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Cross L, Banham D, Melendez-Torres GJ, Ford T, van Sluijs E, Liabo K. Developing inclusive public involvement and engagement activities with secondary school students and educational professionals: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:68. [PMID: 38951878 PMCID: PMC11218269 DOI: 10.1186/s40900-024-00581-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/01/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Public involvement and engagement (PI&E) is increasingly recognised as an important component of research. It can offer valuable insights from those with experiential knowledge to improve research quality, relevance, and reach. Similarly, schools are ever more common sites for health research and, more recently, PI&E. However, 'gold-standard' practice is yet to be established, and activities/approaches remain underreported. As a result, knowledge can remain localised or lost. Diversity and inclusion also remains a challenge. METHODS This protocol has been informed by UK national guidance, evidence-based frameworks and available implementation literature. It describes both rationale and approach to conducting PI&E activities within a secondary school context. Activities are designed to be engaging, safe and accessible to young people with diverse experiences, with scope to be iteratively developed in line with public collaborator preference. DISCUSSION Young people should be architects of their involvement and engagement. Ongoing appraisal and transparency of approaches to PI&E in school settings is crucial. Expected challenges of implementing this protocol include facilitating a safe space for the discussion of sensitive topics, absence and attrition, recruiting students with a diverse range of experiences, and potential knowledge and capacity barriers of both facilitator and contributors. Activities to mitigate these risks are suggested and explored.
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Affiliation(s)
- Lauren Cross
- University of Cambridge (MRC Epidemiology Unit), Cambridge, UK.
| | | | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Gafari O, Bahrami-Hessari M, Norton J, Parmar R, Hudson M, Ndegwa L, Agyapong-Badu S, Asante KP, Alwan NA, McDonough S, Tully MA, Calder PC, Barker M, Stokes M. Building trust and increasing inclusion in public health research: co-produced strategies for engaging UK ethnic minority communities in research. Public Health 2024; 233:90-99. [PMID: 38865828 DOI: 10.1016/j.puhe.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 06/14/2024]
Abstract
Patient and public involvement and engagement (PPIE) is essential for improved research outcomes and reduced research waste. To be effective, PPIE should provide opportunities for diverse groups to contribute to all research stages. However, UK ethnic minority communities remain underrepresented in research. This article describes strategies adopted in a public health research project that were effective in building trust and increasing inclusion of ethnic minority communities. The study team of researchers and PPIE partners reflects lessons learnt during the project and describe six main strategies that built meaningful levels of trust and inclusion: 1) early start to recruitment of PPIE partners; 2) relationship-focused engagement; 3) co-production and consultation activities; 4) open communication and iterative feedback; 5) co-production of project closure activities, and; 6) diverse research team. Meaningful outcomes for the community included the involvement of people from ethnic minorities as research participants and PPIE partners, community wellbeing, co-production of public health recommendations co-presented at the UK Houses of Parliament, and consortium-wide impact evidenced by the enrolment of 51 active PPIE partners. PPIE partners reflect on their research involvement, offering advice to researchers and encouraging people from ethnic minority communities to take part in research. An important message from PPIE partners is that involvement should not be restricted to projects specific to ethnic minorities but become a routine part of general population research, recognising ethnic minorities as an integral part of UK society. In conclusion, this article demonstrates that with appropriate strategies, inclusion and diversity can be achieved in public health research. We recommend researchers, practitioners and policy makers adopt these strategies when planning their public health projects.
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Affiliation(s)
- O Gafari
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
| | - M Bahrami-Hessari
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; NIHR Southampton Clinical Research Facility, University of Southampton and University Hospitals Southampton NHS Foundation Trust, UK
| | - J Norton
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - R Parmar
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - M Hudson
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - L Ndegwa
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - S Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - K P Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Ghana
| | - N A Alwan
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S McDonough
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - M A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - P C Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Barker
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Stokes
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
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Mitchell C, Woodward-Nutt K, Dancer A, Taylor S, Bugler J, Bowen A, Conroy P, Whelan BM, Wallace SJ, El Kouaissi S, Kirkham J. Towards a core outcome set for dysarthria after stroke: What should we measure? Clin Rehabil 2024; 38:802-810. [PMID: 38374687 PMCID: PMC11059832 DOI: 10.1177/02692155241231929] [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: 11/17/2023] [Accepted: 01/26/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To identify and agree on what outcome domains should be measured in research and clinical practice when working with stroke survivors who have dysarthria. DESIGN Delphi process, two rounds of an online survey followed by two online consensus meetings. SETTING UK and Australia. PARTICIPANTS Stroke survivors with experience of dysarthria, speech and language therapists/pathologists working in stroke and communication researchers. METHODS Initial list of outcome domains generated from existing literature and with our patient and public involvement group to develop the survey. Participants completed two rounds of this survey to rate importance. Outcomes were identified as 'in', 'unclear' or 'out' from the second survey. All participants were invited to two consensus meetings to discuss these results followed by voting to identify critically important outcome domains for a future Core Outcome Set. All outcomes were voted on in the consensus meetings and included if 70% of meeting participants voted 'yes' for critically important. RESULTS In total, 148 surveys were fully completed, and 28 participants attended the consensus meetings. A core outcome set for dysarthria after stroke should include four outcome domains: (a) intelligibility of speech, (b) ability to participate in conversations, (c) living well with dysarthria, (d) skills and knowledge of communication partners (where relevant). CONCLUSIONS We describe the consensus of 'what' speech outcomes after stroke are valued by all stakeholders including those with lived experience. We share these findings to encourage the measurement of these domains in clinical practice and research and for future research to identify 'how' best to measure these outcomes.
