence needed to support the effective implementation of public health interventions, taking into consideration the diverse contexts of these interventions in Iran.
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Affiliation(s)
- Zahra Afshar Hosseinabadi
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Reza Raeisi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Amiresmaili
- Health in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Amini-Rarani
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Shaarbafchizadeh
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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MacKenzie NE, Chambers CT, Cassidy CE, Corkum PV, McGrady ME, Parker JA, Birnie KA. Understanding the unique and common perspectives of partners engaged in knowledge mobilization activities within pediatric pain management: a mixed methods study. BMC Health Serv Res 2024; 24:337. [PMID: 38486223 PMCID: PMC10938714 DOI: 10.1186/s12913-024-10782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/25/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Knowledge mobilization (KM) is essential to close the longstanding evidence to practice gap in pediatric pain management. Engaging various partners (i.e., those with expertise in a given topic area) in KM is best practice; however, little is known about how different partners engage and collaborate on KM activities. This mixed-methods study aimed to understand what different KM partner groups (i.e., health professionals, researchers, and patient/caregiver partners) perceive as supporting KM activities within pediatric pain management. METHODS This study used a convergent mixed-methods design. Ten partners from each of the three groups participated in interviews informed by the Consolidated Framework for Implementation Research, where they discussed what impacted KM activities within pediatric pain. Participants then rated and ranked select factors discussed in the interview. Transcripts were analyzed within each group using reflexive thematic analysis. Group-specific themes were then triangulated to identify convergence and divergence among groups. A matrix analysis was then conducted to generate meta-themes to describe overarching concepts. Quantitative data were analyzed using descriptive statistics. RESULTS Unique themes were developed within each partner group and further analysis generated four meta-themes: (1) team dynamics; (2) role of leadership; (3) policy influence; (4) social influence. There was full agreement among groups on the meaning of team dynamics. While there was partial agreement on the role of leadership, groups differed on who they described as taking on leadership positions. There was also partial agreement on policy influence, where health professionals and researchers described different institutions as being responsible for providing funding support. Finally, there was partial agreement on social influence, where the role of networks was seen as serving distinct purposes to support KM. Quantitative analyses indicated that partner groups shared similar priorities (e.g., team relationships, communication quality) when it came to supporting KM in pediatric pain. CONCLUSIONS While partners share many needs in common, there is also nuance in how they wish to be engaged in KM activities as well as the contexts in which they work. Strategies must be introduced to address these nuances to promote effective engagement in KM to increase the impact of evidence in pediatric pain.
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Affiliation(s)
- Nicole E MacKenzie
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, NS, B3H4J1, Canada.
- Centre for Pediatric Pain Research, IWK Health, Halifax, NS, Canada.
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, NS, B3H4J1, Canada
- Centre for Pediatric Pain Research, IWK Health, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Solutions for Kids in Pain, Halifax, NS, Canada
| | | | - Penny V Corkum
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, NS, B3H4J1, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Health, Halifax, NS, Canada
| | - Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Kathryn A Birnie
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford Street, Halifax, NS, B3H4J1, Canada
- Solutions for Kids in Pain, Halifax, NS, Canada
- Department of Anesthesiology, Perioperative, and Pain Medicine, and Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Fontaine G, Smith M, Langmuir T, Mekki K, Ghazal H, Noad EE, Buchan J, Dubey V, Patey AM, McCleary N, Gibson E, Wilson M, Alghamyan A, Zmytrovych K, Thompson K, Crawshaw J, Grimshaw JM, Arnason T, Brehaut J, Michie S, Brouwers M, Presseau J. One size doesn't fit all: methodological reflections in conducting community-based behavioural science research to tailor COVID-19 vaccination initiatives for public health priority populations. BMC Public Health 2024; 24:784. [PMID: 38481197 PMCID: PMC10936009 DOI: 10.1186/s12889-024-18270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs' response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology. METHODS The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods. RESULTS We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement. CONCLUSION Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.
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Affiliation(s)
- Guillaume Fontaine
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | | | - Tori Langmuir
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Karim Mekki
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | - Hanan Ghazal
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | | | - Judy Buchan
- Peel Public Health, 7120 Hurontario St, Mississauga, ON, L5W 1N4, Canada
| | - Vinita Dubey
- Toronto Public Health, City Hall, 100 Queen St W, Toronto, ON, M5H 2N2, Canada
| | - Andrea M Patey
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
- School of Rehabilitation Therapy, Queen's University, Louise D Acton Building, 31 George St, Kingston, ON, K7L 3N6, Canada
| | - Nicola McCleary
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Emily Gibson
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | - Mackenzie Wilson
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
| | | | | | | | - Jacob Crawshaw
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Jeremy M Grimshaw
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Trevor Arnason
- Ottawa Public Health, 100 Constellation Dr, Nepean, ON, K2G 6J8, Canada
| | - Jamie Brehaut
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Susan Michie
- Centre for Behaviour Change, University College London, Gower St, London, WC1E 6BT, UK
| | - Melissa Brouwers
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Justin Presseau
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
- School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Vanier Hall, Ottawa, ON, K1N 6N5, Canada.
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Subramanian HV, Canfield C, Shank DB. Designing explainable AI to improve human-AI team performance: A medical stakeholder-driven scoping review. Artif Intell Med 2024; 149:102780. [PMID: 38462282 DOI: 10.1016/j.artmed.2024.102780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/20/2023] [Accepted: 01/14/2024] [Indexed: 03/12/2024]
Abstract
The rise of complex AI systems in healthcare and other sectors has led to a growing area of research called Explainable AI (XAI) designed to increase transparency. In this area, quantitative and qualitative studies focus on improving user trust and task performance by providing system- and prediction-level XAI features. We analyze stakeholder engagement events (interviews and workshops) on the use of AI for kidney transplantation. From this we identify themes which we use to frame a scoping literature review on current XAI features. The stakeholder engagement process lasted over nine months covering three stakeholder group's workflows, determining where AI could intervene and assessing a mock XAI decision support system. Based on the stakeholder engagement, we identify four major themes relevant to designing XAI systems - 1) use of AI predictions, 2) information included in AI predictions, 3) personalization of AI predictions for individual differences, and 4) customizing AI predictions for specific cases. Using these themes, our scoping literature review finds that providing AI predictions before, during, or after decision-making could be beneficial depending on the complexity of the stakeholder's task. Additionally, expert stakeholders like surgeons prefer minimal to no XAI features, AI prediction, and uncertainty estimates for easy use cases. However, almost all stakeholders prefer to have optional XAI features to review when needed, especially in hard-to-predict cases. The literature also suggests that providing both system- and prediction-level information is necessary to build the user's mental model of the system appropriately. Although XAI features improve users' trust in the system, human-AI team performance is not always enhanced. Overall, stakeholders prefer to have agency over the XAI interface to control the level of information based on their needs and task complexity. We conclude with suggestions for future research, especially on customizing XAI features based on preferences and tasks.