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Affiliation(s)
- Claire Mitchell
- Division of Psychology, Communication & Human Neuroscience, Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
| | - Kate Woodward-Nutt
- Research and Innovation, Northern Care Alliance, Salford Royal Hospital, Salford, UK
| | - Annette Dancer
- Healing, Empowering and Recovering from Dysarthria, HEARD group, Patient Public Involvement, Manchester, UK
| | - Stephen Taylor
- Healing, Empowering and Recovering from Dysarthria, HEARD group, Patient Public Involvement, Manchester, UK
| | - Joe Bugler
- Healing, Empowering and Recovering from Dysarthria, HEARD group, Patient Public Involvement, Manchester, UK
| | - Audrey Bowen
- Division of Psychology & Mental Health, Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
| | - Paul Conroy
- School of Linguistic, Speech and Communication Sciences, Trinity College Dublin, Dublin, Ireland
| | - Brooke-Mai Whelan
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, QLD, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, QLD, Australia
- Queensland Aphasia Research Centre, The University of Queensland, Brisbane, QLD, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, QLD, Australia
| | - Sabrina El Kouaissi
- Division of Psychology, Communication & Human Neuroscience, Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK
| | - Jamie Kirkham
- Centre for Biostatistics, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Nollett C, Eberl M, Fitzgibbon J, Joseph-Williams N, Hatch S. Public involvement and engagement in scientific research and higher education: the only way is ethics? RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:50. [PMID: 38822417 PMCID: PMC11140937 DOI: 10.1186/s40900-024-00587-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/24/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Involving and engaging the public in scientific research and higher education is slowly becoming the norm for academic institutions in the United Kingdom and elsewhere. Driven by a wide range of stakeholders including regulators, funders, research policymakers and charities public involvement and public engagement are increasingly seen as essential in delivering open and transparent activity that is relevant and positively impacts on our society. It is obvious that any activities involving and engaging members of the public should be conducted safely and ethically. However, it is not clear whether conducting activities ethically means they require ethical approval from a research ethics committee. MAIN BODY Although there is some guidance available from government organisations (e.g. the UK Health Research Authority) to suggest ethical approval is not required for such activities, requests from funders and publishers to have ethical approval in place is commonplace in the authors' experience. We explore this using case studies from our own institution. CONCLUSION We conclude that any public-facing activity with the purpose to systemically investigate knowledge, attitudes and experiences of members of the public as research and as human participants requires prior approval from an ethics committee. In contrast, engaging and involving members of the public and drawing on lived experience to inform aspects of research and teaching does not. However, lack of clarity around this distinction often results in the academic community seeking ethical approval 'just in case', leading to wasted time and resources and erecting unnecessary barriers for public involvement and public engagement. Instead, ethical issues and risks should be appropriately considered and mitigated by the relevant staff within their professional roles, be it academic or a professional service. Often this can involve following published guidelines and conducting an activity risk assessment, or similar. Moving forward, it is critical that academic funders and publishers acknowledge the distinction and agree on an accepted approach to avoid further exacerbating the problem.
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Affiliation(s)
- Claire Nollett
- Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park Campus, Cardiff, UK.
| | - Matthias Eberl
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
- Systems Immunity Research Institute, Cardiff University, Cardiff, UK
| | - Jim Fitzgibbon
- School of Medicine, Lead Public Contributor, Cardiff University, Cardiff, UK
| | - Natalie Joseph-Williams
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
- Health and Care Research Wales Evidence Centre, Cardiff, UK
| | - Sarah Hatch
- Public Involvement and Engagement Team, School of Medicine, Cardiff University, Cardiff, UK.
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Bagg MK, Hicks AJ, Hellewell SC, Ponsford JL, Lannin NA, O'Brien TJ, Cameron PA, Cooper DJ, Rushworth N, Gabbe BJ, Fitzgerald M. The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions. Neurotrauma Rep 2024; 5:424-447. [PMID: 38660461 PMCID: PMC11040195 DOI: 10.1089/neur.2023.0116] [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] [Indexed: 04/26/2024] Open
Abstract
The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.
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Affiliation(s)
- Matthew K. Bagg
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amelia J. Hicks
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Sarah C. Hellewell
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- National Trauma Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D. Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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Kjellström S, Sarre S, Masterson D. The complexity of leadership in coproduction practices: a guiding framework based on a systematic literature review. BMC Health Serv Res 2024; 24:219. [PMID: 38368329 PMCID: PMC10873973 DOI: 10.1186/s12913-024-10549-4] [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: 04/11/2023] [Accepted: 01/03/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND As coproduction in public services increases, understanding the role of leadership in this context is essential to the tasks of establishing relational partnerships and addressing power differentials among groups. The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices. METHODS A systematic review that synthesizes the evidence reported by 73 papers related to coproduction of health and welfare. RESULTS Despite the fact that models of coleadership and collective leadership exhibit a better fit with the relational character of coproduction, the majority of the articles included in this review employed a leader-centric underlying theory. The practice of coproduction leadership is a complex activity pertaining to interactions among people, encompassing nine essential practices: initiating, power-sharing, training, supporting, establishing trust, communicating, networking, orchestration, and implementation. CONCLUSIONS This paper proposes a novel framework for coproduction leadership practices based on a systematic review of the literature and a set of reflective questions. This framework aims to help coproduction leaders and participants understand the complexity, diversity, and flexibility of coproduction leadership and to challenge and enhance their capacity to collaborate effectively.
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Affiliation(s)
- Sofia Kjellström
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Barnarpsgatan 39, Jönköping, Sweden.
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Daniel Masterson
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Barnarpsgatan 39, Jönköping, Sweden
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Chudyk AM, Stoddard R, Duhamel TA, Schultz ASH. Future directions for patient engagement in research: a participatory workshop with Canadian patient partners and academic researchers. Health Res Policy Syst 2024; 22:24. [PMID: 38350974 PMCID: PMC10865599 DOI: 10.1186/s12961-024-01106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Patient engagement in research (also commonly referred to as patient or patient and public involvement in research) strives to transform health research wherein patients (including caregivers and the public) are regularly and actively engaged as multidisciplinary research team members (i.e. patient partners) working jointly towards improved health outcomes and an enhanced healthcare system. To support its mindful evolution into a staple of health research, this participatory study aimed to identify future directions for Canadian patient engagement in research and discusses its findings in the context of the international literature. METHODS The study met its aim through a multi-meeting pan-Canadian virtual workshop. Participants (n = 30) included Strategy for Patient-Oriented Research-funded academic researchers and patient partners identified through a publicly available database, personal and professional networks and social media. All spoke English, could access the workshop virtually, and provided written informed consent. The workshop was composed of four, 1.5-3-h virtual meetings wherein participants discussed the current and preferred future states of Canadian patient engagement in research. Workshop discussions (i.e. data) were video and audio recorded. Themes were generated through an iterative process of inductive thematic analysis that occurred concurrently with the multi-week workshop. RESULTS Our participatory and iterative process identified 10 targetable areas of focus for the future of Canadian patient engagement in research. Five were categorized as system-level (systemic integration; academic culture; engagement networks; funding models; compensation models), one as researcher-level (engagement processes), and four crossed both levels (awareness; diversity and recruitment; training, tools and education; evaluation and impact). System level targetable areas called for reshaping the patient engagement ecosystem to create a legitimized and supportive space for patient engagement to be a staple component of a learning health system. Researcher level targetable areas called for academic researchers and patient partners to collaboratively generate evidence and apply knowledge to inform values and behaviours necessary to foster and sustain supportive health research spaces that are accessible to all. CONCLUSIONS Future directions for Canadian patient engagement in research span 10 interconnected targetable areas that require strong leadership and joint action between patient partners, academic researchers, and health and research institutions if patient engagement is to become a ubiquitous component of a learning health system.
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Affiliation(s)
- Anna Maria Chudyk
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, CR3024-369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
| | - Roger Stoddard
- Horizon Health Network, 80 Woodbridge Street, Fredericton, NB, E3B 4R3, Canada
| | - Todd A Duhamel
- Faculty of Kinesiology and Recreation Management, 212 Active Living Centre, Winnipeg, MB, R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital-Albrechtsen Research Centre, 351 Tache Ave, Winnipeg, MB, R2H 2A6, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, CR3022-369 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada
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Ríos-León M, Onal B, Arango-Lasprilla JC, Augutis M, Graham A, Kelly EH, Kontaxakis A, López-Dolado E, Scheel-Sailer A, Valiullina S, Taylor J. Research Priorities of the Pediatric Spinal Cord Injury Population: An International Insight for Rehabilitation Care. Pediatr Neurol 2024; 151:121-130. [PMID: 38154239 DOI: 10.1016/j.pediatrneurol.2023.11.010] [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: 11/26/2022] [Revised: 10/20/2023] [Accepted: 11/26/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Although feedback from people with adult-onset spinal cord injury (SCI) has been considered for new rehabilitation programs, little is known about the priorities of the pediatric-onset SCI population. This study describes and compares health and life (H&L) domain research priorities of youth with pediatric-onset SCI and their parents/caregivers. METHODS A cross-sectional survey, designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) Collaboration, was performed at six European countries. Dyad data from 202 participants, youth with pediatric-onset SCI (n = 101) and their parents/caregivers (n = 101), were analyzed with the PEPSCI H&L domain surveys. RESULTS The cohort was composed of 8 to 12-year-olds (30.7%), 13 to 17-year-olds (38.6%), and 18 to 25-year-olds (30.7%). The top three H&L domain research priorities reported by parents/caregivers of 8 to 12-year-olds were "walking/ability to move" (91%), "bladder" function (90%), and "general health/feel" (89%), compared with "physical function" (93%), "general health/feel" (90%), and "walking/ability to move" (89%) rated by parents/caregivers of 13 to 25-year-olds. "Bowel" function (85%), "leg/foot movement" (84%), and "bladder" function (84%) were reported as priorities by 13 to 25-year-olds, whereas "physical function" (84%), "experience at school" (83%), and "general mood" were highlighted by 8 to 12-year-olds. The top 10 priorities preferred by 13 to 25-year-olds when compared with the top 10 priorities reported by their parents/caregivers, included problems related to "bowel" and "pain." CONCLUSIONS Health domain research priorities were highlighted by 13 to 25-year-olds, compared with their parents/caregivers who equally identified H&L domains. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive research strategy for the pediatric SCI population.
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Affiliation(s)
- Marta Ríos-León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.
| | - Bashak Onal
- NHS Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain; Department of Cell Biology and Histology, University of the Basque Country, Leioa, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Marika Augutis
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Allison Graham
- National Spinal Injuries Centre, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville, UK
| | | | | | - Elisa López-Dolado
- Rehabilitation Department, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland; Department of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Svetlana Valiullina
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia
| | - Julian Taylor
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos (SESCAM), Toledo, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain; Harris Manchester College, University of Oxford, Oxford, UK
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Dews SA, Daley R, Bansal A, Preston J, Bohm N. The power of language: how to bridge the gap between healthcare research and patients - a scoping review. Curr Med Res Opin 2024; 40:279-291. [PMID: 38131338 DOI: 10.1080/03007995.2023.2295984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The value of patient involvement to the design, conduct, and outcomes of healthcare research is increasingly being recognized. Patient involvement also provides greater patient accessibility and contribution to research. However, the use of inaccessible and technical language when communicating with patients is a barrier to effective patient involvement. METHODS We analyzed peer-reviewed and gray literature on how language is used in communication between healthcare researchers and patients. We used this analysis to generate a set of recommendations for healthcare researchers about using more inclusive and accessible language when involving patients in research. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Review (PRISMA-ScR) checklist. RESULTS Four major themes about the use of language were developed from the literature analysis and were used to develop the set of recommendations. These recommendations include guidance on using standardized terminology and plain language when involving patients in healthcare research. They also discuss the implementation of co-development practices, patient support initiatives, and researcher training, as well as ways to improve emotional awareness and the need for greater equality, diversity, and inclusion. DISCUSSION AND CONCLUSION The use of inclusive, empathetic, and clear language can encourage patients to be involved in research and, once they are involved, make them feel like equal, empowered, and valued partners. Working toward developing processes and guidelines for the use of language that enables an equal partnership between researchers and patients is critical.