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Affiliation(s)
- Harishankar V Subramanian
- Engineering Management & Systems Engineering, Missouri University of Science and Technology, 600 W 14(th) Street, Rolla, MO 65409, United States of America
| | - Casey Canfield
- Engineering Management & Systems Engineering, Missouri University of Science and Technology, 600 W 14(th) Street, Rolla, MO 65409, United States of America.
| | - Daniel B Shank
- Psychological Science, Missouri University of Science and Technology, 500 W 14(th) Street, Rolla, MO 65409, United States of America
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von Keyserlingk MAG, Hendricks J, Ventura B, Weary DM. Swine industry perspectives on the future of pig farming. Anim Welf 2024; 33:e7. [PMID: 38510419 PMCID: PMC10951666 DOI: 10.1017/awf.2024.2] [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: 09/15/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 03/22/2024]
Abstract
Understanding the views of those working along the value chain reliant on livestock is an important step in supporting the transition towards more sustainable farming systems. We recruited 31 delegates attending the Pig Welfare Symposium held in the United States to participate in one of six focus group discussions on the future of pig farming. Each of these six group discussions was subjected to a thematic analysis that identified four themes: (1) technical changes on the farm; (2) farm and industry culture; (3) the farm-public interface; and (4) sustainability. The results of this study illustrate the complexity and diversity of views of those working along the associated value chain within the swine industry. Participants spent the majority of their time discussing current challenges, including technical challenges on the farm and public perception of pig farms. Participants were more hesitant to discuss future issues, but did engage on the broader issue of sustainability, focusing upon economic and environmental aspects.
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Affiliation(s)
- Marina AG von Keyserlingk
- Animal Welfare Program, Faculty of Land and Food Systems, The University of British Columbia, 2357 Main Mall, Vancouver, BC, CanadaV6T 1Z4
| | - Jillian Hendricks
- Animal Welfare Program, Faculty of Land and Food Systems, The University of British Columbia, 2357 Main Mall, Vancouver, BC, CanadaV6T 1Z4
| | - Beth Ventura
- Department of Life Sciences, University of Lincoln, Lincoln, LincsLN6 7DL, UK
| | - Daniel M Weary
- Animal Welfare Program, Faculty of Land and Food Systems, The University of British Columbia, 2357 Main Mall, Vancouver, BC, CanadaV6T 1Z4
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Klingberg S, Adhikari B, Draper CE, Bosire E, Nyirenda D, Tiigah P, Mukumbang FC. Enhanced or hindered research benefits? A realist review of community engagement and participatory research practices for non-communicable disease prevention in low- and middle-income countries. BMJ Glob Health 2024; 9:e013712. [PMID: 38341191 PMCID: PMC10862340 DOI: 10.1136/bmjgh-2023-013712] [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: 08/15/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Community engagement and participatory research are widely used and considered important for ethical health research and interventions. Based on calls to unpack their complexity and observed biases in their favour, we conducted a realist review with a focus on non-communicable disease prevention. The aim was to generate an understanding of how and why engagement or participatory practices enhance or hinder the benefits of non-communicable disease research and interventions in low- and middle-income countries. METHODS We retroductively formulated theories based on existing literature and realist interviews. After initial searches, preliminary theories and a search strategy were developed. We searched three databases and screened records with a focus on theoretical and empirical relevance. Insights about contexts, strategies, mechanisms and outcomes were extracted and synthesised into six theories. Five realist interviews were conducted to complement literature-based theorising. The final synthesis included 17 quality-appraised articles describing 15 studies. RESULTS We developed six theories explaining how community engagement or participatory research practices either enhance or hinder the benefits of non-communicable disease research or interventions. Benefit-enhancing mechanisms include community members' agency being realised, a shared understanding of the benefits of health promotion, communities feeling empowered, and community members feeling solidarity and unity. Benefit-hindering mechanisms include community members' agency remaining unrealised and participation being driven by financial motives or reputational expectations. CONCLUSION Our review challenges assumptions about community engagement and participatory research being solely beneficial in the context of non-communicable disease prevention in low- and middle-income countries. We present both helpful and harmful pathways through which health and research outcomes are affected. Our practical recommendations relate to maximising benefits and minimising harm by addressing institutional inflexibility and researcher capabilities, managing expectations on research, promoting solidarity in solving public health challenges and sharing decision-making power.
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Affiliation(s)
- Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Bipin Adhikari
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Edna Bosire
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Deborah Nyirenda
- Community Engagement & Bioethics, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
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Juel A, Berring LL, Erlangsen A, Larsen ER, Buus N. Sense of psychological ownership in co-design processes: A case study. Health Expect 2024; 27:e13886. [PMID: 37890859 PMCID: PMC10726143 DOI: 10.1111/hex.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Service users are increasingly participating in health research. Although collaborative research is assumed to give users a sense of psychological ownership, little is known about the specific psychosocial processes through which ownership develops and is displayed. The present study yields insight into a process in which service users, researchers and a website designer collaborated to design a website. AIM The aim of this study was to explore how participants developed and displayed feelings of ownership during a collaborative process to design a website. METHODS A case study design was adopted by which audio recordings were subjected to thematic analysis and interpreted by drawing on the concept of psychological ownership. FINDINGS A sense of psychological ownership of the website design process emerged in two distinct and overlapping phases. In the first phase, 'sense of ownership during the early design phase', only researchers and the website designer displayed a sense of ownership, which was facilitated by the research context preceding the collaborative workshops. In the second phase, 'sense of ownership during the collaborative design phase', service users gradually started to develop parallel feelings of ownership that were facilitated by workshop design activities. These activities enabled service users to increasingly control the process, to invest themselves in the process and to gain intimate knowledge of the process and its outcome. Service users' sense of ownership was displayed in their statements about the website and its elements. CONCLUSION Participants engaged in codesign processes may develop a sense of psychological ownership at different speeds because of contextual factors. It is important to take this into account as it may complicate the formation of egalitarian work groups. PATIENT AND PUBLIC CONTRIBUTION Parents of children with suicidal behaviour and a counsellor participated as service users in a website design process.