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Affiliation(s)
| | - Rachel Daley
- The Positivitree Charity, Wallasey, UK
- Parent and Carers Research Forum, National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Akhil Bansal
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Stanford Existential Risk Initiative, Stanford University, Stanford, CA, USA
| | - Jennifer Preston
- National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Natalie Bohm
- Pfizer Ltd, Tadworth, UK
- Department of Continuing Education, University of Oxford, Oxford, UK
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Chen Y, Shah A, Jani Y, Higgins D, Saleem N, Chafer K, Sydes MR, Asselbergs FW, Lumbers RT. Rationale and design of the THIRST Alert feasibility study: a pragmatic, single-centre, parallel-group randomised controlled trial of an interruptive alert for oral fluid restriction in patients treated with intravenous furosemide. BMJ Open 2024; 14:e080410. [PMID: 38216198 PMCID: PMC10806795 DOI: 10.1136/bmjopen-2023-080410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/11/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Acute heart failure (HF) is a major cause of unplanned hospitalisation characterised by excess body water. A restriction in oral fluid intake is commonly imposed on patients as an adjunct to pharmacological therapy with loop diuretics, but there is a lack of evidence from traditional randomised controlled trials (RCTs) to support the safety and effectiveness of this intervention in the acute setting.This study aims to explore the feasibility of using computer alerts within the electronic health record (EHR) system to invite clinical care teams to enrol patients into a pragmatic RCT at the time of clinical decision-making. It will additionally assess the effectiveness of using an alert to help address the clinical research question of whether oral fluid restriction is a safe and effective adjunct to pharmacological therapy for patients admitted with fluid overload. METHODS AND ANALYSIS THIRST (Randomised Controlled Trial within the electronic Health record of an Interruptive alert displaying a fluid Restriction Suggestion in patients with the treatable Trait of congestion) Alert is a single-centre, parallel-group, open-label pragmatic RCT embedded in the EHR system that will be conducted as a feasibility study at an National Health Service (NHS) hospital in London. The clinical care team will be invited to enrol suitable patients in the study using a point-of-care alert with a target sample size of 50 patients. Enrolled patients will then be randomised to either restricted or unrestricted oral fluid intake. Two primary outcomes will be explored (1) the proportion of eligible patients enrolled in the study and (2) the mean difference in oral fluid intake between randomised groups. A series of secondary outcomes are specified to evaluate the effectiveness of the alert, adherence to the randomised treatment allocation and the quality of data generated from routine care, relevant to the outcomes of interest. ETHICS AND DISSEMINATION This study was approved by Riverside Research Ethics Committee (Ref: 22/LO/0889) and will be published on completion. TRIAL REGISTRATION NUMBER NCT05869656.
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Affiliation(s)
- Yang Chen
- Institute of Health Informatics, University College London, London, UK
- Clinical and Research Informatics Unit, NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anoop Shah
- Institute of Health Informatics, University College London, London, UK
- Clinical and Research Informatics Unit, NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Yogini Jani
- Centre for Medicines Optimisation Research & Education - CMORE, University College London Hospitals NHS Foundation Trust, London, UK
| | - Daniel Higgins
- Clinical and Research Informatics Unit, NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Nausheen Saleem
- Clinical and Research Informatics Unit, NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kris Chafer
- Clinical and Research Informatics Unit, NIHR UCLH Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Matthew Robert Sydes
- Institute of Clinical Trials and Methodology, Medical Research Council Clinical Trials Unit at University College London, London, UK
- Health Data Research UK, London, UK
| | - Folkert W Asselbergs
- Institute of Health Informatics, University College London, London, UK
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - R Thomas Lumbers
- Institute of Health Informatics, University College London, London, UK
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Woodford J, Reuther C, Ljungberg JL, von Essen L. Involving parents of children treated for cancer in Sweden as public contributors to inform the design and conduct of an evaluation of internet-administered self-help for parents of children treated for cancer: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:2. [PMID: 38167254 PMCID: PMC10759441 DOI: 10.1186/s40900-023-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Public contribution in research can facilitate the design and conduct of meaningful research, resulting in feasible and sustainable solutions to healthcare challenges. However, the evidence concerning the acceptability, feasibility, and impact of public contribution in research is limited. We will embed a mixed-method examination of public contribution activities into the CHANGE trial. The overall aim of the CHANGE trial is to evaluate the efficacy and cost-effectiveness of an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) plus treatment as usual (TAU) versus TAU for symptoms of depression and/or Generalized Anxiety Disorder in a superiority randomized controlled trial with an internal pilot phase. In this protocol we describe how we aim to: (1) involve parents of children treated for cancer in the managing and undertaking, analysis and interpretation, and dissemination phases of the CHANGE trial; and (2) examine the acceptability, feasibility, and perceived impact of Parent Advisory Board contribution to the trial from the perspective of board members and public contribution coordinators. METHODS We will recruit around six parents of children treated for cancer to the Parent Advisory Board. Board members will contribute throughout the trial during online workshops and steering group meetings. An impact log will be used during workshops to record activities and examine the perceived impact of activities according to board members and public contribution coordinators, including anticipated and unanticipated changes to the research process and potential benefits and harms. Activities will be reported using the Guidance for Reporting Involvement of Patients and the Public checklist. We will conduct semi-structured interviews with board members and public contribution coordinators 6 months after the board is established and at the end of the trial to examine the acceptability, feasibility, and perceived impact of public contribution activities. We will also conduct interviews with board members and public contribution coordinators who withdraw participation. Findings will be reported in accordance with the Standards for Reporting Qualitative Research checklist. DISCUSSION We hope adding public contribution to the CHANGE trial will provide guidance on how to embed public contribution in research and add to the evidence base concerning the impact of public contribution.