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Affiliation(s)
- Anette Juel
- Psychiatric Research UnitPsychiatry Region ZealandSlagelseDenmark
- Mental Health Centre CopenhagenDanish Research Institute for Suicide PreventionHellerupDenmark
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Lene L. Berring
- Psychiatric Research UnitPsychiatry Region ZealandSlagelseDenmark
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Annette Erlangsen
- Mental Health Centre CopenhagenDanish Research Institute for Suicide PreventionHellerupDenmark
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center of Mental Health ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
- Copenhagen Research Center for Mental HealthMental Health Centre CopenhagenHellerupDenmark
| | - Erik R. Larsen
- Translational Neuropsychiatry Unit, Department of Clinical MedicineAarhus UniversityAarhus NuDenmark
| | - Niels Buus
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and HealthMonash UniversityClaytonVictoriaAustralia
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Gilfoyle M, MacFarlane A, Hughes Z, Salsberg J. Understanding the evolution of trust in a participatory health research partnership: A qualitative study. Health Expect 2024; 27:e13918. [PMID: 38031384 PMCID: PMC10726269 DOI: 10.1111/hex.13918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/03/2023] [Accepted: 11/12/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Advancements in evaluating the impact of participatory health research (PHR) have been made through comprehensive models like the community-based participatory research (CBPR) conceptual model, which provides a useful framework for exploring how context and partnership processes can influence health research design and interventions. However, challenges in operationalising aspects of the model limit our understanding and evaluation of the PHR process. Trust is frequently identified as an important component of the CBPR model, which supports the development of key partnership outcomes, such as partnership synergy. However, trust continues to be limited to a binary view (as present or absent), which is problematic given its inherently dynamic and temporal nature. STUDY AIM The aim of this qualitative study is to understand the evolution of trust in the national public and patient involvement (PPI) network in Ireland. SETTING AND PARTICIPANTS Participants from the PPI network (n = 15/21) completed a semistructured interview discussing the evolution of trust by reviewing four social network maps derived from a previous longitudinal study. ANALYSIS Following Braun and Clarke, we used reflexive thematic analysis, to iteratively develop, analyse and interpret our mediated reflection of the data. RESULTS Participants described the evolution of trust as a function of three contextual factors: (1) the set-up and organisation of the network, (2) how people work together and (3) reflection on the process and outcomes. Their descriptions across these themes seemed to vary depending on partnership type with National Partners and Site Leads having more opportunities to demonstrate trust (e.g., via leadership roles or more resources), compared to Local. Thus, visibility and the opportunity to be visible, depending on the set-up and organisation of the network and how people work together, seemingly play an important role in the evolution of trust over time. Based on these findings, we provide important questions for reflection across themes that could be considered for future PHR partnerships. DISCUSSION Given that the opportunity and visibility to build and maintain trust over time may not be equally available to all partners, it is important to find ways to invest in and commit to equitable relationships as the key to the success (i.e., longevity) of partnerships. We reflect on/offer important implications for those engaging in PHR partnerships and those who fund such research. PATIENT OR PUBLIC CONTRIBUTION A Research Advisory Group comprising four research partners (representing academic, service and community organisations) from the PPI Ignite Network provided input and approval for the research objectives of this study as well as previously published work informing this study. Informal consultation occurred with members of this group to discuss findings from this study, assisting with the way findings are presented and described, to be accessible for diverse audiences. Two Research Advisory Group members were involved in the interpretation of the results, and one is a co-author of this manuscript (Zoe Hughes).
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Affiliation(s)
- Meghan Gilfoyle
- Health Research Institute (HRI)University of LimerickLimerickIreland
- Public and Patient Involvement Research UnitUniversity of LimerickLimerickIreland
| | - Anne MacFarlane
- Health Research Institute (HRI)University of LimerickLimerickIreland
- Public and Patient Involvement Research UnitUniversity of LimerickLimerickIreland
| | | | - Jon Salsberg
- Health Research Institute (HRI)University of LimerickLimerickIreland
- Public and Patient Involvement Research UnitUniversity of LimerickLimerickIreland
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Layani G, Tremblay A, Lussier MT, Godbout I, Bihan H, Gosselin C, Pierre M, Motulsky A, Brault I, Rodrigues I, Kaczorowski J, Vanier MC, Yapi SM. Cross-Sector Collaboration to Improve Access to Community Services for People Living With Diabetes: Contributions From Actor-Network Theory. Health Serv Insights 2024; 17:11786329231222408. [PMID: 38288094 PMCID: PMC10823851 DOI: 10.1177/11786329231222408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/07/2023] [Indexed: 01/31/2024] Open
Abstract
Diabetes is a global public health issue. The Public Health Agency of Canada published a Diabetes Framework 2022 which recommends collaborative work across sectors to mitigate the impact of diabetes on health and quality of life. Since 2020, the INMED-COMMUNITY pathway has been implemented in Laval, Québec developing collaboration between healthcare and community sectors through a participatory action research approach. The aim of this article is to gain a better understanding of the INMED-COMMUNITY pathway implementation process, based on the mobilization of network actor theory. Qualitative analysis of semi-structured interviews conducted from January to March 2023 with 12 participants from 3 different sectors (community, health system, research), were carried out using actor-network theory. The results explored the conditions for effective intersectoral collaboration in a participatory action research approach to implement the INMED-COMMUNITY pathway. These were: (1) contextualization of the project, (2) a consultation approach involving various stakeholders, (3) creation of new partnerships, (4) presence of a project coordinator, and (5) mobilization of stakeholders around a common definition of diabetes. Mediation supported by a project coordinator contributed to the implementation of an intersectoral collaborative health intervention, largely due to early identification of controversies.
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Affiliation(s)
- Géraldine Layani
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada
- Research Centre of the University of Montreal, Montréal, QC, Canada
- Pôle 1, Centre de recherche des pratiques cliniques et organisationnelles du Centre intégré de santé et de services sociaux de Laval, Laval, QC, Canada
| | | | - Marie-Thérèse Lussier
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada
- Research Centre of the University of Montreal, Montréal, QC, Canada
| | | | - Hélène Bihan
- Avicenne hospital, Bobigny, France
- Health Education and Practices Laboratory, Université Paris 13, Paris, France
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | - Claire Gosselin
- Research Centre of the University of Montreal, Montréal, QC, Canada
| | - Mégane Pierre
- Research Centre of the University of Montreal, Montréal, QC, Canada
| | - Aude Motulsky
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Department of Management, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Isabelle Brault
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Department of Management, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Isabel Rodrigues
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada
- Pôle 1, Centre de recherche des pratiques cliniques et organisationnelles du Centre intégré de santé et de services sociaux de Laval, Laval, QC, Canada
| | - Janusz Kaczorowski
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada
- Research Centre of the University of Montreal, Montréal, QC, Canada
| | - Marie-Claude Vanier
- Pôle 1, Centre de recherche des pratiques cliniques et organisationnelles du Centre intégré de santé et de services sociaux de Laval, Laval, QC, Canada
- Health Education and Practices Laboratory, Université Paris 13, Paris, France
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
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Orfin RH, Siddalingaiah S, Dontu V, Estrada B, Martinez C, Guerra D, Carrillo H, Cervantes-Díaz MJ, Rodríguez-Rojas DV, Rahman I, McIntosh S, Ossip DJ, Cupertino AP, Cartujano-Barrera F. Development of a Vaping Cessation Text Messaging Intervention for Latino Young Adults: A Participatory Research Approach. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X231225928. [PMID: 38183157 DOI: 10.1177/2752535x231225928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
OBJECTIVE Describe the participatory research procedures of developing Kick Vaping, a vaping cessation text messaging intervention for Latino young adults, available in English and Spanish. METHODS Using community-based recruitment strategies, we convened a Community Advisory Board (CAB) of eight Latino young adults (ages 18-25) with different vaping experiences (never users, ex-users, and current users of e-cigarettes). Members held a series of working meetings to adapt Decídetexto, a smoking cessation text messaging intervention, for vaping cessation. Members provided iterative feedback on the text messages until reaching a consensus on content. Messages were translated from English to Spanish following a committee approach. Readability assessments were used to evaluate the legibility of the text messages. RESULTS At baseline, members' mean age was 22.6 years old (SD 3.1), 75% were female, and 50% used both English and Spanish equally. Three members (37.5%) were ex-users and one member (12.5%) was a current user of e-cigarettes. 18 meetings provided sufficient opportunities for iterative feedback on the text messages for developing the intervention. The Kick Vaping intervention consists of 208 text messages. Readability scores of the text messages in English were equivalent to fourth and fifth grade, and in Spanish were equivalent to easy and somewhat easy. CONCLUSION It is feasible and practical to build participatory research among Latino young adults focused on vaping cessation. Members of the CAB added innovation and creativity to the development of the vaping cessation text messaging intervention. Future research is needed to evaluate the impact of the intervention on vaping cessation.
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Affiliation(s)
- Rafael H Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Simran Siddalingaiah
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Vignya Dontu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Bianca Estrada
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Chabeli Martinez
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Darcy Guerra
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Hanzell Carrillo
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - María José Cervantes-Díaz
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico
- Residencia de Medicina Preventiva, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Irfan Rahman
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
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García-Egea A, Holst AS, Jacques-Aviñó C, Martínez-Bueno C, Berenguera A, Vicente-Hernández MM, Valls-Llobet C, Pinzón-Sanabria D, Pujolar-Díaz G, Medina-Perucha L. Perspectives on menstrual policymaking and community-based actions in Catalonia (Spain): a qualitative study. Reprod Health 2024; 21:1. [PMID: 38178256 PMCID: PMC10768382 DOI: 10.1186/s12978-023-01730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Menstrual research and policymaking have become imperative worldwide. It is necessary that these are informed by women and people who menstruate (PWM) alongside expert professionals and activists. METHODS The main aim of this study was to identify and propose policies and community-based actions to address menstrual inequity and promote menstrual health in Catalonia (Spain). This study consisted of two qualitative studies: (a) 34 individual photoelicitation interviews with women and PWM, (b) a World Café study with 22 professionals and activists. Sampling for both studies was purposive and selective. Recruitment was conducted through healthcare centres, social media, key contacts, and snowball sampling techniques. Data were collected in December 2020-September 2022, and analysed using Framework Analysis. RESULTS Participants considered the implementation of menstrual policies that address the taboo and stigma of menstruation to be crucial. They stressed the need for menstrual education, which should be integrated into formal education curricula. Participants, and especially women and PWM, highlighted the need to improve the access and quality of healthcare services, so that the menstrual cycle and menstruation are seen as health indicators. Health professionals should encourage agentic informed decisions, hence why both participant groups considered menstrual health education amongst health professionals to be pivotal. Taking action to improve the access and affordability of menstrual products was also imperative for participants, especially for socioeconomically vulnerable populations. Participants agreed on guaranteeing fully equipped menstrual management facilities, and and professionals discussed gender-neutral and sex-segregated bathrooms. Workplace menstrual policies to accommodate and ensure menstrual self-care were also suggested. CONCLUSIONS Our study highlights the need for multi-dimensional menstrual policies. These should include actions to address menstrual taboo and stigma, to promote menstrual education that goes beyond the hegemonic biomedical prism, to improve the access and quality of menstrual health services, along with policies ensuring adequate menstrual management facilities in public spaces and the access to menstrual products. Policymaking should also focus on how to ensure menstrual management and care in workplaces. Menstrual policies and community-based actions should be framed within intersectionality, to consider how societal structures of power and oppression influence menstrual experiences.
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Affiliation(s)
- Andrea García-Egea
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Anna Sofie Holst
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Cristina Martínez-Bueno
- Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Anna Berenguera
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Departament d'Infermeria, Universitat de Girona, Girona, Spain
| | | | | | | | - Georgina Pujolar-Díaz
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Laura Medina-Perucha
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Gran Via de les Corts Catalanes 587 attic, 08007, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain.