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Affiliation(s)
- Joanne Woodford
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Johan Lars Ljungberg
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden.
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12
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Mukherjee D, Bhavnani S, Lockwood Estrin G, Rao V, Dasgupta J, Irfan H, Chakrabarti B, Patel V, Belmonte MK. Digital tools for direct assessment of autism risk during early childhood: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:6-31. [PMID: 36336996 PMCID: PMC10771029 DOI: 10.1177/13623613221133176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
LAY ABSTRACT The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children's homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the 'proof-of-concept' stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children's behaviours or speech. Computerised analysis of children's interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.
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Affiliation(s)
- Debarati Mukherjee
- Indian Institute of Public Health - Bengaluru, Public Health Foundation of India, India
| | | | | | - Vaisnavi Rao
- Institute for Democracy and Economic Affairs (IDEAS), Malaysia
| | | | | | | | - Vikram Patel
- Child Development Group, Sangath, India
- Harvard Medical School, USA
- Harvard T.H. Chan School of Public Health, USA
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Knowles S, Morley K, Foster R, Middleton A, Pinar S, Rose F, Williams E, Hendon J, Churchill R. Collaborative evaluation of a pilot involvement opportunity: Cochrane Common Mental Disorders Voice of Experience College. Health Expect 2023; 26:2428-2440. [PMID: 37583285 PMCID: PMC10632641 DOI: 10.1111/hex.13835] [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: 03/28/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Involving consumers in systematic reviews can make them more valuable and help achieve goals around transparency. Systematic reviews are technically complex and training can be needed to enable consumers to engage with them fully. The Cochrane Common Mental Disorders group sought to engage people with lived experience of mental health problems in the Voice of Experience College, three workshops introducing them to systematic review methods and to opportunities to contribute as Cochrane consumers. We aimed to collectively evaluate the College from the perspective of both facilitators and consumers, to critically reflect on the experience, and to identify how the College could be sustained and spread to other review groups. METHODS This study was a longitudinal qualitative and collaborative evaluation, structured around normalisation process theory. Both facilitators and consumers were involved in not only providing their perspectives but also reflecting on these together to identify key learning points. RESULTS The workshops were positively evaluated as being engaging and supportive, largely due to the relational skills of the facilitators, and their willingness to engage in joint or two-way learning. The College suffered from a lack of clarity over the role of consumers after the College itself, with a need for greater communication to check assumptions and clarify expectations. This was not achieved due to pandemic disruptions, which nevertheless demonstrated that resources for involvement were not prioritised as core business during this period. CONCLUSIONS Soft skills around communication and support are crucial to effective consumer engagement. Sustaining involvement requires sustained communication and opportunities to reflect together on opportunities and challenges. This requires committed resources to ensure involvement activity is prioritised. This is critical as negative experiences later in the involvement journey can undermine originally positive experiences if contributors are unclear as to what their involvement can lead to. Open discussions about this are necessary to avoid conflicting assumptions. The spread of the approach to other review groups could be achieved by flexibly adapting to group-specific resources and settings, but maintaining a core focus on collaborative relationships as the key mechanism of engagement. PATIENT AND PUBLIC CONTRIBUTION Public contributors were collaborators throughout the evaluation process and have co-authored the paper.
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Affiliation(s)
- Sarah Knowles
- Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Karen Morley
- Cochrane Common Mental Disorders Group, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Rob Foster
- Voice of Experience College, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Amy Middleton
- Voice of Experience College, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Semra Pinar
- Voice of Experience College, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Fiona Rose
- Voice of Experience College, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Emma Williams
- Voice of Experience College, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Jessica Hendon
- Cochrane Common Mental Disorders Group, Centre for Reviews and DisseminationUniversity of YorkYorkUK
| | - Rachel Churchill
- Cochrane Common Mental Disorders Group, Centre for Reviews and DisseminationUniversity of YorkYorkUK
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Blackburn S, Clinch M, de Wit M, Moser A, Primdahl J, van Vliet E, Walker C, Stevenson F. Series: Public engagement with research. Part 1: The fundamentals of public engagement with research. Eur J Gen Pract 2023; 29:2232111. [PMID: 37578421 PMCID: PMC10431741 DOI: 10.1080/13814788.2023.2232111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND In the first of a four-part series, we describe the fundamentals of public engagement in primary care research. OBJECTIVES The article's purpose is to encourage, inform and improve the researcher's awareness about public engagement in research. For a growing number of researchers, funders and patient organisations in Europe, public engagement is a moral and ethical imperative for conducting high-quality research. DISCUSSION Starting with an explanation of the role of public engagement in research, we highlight its diversity and benefits to research, researchers and the public members involved. We summarise principles of good practice and provide valuable resources for researchers to use in their public engagement activities. Finally, we discuss some of the issues encountered when researchers collaborate with members of the public and provide practical steps to address them. Case studies of real-life situations are used to illustrate and aid understanding. CONCLUSION We hope this article and the other papers in this series will encourage researchers to better consider the role and practice of public engagement and the potential added value to research that collaborating with the public could provide.