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Conte KP, Laycock A, Bailie J, Walke E, Onnis LA, Feeney L, Langham E, Cunningham F, Matthews V, Bailie R. Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health. Health Res Policy Syst 2024; 22:3. [PMID: 38172892 PMCID: PMC10765661 DOI: 10.1186/s12961-023-01087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Despite that stakeholder participation in evidence synthesis could result in more useful outcomes, there are few examples of processes that actively involve them in synthesis work. Techniques are needed that engage diverse stakeholders as equal partners in knowledge co-production. The aims of this paper are to describe an innovative participatory process of synthesising a large body of academic research products and compare the findings of the participatory process against two traditional approaches to synthesis: a rapid review and a structured review. METHODS First, a rapid synthesis of all research outputs (n = 86) was conducted by researchers with in-depth knowledge of the collaboration's research. Second, a team of researchers and service providers conducted a structured synthesis of seventy-eight peer-reviewed articles and reports generated by the collaboration. Fifty-five publications were brought forward for further synthesis in part three, a facilitated participatory synthesis. Finally, we explored the value added by the participatory method by comparing findings generated across the three synthesis approaches. RESULTS Twelve researchers and 11 service providers/policy partners-8 self-identified as Aboriginal and/or Torres Strait Islander-participated in two facilitated workshops (totalling 4 h). Workshop activities engaged participants in reviewing publication summaries, identifying key findings, and evoked review, discussion and refinement. The process explicitly linked experiential knowledge to citations of academic research, clearly connecting the two knowledge types. In comparing the findings generated across all three methods we found mostly consistencies; the few discrepancies did not contradict but gave deeper insights into statements created by the other methods. The participatory synthesis generated the most, detailed, and unique findings, and contextual insights about the relevance of the key messages for practice. CONCLUSION The participatory synthesis engaged stakeholders with diverse backgrounds and skillsets in synthesising a large body of evidence in a relatively short time. The participatory approach produced findings comparable to traditional synthesis methods while extending knowledge and identifying lessons most relevant for the participants who, ultimately, are the end users of the research. This process will interest other large-scale research collaborations seeking to engage stakeholders in evidence synthesis.
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Affiliation(s)
- Kathleen P Conte
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia.
- Oregon Health Sciences University-Portland State University School of Public Health, Portland State University, Portland, USA.
| | - Alison Laycock
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
- School of Public Health, The University of Sydney, Camperdown, Australia
| | - Emma Walke
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Leigh-Ann Onnis
- College of Business, Law and Governance, James Cook University, Cairns, Australia
| | - Lynette Feeney
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Erika Langham
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Australia
| | - Frances Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Ross Bailie
- Sydney Medical School, The University of Sydney, Camperdown, Australia
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Hwang JHA, Downing MG, Specht RAG, Ponsford JL. Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit. BRAIN IMPAIR 2024; 25:IB23068. [PMID: 38566291 DOI: 10.1071/ib23068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/24/2023] [Indexed: 04/04/2024]
Abstract
Background Persistent changes in sexuality often follow traumatic brain injury (TBI). However, health professionals remain reticent about discussing sexuality and have reported barriers including uncertainties around whose role it is and limited educational and institutional support. This study employed a co-design and implementation process, aiming to promote team-wide behavioural change, whereby health professionals at a TBI rehabilitation unit would attempt to address sexuality with patients routinely. Methods Focus group sessions with multidisciplinary health professionals were conducted to identify barriers and enablers to behavioural change, identify areas for development, and co-design intervention options. Implementation deliverables were then finalised and provided to the team. The Theoretical Domains Framework was used to map factors influencing behaviours and the Behaviour Change Wheel was used to map interventions. Thematic analysis was used to further analyse barrier themes. Results Thirty-five barriers and eight enablers falling within 12 theoretical domains to behavioural change were identified. Thematic analysis revealed highly correlated barriers in initiating and sustaining change. Nine co-designed intervention options aligned with five intervention functions of the Behaviour Change Wheel, resulting in six final implementation deliverables. Conclusions Barriers were highly interrelated, influencing the approach to implementation deliverables. Simultaneously addressing multiple barriers could potentially alleviate discomfort associated with discussing sexuality. Concerns around initiating change were related to confidence in achieving sustainable changes. Achieving change requires organisational and team-level environmental restructuring and enablement. The next step involves evaluating the effectiveness of the co-design and implementation process in driving behavioural change and potential impacts on patient satisfaction and sexuality outcomes.
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Affiliation(s)
- Jill H A Hwang
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
| | - Marina G Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
| | - Riccarda A G Specht
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Vic. 3121, Australia; and Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Vic. 3121 Australia
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Brooks A, Young G, Misyak S, Johnson ML, Serrano E. Contextual Factors Influencing the Adoption of Physical Activity Direct Education and Policy, Systems, and Environmental Change Initiatives by Virginia EFNEP and SNAP-Ed Staff. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:35-42. [PMID: 38032565 DOI: 10.1016/j.jneb.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program-eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff. METHODS Online survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables. RESULTS The main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE. CONCLUSIONS AND IMPLICATIONS The results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs.
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Affiliation(s)
- Austin Brooks
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Gabrielle Young
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Sarah Misyak
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Meredith Ledlie Johnson
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Elena Serrano
- Virginia Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
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Leach C, Jankowski TB. Older Adults as Key Assets in a Community-Based Participatory Needs Assessment: How Partnering With Older Residents Improves Local Aging Policy and Practice. Gerontol Geriatr Med 2024; 10:23337214241234237. [PMID: 38505742 PMCID: PMC10949539 DOI: 10.1177/23337214241234237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 01/20/2024] [Accepted: 01/29/2024] [Indexed: 03/21/2024] Open
Abstract
Older adults are often overlooked in decision making processes despite the detrimental effects on their well-being. The representation of older adults in investigations and initiatives is needed so that the issues they face, today and in the future, can be resolved through partnership and their active involvement. The aim of this article is to describe a participatory process for conducting a needs assessment (NA) and the contributions and opportunities of partnering with older adults to shape community services and support for older adults. Data were collected from 1,863 participants in a midwestern county via focus groups, interviews, and surveys. We describe how participatory principles were enacted, the involvement of older adults influenced the design and contributed to making sure hard-to-reach residents' voices were included. Finally, we discuss the ways in which a community inclusive multi-method strategy can optimize resource allocation, identify pathways to more effective policymaking that is matched to the needs and interests of its oldest residents, and lead to unanticipated benefits. Single method, non-inclusive approaches can obscure the critical context and exclude perspectives of the most burdened and vulnerable, who are most in need of support from their community.