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Affiliation(s)
- Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Megan Clinch
- Centre for Public Health & Policy, Queen Mary University of London, London, UK
| | - Maarten de Wit
- Patient Research Partner Stichting Tools, Amsterdam, the Netherlands
| | - Albine Moser
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, the Netherlands
| | - Christine Walker
- Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Fiona Stevenson
- Primary Care and Population Health, University College London, London, UK
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Lithander FE, Tenison E, Jones DA, Stocker S, Hopewell‐Kelly N, Gibson A, McGrath C. Working with public contributors in Parkinson's research: What were the changes, benefits and learnings? A critical reflection from the researcher and public contributor perspective. Health Expect 2023; 27:e13914. [PMID: 37990485 PMCID: PMC10768872 DOI: 10.1111/hex.13914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION This paper provides a critical reflection from both the researcher and public contributor (PC) perspective on the benefits and the learnings taken from involving PCs in research related to Parkinson's. APPROACH TO PATIENT AND PUBLIC INVOLVEMENT (PPI): This paper reports on how PCs shaped the design and development of the PRIME-UK research programme study materials through input into information leaflets, consent forms and other patient-facing documents used across three studies within the PRIME-UK research programme. The PRIME-UK research programme is designed to improve the quality of life of people with Parkinson's and this project included three studies: a cross-sectional study, a randomised control trial and a qualitative study. We captured these impacts using Public Involvement Impact Logs, which provide a framework allowing researchers and PCs to report on the learnings, immediate outcomes and impacts from PPI. For this project, the impact logs enabled us to provide reflections from PCs and researchers on the process of involving 'the public' in Parkinson's research. FINDINGS This paper builds on existing evidence of the range of benefits and challenges that emerge from working with patients and the public in Parkinson's research; this includes reflecting on the changes made to the study materials and benefits for the people involved. Four themes emerged from the reflections that were common to the researchers and PCs; these were the importance of providing a supportive environment; recognition of the benefit of the evaluation of the impact of PPI; acknowledgement that engagement of PPI can make a positive difference to the research process and that timely communication and the use of face-to-face communication, where available, is key. Furthermore, we demonstrate how impact logs provide a useful and straightforward tool for evaluating public involvement practices and supporting the feedback process. CONCLUSION We offer key recommendations for involving patients and the public in Parkinson's research and suggest approaches that could be implemented to capture the impacts of public involvement. PUBLIC CONTRIBUTION Public contributors (PCs) were involved in the design and development of the participant information leaflets, consent forms and other patient-facing documents used for studies within the PRIME-UK research programme. In addition, PCs evaluated their involvement using impact logs and co-authored this paper.
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Affiliation(s)
- Fiona E. Lithander
- Ageing and Movement Research Group, Population Health SciencesBristol Medical School, University of BristolBristolUK
- Liggins InstituteUniversity of AucklandAucklandNew Zealand
- Department of Nutrition and DieteticsUniversity of AucklandAucklandNew Zealand
| | - Emma Tenison
- Ageing and Movement Research Group, Population Health SciencesBristol Medical School, University of BristolBristolUK
- Older People's UnitRoyal United Hospitals Bath NHS Foundation TrustBathUK
| | | | | | | | - Andy Gibson
- People in the Health West of EnglandUniversity of the West of EnglandBristolUK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West)University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
- Faculty of Health and Applied Sciences, School of Health and Social WellbeingUniversity of West EnglandBristolUK
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health SciencesBristol Medical School, University of BristolBristolUK
| | - Carmel McGrath
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West)University Hospitals Bristol and Weston NHS Foundation TrustBristolUK
- Faculty of Health and Applied Sciences, School of Health and Social WellbeingUniversity of West EnglandBristolUK
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health SciencesBristol Medical School, University of BristolBristolUK
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16
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Hatch S, Fitzgibbon J, Tonks AJ, Forty L. Diversity in patient and public involvement in healthcare research and education-Realising the potential. Health Expect 2023; 27:e13896. [PMID: 37867364 PMCID: PMC10726264 DOI: 10.1111/hex.13896] [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: 06/27/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Patient and public involvement (PPI) is an increasing priority in health-related research and education. Attracting and supporting people from different demographic groups to give up their time and get involved is important to help ensure that all parts of society are empowered, represented and their voices heard in decisions that may affect their health and quality of life. OBJECTIVES (1) To determine if a demographically diverse cross-section of society would be interested in contributing to healthcare research and education. (2) To understand factors that can act as barriers and enablers to effective and diverse PPI. METHOD PPI survey data was collected via engagement events, with the aim of scoping interest in PPI from a diverse public. A Focus Group study involving members of the public, academic and professional service staff, was then conducted to gain a deeper understanding around the barriers and enablers of diversity within PPI. RESULTS 71% of a diverse rich public indicated they would like to get involved in healthcare research and teaching. 76% of survey respondents indicated that they would be happy to share a personal or family experience of healthcare. The two biggest factors impacting on our cohort getting involved are' availability of time' and 'being aware of PPI opportunities'. These factors may disproportionally affect specific groups. Shared and individual PPI enablers and barriers were identified across all stakeholder groups within the Focus Group Study, as well as generic and novel factors that would impact on an institutions' ability to improve PPI diversity. CONCLUSION These data points confirm a demographically diverse public's appetite to get involved in academic health research and teaching. This needs to be recognised and harnessed to ensure public contributor networks are representative of society. Equality Impact Assessments should be undertaken in relation to all PPI opportunities. There is a need to recognise the investment of time and resources required to build mutually beneficial relationships with diverse communities as well as the development of inclusive 'fit for purpose' PPI infrastructures to support the uptake of diverse PPI contributors. PUBLIC CONTRIBUTION This study involved members of the public responding to a short survey. Public contributors made up one of the three focus groups. The School of Medicine lead public contributor was also involved in the preparation of this manuscript.