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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Moser C, Nowell L, Goertzen A, Swain L, Pfadenhauer LM, Sibley KM, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. A scoping review of the globally available tools for assessing health research partnership outcomes and impacts. Health Res Policy Syst 2023; 21:139. [PMID: 38129871 PMCID: PMC10740226 DOI: 10.1186/s12961-023-00958-y] [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: 02/20/2022] [Accepted: 01/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their outcomes and impacts through systematic study. OBJECTIVE To locate and identify globally available tools for assessing the outcomes and impacts of health research partnerships. METHODS We searched four electronic databases (Ovid MEDLINE, Embase, CINAHL + , PsychINFO) with an a priori strategy from inception to June 2021, without limits. We screened studies independently and in duplicate, keeping only those involving a health research partnership and the development, use and/or assessment of tools to evaluate partnership outcomes and impacts. Reviewer disagreements were resolved by consensus. Study, tool and partnership characteristics, and emerging research questions, gaps and key recommendations were synthesized using descriptive statistics and thematic analysis. RESULTS We screened 36 027 de-duplicated citations, reviewed 2784 papers in full text, and kept 166 studies and three companion reports. Most studies originated in North America and were published in English after 2015. Most of the 205 tools we identified were questionnaires and surveys targeting researchers, patients and public/community members. While tools were comprehensive and usable, most were designed for single use and lacked validity or reliability evidence. Challenges associated with the interchange and definition of terms (i.e., outcomes, impacts, tool type) were common and may obscure partnership measurement and comparison. Very few of the tools identified in this study overlapped with tools identified by other, similar reviews. Partnership tool development, refinement and evaluation, including tool measurement and optimization, are key areas for future tools-related research. CONCLUSION This large scoping review identified numerous, single-use tools that require further development and testing to improve their psychometric and scientific qualities. The review also confirmed that the health partnership research domain and its measurement tools are still nascent and actively evolving. Dedicated efforts and resources are required to better understand health research partnerships, partnership optimization and partnership measurement and evaluation using valid, reliable and practical tools that meet partners' needs.
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Affiliation(s)
- Kelly J Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada.
| | - Jamie M Boyd
- Knowledge Translation Program, St Michael's Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Sumair Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sera Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Masood Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Cheryl Moser
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Amelia Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Liam Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, and Epidemiology-IBE, Ludwig-Maximilians Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kathryn M Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | | | - Michael D Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10-3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Marcello Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB, Canada
| | - Ian D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Schools of Epidemiology and Public Health and Nursing, University of Ottawa, Ottawa, ON, Canada
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Archibald MM. Co-implementation: collaborative and concurrent approaches to advance embedded implementation in the health sciences. FRONTIERS IN HEALTH SERVICES 2023; 3:1068297. [PMID: 38174215 PMCID: PMC10761409 DOI: 10.3389/frhs.2023.1068297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
There is a global movement towards stakeholder engagement in healthcare research. This movement has been catalyzed by a need to create context relevant evidence of maximal utility to health service provision and policy. The concept of "co-implementation" has potential to inform and extend these discussions of partnership and to complement the growing literature on collaborative implementation. Attending to this concept may preempt conceptual confusion and provide opportunities for sustainable and context-responsive embedded research necessary for the strengthening of health systems. In this perspective article, I seek to advance the discussion of co-implementation through an examination of the concept and through consideration of it merits to the health sciences.
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Affiliation(s)
- Mandy M. Archibald
- Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, MB, Canada
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Horne M, Youell J, Brown Wilson C, Brown L, Simpson P, Dickinson T. Using participatory research to co-produce an education and training e-resource to support care home staff to meet the sexuality, intimacy and relationship needs of care home residents with and without dementia. FRONTIERS IN DEMENTIA 2023; 2:1235517. [PMID: 39081975 PMCID: PMC11285635 DOI: 10.3389/frdem.2023.1235517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/24/2023] [Indexed: 08/02/2024]
Abstract
Aim To present the methodological approach and research methods chosen in a research study designed to enable the collaborative creation of an education and training e-resource designed to facilitate and support care home staff to address the sexuality, intimacy and relationship needs of older care home residents. Design Co-production using community-based participatory approach. Methods Four participatory workshops with care home staff, residents and their significant others. Results Workshops 1 and 2 identified and developed real-world case scenarios related to sexuality, intimacy and relationship needs and identified care staff training needs in this area. Then workshop 3 provided valuable feedback on the prototype training e-resource, and the final workshop identified care home staff engagement with and implementation of the e-resource in practice. Conclusion The findings provide evidence that using participatory approaches, such as co-production, to develop education and training resources in a sensitive subject area with care home residents, significant others, carers and care home staff, was a useful approach in engaging a vulnerable population group, in a sensitive area. However, this approach is not without challenges in care home communities.
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Affiliation(s)
- Maria Horne
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, United Kingdom
| | - Jane Youell
- Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds, United Kingdom
| | | | - Laura Brown
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Paul Simpson
- School of Social Sciences, University of Manchester, Manchester, United Kingdom
| | - Tommy Dickinson
- Department of Mental Health Nursing, Kings College London, London, United Kingdom
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Ferra F, Drewelow E, Klein O, Daum M, Walde P, Gerullis K, Kilimann I, Tomlin J, Teipel S, Völlm B. Implementation and evaluation of participatory advisory boards in mental health research: a research protocol of the 'PART-Beirat' project. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:112. [PMID: 38057888 DOI: 10.1186/s40900-023-00522-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND The use of participatory research approaches in the field of dementia and forensic mental health research has been on the rise. Advisory board structures, involving people with lived experience (PWLE), have frequently been used for guiding and leading research. Yet, there has been limited guidance on the establishment, retention and use of advisory boards in the field of dementia and forensic mental health research. OBJECTIVE This project outlined in this research protocol will investigate the benefits and challenges of establishing three patient advisory boards, involving PWLE, practitioners and researchers with the purpose to guide research. Data will be used to develop guidelines for best practice in involving PWLE in dementia and forensic mental health research through advisory boards. METHODS The research project will be divided into three phases: Phase I will involve two topic-specific systematic reviews on the use of participatory research with PWLE, followed by an initial study exploring PWLE's, practitioners' and researchers' expectations on research involvement. Phase II will consist of the establishment of three advisory boards, one focusing on dementia, one on forensic mental health and one overarching coordinating advisory board, which will involve PWLE from both fields. Phase III, will consist of interviews and focus groups with advisory board members, exploring any challenges and benefits of involving PWLE and practitioners in advisory boards for guiding research. To capture the impact of involving PWLE in different research phases and tasks, interviews and focus groups will be conducted at four different points of time (0, 6, 12, 18 months). Reflexive thematic analysis will be used for the analysis of data. DISCUSSION The project aims to explore the involvement of PWLE and practitioners in guiding research and aims to develop guidelines for best practice in establishing and using patient advisory boards in dementia and forensic mental health research and involving PWLE and practitioners in research.
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Affiliation(s)
- Fenia Ferra
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany.
| | - Eva Drewelow
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany
| | - Olga Klein
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Marcel Daum
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Peggy Walde
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany
| | - Kai Gerullis
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany
| | - Ingo Kilimann
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Jack Tomlin
- School of Law and Criminology, University of Greenwich, London, UK
| | - Stefan Teipel
- Deutsches Zentrum Für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Birgit Völlm
- Clinic of Forensic Psychiatry, Rostock University Medical Centre, Rostock, Germany
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Padley N, Moubayed D, Lanteigne A, Ouimet F, Clermont MJ, Fournier A, Racine E. Transition from Paediatric to adult health services: Aspirations and practices of human flourishing. Int J Qual Stud Health Well-being 2023; 18:2278904. [PMID: 37994797 PMCID: PMC11000676 DOI: 10.1080/17482631.2023.2278904] [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: 02/13/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Transition from paediatric to adult care is challenging for youths with a chronic condition. Most transition programmes place high value in autonomy and independence. We undertook a qualitative study to: (1) identify the needs and aspirations of youths and (2) better understand the well-being and flourishing of youths. METHODS Semi-structured interviews were conducted with youths, parents of youths and healthcare professionals recruited from four clinics. Thematic analysis focused on: (1) perceptions of transition; (2) key aspects of human flourishing during transition; and (3) salient concerns with respect to the transition and dimensions of human flourishing. RESULTS 54 interviews were conducted. Perceptions of transition clustered around: (1) apprehension about adult care; (2) lack of clarity about the transition process; (3) emotional attachment to paediatric healthcare professionals; (4) the significance of the coinciding transition into adulthood. Fourteen salient concerns (e.g., Knowledge and information about the transition, Parental involvement in healthcare) were identified with corresponding recommendations. Salient concerns related to important dimensions of human flourishing (e.g., environmental mastery, autonomy). DISCUSSION AND CONCLUSION The flourishing of youths is affected by suboptimal transition practices. We discuss the implications of our findings for environmental mastery, contextual autonomy, and the holistic and humanistic aspects of transition.
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Affiliation(s)
- Nicole Padley
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Dina Moubayed
- Département de pédiatrie (section médecine de l'adolescence), Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
- Département de médecine, Université de Montréal, Montréal, QC, Canada
| | - Amélie Lanteigne
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - François Ouimet
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Marie-José Clermont
- Département de pédiatrie, CHU Sainte-Justine, Montréal, Québec, Canada
- Département de pédiatrie, Université de Montréal, Montréal, QC, Canada
| | - Anne Fournier
- Département de pédiatrie (section médecine de l'adolescence), Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine, Université de Montréal, Montréal, QC, Canada
- Département de médecine sociale et préventive, École de santé publique de l’Université de Montréal, Montréal, QC, Canada
- Department of Medicine (Division of Experimental Medicine), McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, 3801 Rue University, Montréal, QC, Canada
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Mandoh M, Raeside R, Todd A, Redfern J, Mihrshahi S, Cheng HL, Phongsavan P, Partridge SR. Evaluating the effect of a 12-month youth advisory group on adolescent's leadership skills and perceptions related to chronic disease prevention research: a mixed-methods study. BMC Public Health 2023; 23:2344. [PMID: 38012583 PMCID: PMC10680352 DOI: 10.1186/s12889-023-17283-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Youth Advisory Groups (YAGs) represent a promising method to engage adolescents in research of relevance to them and their peers. However, YAGs are rarely implemented or evaluated in chronic disease prevention research. The aims of this study were firstly, to evaluate the effect of participation in a 12-month YAG on adolescents' leadership skills and perceptions related to chronic disease prevention research and secondly, to evaluate the process of establishing and facilitating a 12-month YAG and identify barriers and enablers to establishment and facilitation. METHODS This study was a 12-month pre-post study. Eligible participants were adolescents (13-18-years) and current members of an established YAG. Data collection involved online surveys and semi-structured interviews at baseline, six-months and 12-months follow-up. Participatory outcomes such as self-efficacy, leadership skills, and collective participation were derived from Youth Participatory Action Research Principles (YPAR), and the Lansdown-UNICEF conceptual framework for measuring outcomes of adolescent participation. Process evaluation data were captured via meeting minutes, Slack metrics and researcher logs. Quantitative data was analysed using descriptive statistics and qualitative data was thematically analysed using a reflexive thematic analysis approach. RESULTS Thirteen (13/16) YAG youth advisors consented to participate in the evaluation study (mean age 16.0 years, SD 1.3; 62% (8/13) identified as female). Survey data assessing participatory outcomes found an increase in leadership and life skills scores over 12-months (+ 8.90 points). Semi-structured interview data collected over the 12-month term revealed three key themes namely: influence, empowerment, and contribution. Comparison of pre-post themes determined a positive trend at follow-ups, demonstrating improved participatory outcomes. Process indicators revealed that at 12-month follow-up the YAG was implemented as planned. Semi-structured interview data determined barriers to YAG facilitation included time and limited face-to-face components, while enablers to YAG facilitation included flexibility, accessible delivery methods, and a supportive adult facilitator. CONCLUSION This study found that a YAG fostered positive participatory outcomes and unique opportunities for youth participants. A successful YAG based on YPAR principles requires researchers to ensure YAG establishment and facilitation is an iterative process. Taking into consideration important barriers and enablers to YAG facilitation ensures adolescent engagement in a YAG is both meaningful and impactful.