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Affiliation(s)
- Sarah Hatch
- Public Involvement and Engagement Team, School of MedicineCardiff UniversityCardiffUK
| | - Jim Fitzgibbon
- Public Involvement and Engagement Team, School of MedicineCardiff UniversityCardiffUK
| | - Amanda Jayne Tonks
- Centre for Medical Education, School of MedicineCardiff UniversityCardiffUK
| | - Liz Forty
- Centre for Medical Education, School of MedicineCardiff UniversityCardiffUK
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Pearce G, Bell L, Magee P, Pezaro S. Co-Created Solutions for Perinatal Professionals and Childbearing Needs for People with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6955. [PMID: 37887694 PMCID: PMC10606217 DOI: 10.3390/ijerph20206955] [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: 06/15/2023] [Revised: 08/08/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Individuals living with hypermobile Ehlers-Danlos syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) have reported feeling discredited and unsupported by healthcare professionals. However, the level of knowledge about hEDS/HSD among maternity staff remains unknown. Informed by patient and public involvement, this research aimed to investigate maternity staff's knowledge and confidence in supporting people with hEDS/HSD, examine people with hEDS/HSD's experiences of perinatal care, and co-create tools to help maternity staff support people childbearing with hEDS/HSD. Two online mixed-methods international surveys were completed by childbearing people with hEDS/HSD (N = 955) and maternity staff (N = 307). This was followed by the co-creation of three tools with 17 co-creators and a design team. Two main qualitative themes were identified through thematic analysis: (1) a need for recognition of hEDS/HSD in perinatal care and (2) the delivery of appropriate individualised perinatal care. Quantitatively, people with hEDS/HSD perceived maternity professionals to have a low level of knowledge about the conditions. Respectively, maternity staff reported low levels of confidence in supporting people with hEDS/HSD. The co-created tools provide applicable outputs for both education and practice and include an i-learn module hosted by the Royal College of Midwives, a tool for perinatal records, and infomercials.
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Affiliation(s)
- Gemma Pearce
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
| | - Lauren Bell
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
- Coventry City Council, Coventry CV1 2GN, UK
| | - Paul Magee
- Centre for Future Transport and Cities, Coventry University, Coventry CV1 5FB, UK;
| | - Sally Pezaro
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
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Brockhoven F, Raphael M, Currier J, Jäderholm C, Mody P, Shannon J, Starling B, Turner-Uaandja H, Pashayan N, Arteaga I. REPRESENT recommendations: improving inclusion and trust in cancer early detection research. Br J Cancer 2023; 129:1195-1208. [PMID: 37689805 PMCID: PMC10575902 DOI: 10.1038/s41416-023-02414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
Detecting cancer early is essential to improving cancer outcomes. Minoritized groups remain underrepresented in early detection cancer research, which means that findings and interventions are not generalisable across the population, thus exacerbating disparities in cancer outcomes. In light of these challenges, this paper sets out twelve recommendations to build relations of trust and include minoritized groups in ED cancer research. The Recommendations were formulated by a range of stakeholders at the 2022 REPRESENT consensus-building workshop and are based on empirical data, including a systematic literature review and two ethnographic case studies in the US and the UK. The recommendations focus on: Long-term relationships that build trust; Sharing available resources; Inclusive and accessible communication; Harnessing community expertise; Unique risks and benefits; Compensation and support; Representative samples; Demographic data; Post-research support; Sharing results; Research training; Diversifying research teams. For each recommendation, the paper outlines the rationale, specifications for how different stakeholders may implement it, and advice for best practices. Instead of isolated recruitment, public involvement and engagement activities, the recommendations here aim to advance mutually beneficial and trusting relationships between researchers and research participants embedded in ED cancer research institutions.
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Grants
- EICEDAAP\100011 Cancer Research UK
- Cancer Research UK (CRUK)
- The International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
- This work was supported by the International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
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Affiliation(s)
| | - Maya Raphael
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jessica Currier
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Christina Jäderholm
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Perveez Mody
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jackilen Shannon
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Bella Starling
- Vocal, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
| | - Ignacia Arteaga
- Department of Social Anthropology, University of Cambridge, Cambridge, UK.
- Early Cancer Institute, University of Cambridge, Cambridge, UK.
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Lloyd N, Hyett N, Kenny A. Barriers and Enablers to Evaluating Outcomes From Public Involvement in Health Service Design: An Interpretive Description. QUALITATIVE HEALTH RESEARCH 2023; 33:983-994. [PMID: 37548221 PMCID: PMC10494479 DOI: 10.1177/10497323231191048] [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: 08/08/2023]
Abstract
While health services are expected to have public involvement in service (re)design, there is a dearth of evaluation of outcomes to inform policy and practice. There are major gaps in understanding why outcome evaluation is under-utilised. The aims of this interpretive descriptive study were to explore researcher participants' experiences of and/or attitudes towards evaluating health service outcomes from public involvement in health service design in high-income countries. Additionally, the aims were to explore barriers and enablers of evaluation, and reasons for the use of evaluation tools or frameworks. Semi-structured interviews (n = 13) were conducted with researchers of published studies where the public was involved in designing health services. Using framework analysis, four themes were developed that captured participants' experiences: Public involvement is hard - evaluation is harder; power, a diversity of agendas, and the invisible public; practical and methodological challenges; and genuineness and authenticity matter. Evaluation is driven by stakeholder requirements, including decision-makers, funding bodies, researchers, and academics, and evaluation tools are rarely used. The public is largely absent from the outcome evaluation agenda. There is a lack of commitment and clarity of purpose of public involvement and its evaluation. Outcome evaluation must be multi-layered and localised and reflect the purpose of public involvement, what constitutes success (and to whom), and use the most appropriate methods. Multi-level supports should include increased resources, such as funding, time, and expertise. Without improved evaluation, outcomes of investment in public involvement in health service design/redesign remain unknown.