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Affiliation(s)
- Mariam Mandoh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Rebecca Raeside
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Allyson Todd
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW, 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Hoi Lun Cheng
- Sydney Medical School, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Stephanie R Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
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Quintal A, Carreau I, Grenier AD, Hébert C, Yergeau C, Berthiaume Y, Racine E. An Ethics Action Plan for Rare Disease Care: Participatory Action Research Approach. J Particip Med 2023; 15:e46607. [PMID: 37995128 DOI: 10.2196/46607] [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: 02/21/2023] [Revised: 08/03/2023] [Accepted: 09/01/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Owing to their low prevalence, rare diseases are poorly addressed in the scientific literature and clinical practice guidelines. Thus, health care workers are inadequately equipped to provide timely diagnoses, appropriate treatment, and support for these poorly understood conditions. These clinical tribulations are experienced as moral challenges by patients, jeopardizing their life trajectories, dreams, and aspirations. OBJECTIVE This paper presents an ethical action plan for rare disease care and the process underlying its development. METHODS This action plan was designed through an ethical inquiry conducted by the Ethics and Rare Diseases Working Group, which included 3 patient partners, 2 clinician researchers, and 1 representative from Québec's rare disease association. RESULTS The plan is structured into 4 components. Component A presents the key moral challenges encountered by patients, which are the lack of knowledge on rare diseases among health care workers, the problematic attitudes that it sometimes elicits, and the distress and powerlessness experienced by patients. Component B emphasizes a vision for patient partnership in rare disease care characterized by open-mindedness, empathy, respect, and support of patient autonomy from health care workers. Component C outlines 2 courses of action prompted by this vision: raising awareness among health care workers and empowering patients to better navigate their care. Component D compares several interventions that could help integrate these 2 courses of action in rare disease care. CONCLUSIONS Overall, this action plan represents a toolbox that provides a review of multiple possible interventions for policy makers, hospital managers, practitioners, researchers, and patient associations to critically reflect on key moral challenges experienced by patients with rare diseases and ways to mitigate them. This paper also prompts reflection on the values underlying rare disease care, patient experiences, and health care workers' beliefs and behaviors. Health care workers and patients were the primary beneficiaries of this action plan.
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Affiliation(s)
- Ariane Quintal
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Isabelle Carreau
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Annie-Danielle Grenier
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Caroline Hébert
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
| | - Christine Yergeau
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Regroupement québécois des maladies orphelines, Sherbrooke, QC, Canada
| | - Yves Berthiaume
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine, Université de Montréal, Montréal, QC, Canada
| | - Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, QC, Canada
- Ethics and Rare Diseases Working Group, Institut de recherches cliniques de Montréal, Montréal, QC, Canada
- Département de médecine, Université de Montréal, Montréal, QC, Canada
- Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
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50
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Wood MD, West NC, Fokkens C, Chen Y, Loftsgard KC, Cardinal K, Whyte SD, Portales-Casamar E, Görges M. An Individualized Postoperative Pain Risk Communication Tool for Use in Pediatric Surgery: Co-Design and Usability Evaluation. JMIR Pediatr Parent 2023; 6:e46785. [PMID: 37976087 PMCID: PMC10692877 DOI: 10.2196/46785] [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: 02/24/2023] [Revised: 07/07/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Risk identification and communication tools have the potential to improve health care by supporting clinician-patient or family discussion of treatment risks and benefits and helping patients make more informed decisions; however, they have yet to be tailored to pediatric surgery. User-centered design principles can help to ensure the successful development and uptake of health care tools. OBJECTIVE We aimed to develop and evaluate the usability of an easy-to-use tool to communicate a child's risk of postoperative pain to improve informed and collaborative preoperative decision-making between clinicians and families. METHODS With research ethics board approval, we conducted web-based co-design sessions with clinicians and family participants (people with lived surgical experience and parents of children who had recently undergone a surgical or medical procedure) at a tertiary pediatric hospital. Qualitative data from these sessions were analyzed thematically using NVivo (Lumivero) to identify design requirements to inform the iterative redesign of an existing prototype. We then evaluated the usability of our final prototype in one-to-one sessions with a new group of participants, in which we measured mental workload with the National Aeronautics and Space Administration (NASA) Task Load Index (TLX) and user satisfaction with the Post-Study System Usability Questionnaire (PSSUQ). RESULTS A total of 12 participants (8 clinicians and 4 family participants) attended 5 co-design sessions. The 5 requirements were identified: (A) present risk severity descriptively and visually; (B) ensure appearance and navigation are user-friendly; (C) frame risk identification and mitigation strategies in positive terms; (D) categorize and describe risks clearly; and (E) emphasize collaboration and effective communication. A total of 12 new participants (7 clinicians and 5 family participants) completed a usability evaluation. Tasks were completed quickly (range 5-17 s) and accurately (range 11/12, 92% to 12/12, 100%), needing only 2 requests for assistance. The median (IQR) NASA TLX performance score of 78 (66-89) indicated that participants felt able to perform the required tasks, and an overall PSSUQ score of 2.1 (IQR 1.5-2.7) suggested acceptable user satisfaction with the tool. CONCLUSIONS The key design requirements were identified, and that guided the prototype redesign, which was positively evaluated during usability testing. Implementing a personalized risk communication tool into pediatric surgery can enhance the care process and improve informed and collaborative presurgical preparation and decision-making between clinicians and families of pediatric patients.
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Affiliation(s)
- Michael D Wood
- Department of Anesthesiology Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Nicholas C West
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Christina Fokkens
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
- School of Information, The University of British Columbia, Vancouver, BC, Canada
| | - Ying Chen
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
- School of Information, The University of British Columbia, Vancouver, BC, Canada
| | | | - Krystal Cardinal
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Simon D Whyte
- Department of Anesthesiology Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
| | - Elodie Portales-Casamar
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
- Centre de recherche, Centre Hospitalier universitaire Sainte-Justine, Montreal, QC, Canada
| | - Matthias Görges
- Department of Anesthesiology Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada
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