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Affiliation(s)
- Nicola Lloyd
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Nerida Hyett
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
- Monash Rural Health, Monash University, Bendigo, VIC, Australia
| | - Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
- College of Social Science, University of Lincoln, Lincoln, UK
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Cazzolli R, Sluiter A, Guha C, Huuskes B, Wong G, Craig JC, Jaure A, Scholes-Robertson N. Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies. Clin Kidney J 2023; 16:i57-i68. [PMID: 37711636 PMCID: PMC10497378 DOI: 10.1093/ckj/sfad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 09/16/2023] Open
Abstract
Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Brooke Huuskes
- Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Pearce G, Holliday N, Sandhu H, Eftekhari H, Bruce J, Timms E, Ablett L, Kavi L, Simmonds J, Evans R, Magee P, Powell R, Keogh S, McGregor G. Co-creation of a complex, multicomponent rehabilitation intervention and feasibility trial protocol for the PostUraL tachycardia Syndrome Exercise (PULSE) study. Pilot Feasibility Stud 2023; 9:143. [PMID: 37582801 PMCID: PMC10426060 DOI: 10.1186/s40814-023-01365-4] [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: 03/01/2023] [Accepted: 07/15/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND There is a dearth of research to support the treatment of people with postural tachycardia syndrome (PoTS). Despite expert consensus suggesting exercise is recommended for this patient group, there are no randomised control trials examining this rigorously. The aim was to co-create a feasibility trial protocol and a rehabilitation intervention for people living with PoTS. METHODS The intervention and feasibility trial design were co-created as part of the PostUraL tachycardia Syndrome Exercise (PULSE) study. We used the 'three co's framework' of co-define, co-design and co-refine. Recruitment included key national charities and National Health Service Trusts treating people living with PoTS in the UK. Eighteen patient and public involvement members attended the co-define session, and 16 co-creators with a mix of expertise attended the subsequent co-design and co-refine sessions. Seven intervention practitioners were trained in the rehabilitation intervention, providing feedback for further co-refinement. RESULTS The final co-created intervention comprises online physical activity, and lifestyle and behaviour change support sessions. It is based on functional movement activities using a patient-centred approach tailored to individual needs. Physical activity intensity is guided by individuals' perception of effort rather than by objective measures. Recumbent bikes are provided for home use. Patients deemed randomisation to be acceptable because research in this area was considered important. CONCLUSIONS An innovative approach was used to co-create the PULSE intervention and feasibility trial protocol to meet the evidence-based and logistical needs of people living with PoTS, clinicians, service deliverers, third-sector organisations, academics and funders. This can be used as a successful example and template for future research internationally. People living with PoTS were recognised as experts and involved in every aspect of conceptualisation, design and refinement. This complex rehabilitation intervention is currently being tested in a randomised feasibility trial comparing the PULSE intervention with best-practice usual care for people living with PoTS. TRIAL REGISTRATION ISRCTN45323485 was registered on April 7, 2020.
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Affiliation(s)
| | | | | | - Helen Eftekhari
- University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Julie Bruce
- University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Emma Timms
- Patient and Public Involvement, Coventry University, Coventry, UK
- Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - Laura Ablett
- Patient and Public Involvement, Coventry University, Coventry, UK
| | | | | | - Rebecca Evans
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Richard Powell
- Coventry University, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Gordon McGregor
- Coventry University, Coventry, UK
- University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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22
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Colomer‐Lahiguera S, Steimer M, Ellis U, Eicher M, Tompson M, Corbière T, Haase KR. Patient and public involvement in cancer research: A scoping review. Cancer Med 2023; 12:15530-15543. [PMID: 37329180 PMCID: PMC10417078 DOI: 10.1002/cam4.6200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) in research emphasizes the importance of doing research with, rather than for people with lived health/illness experience(s). The purpose of this scoping review is to investigate the breadth and depth of scientific literature on PPI in cancer research and to identify how is PPI applied and reported in cancer research. METHODS We searched MEDLINE, Embase, CINAHL, and PsycInfo up to March 2022. All titles/abstracts and full-text results were screened by two reviewers. Data were analyzed and are presented in both narrative and tabular format. RESULTS We screened 22,009 titles/abstract, reviewed 375 full-text articles, of which 101 studies were included in this review. 66 papers applied PPI; 35 used co-design methodologies. PPI in cancer research in published research has increased steadily since 2015 and often includes those with a past diagnosis of cancer or relatives/informal caregivers. The most common applied methods were workshops or interviews. PPI was generally used at the level of consultation/advisor and occurred mainly in early stages of research. Costs related to PPI were mentioned in 25 papers and four papers described training provided for PPI. CONCLUSIONS Results of our review demonstrate the nature and extent of PPI expansion in cancer research. Researchers and research organizations entering the fray of PPI should consider planning and reporting elements such as the stage, level, and role type of PPI, as well as methods and strategies put in place to assure diversity. Furthermore, a thorough evaluation of whether all these elements meet the stated PPI purpose will help to grasp its impact on research outcomes. PATIENT OR PUBLIC CONTRIBUTION Two patients participated in the stakeholder consultation as part of the scoping review methodology, contributed to the discussion on refining the results, and critically reviewed the manuscript. Both are co-authors of this manuscript.
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Affiliation(s)
- Sara Colomer‐Lahiguera
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | - Matthieu Steimer
- Master of Advanced Studies in Public Health studentInstitute of Global Health, Geneva UniversityGenevaSwitzerland
| | - Ursula Ellis
- Woodward LibraryUniversity of British ColumbiaVancouverCanada
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
| | | | - Tourane Corbière
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne University Hospital (CHUV)LausanneSwitzerland
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Tabor E, Kneale D, Patalay P. Sexual identity data collection and access in UK population-based studies. Lancet Public Health 2023; 8:e400-e401. [PMID: 37244670 DOI: 10.1016/s2468-2667(23)00101-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Affiliation(s)
- Evangeline Tabor
- Social Research Institute, University College London, London WC1H 0NU, UK.
| | - Dylan Kneale
- Social Research Institute, University College London, London WC1H 0NU, UK
| | - Praveetha Patalay
- Social Research Institute, University College London, London WC1H 0NU, UK; Research Department of Population Science and Experimental Medicine, University College London, London WC1H 0NU, UK
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Keane A, Islam S, Parsons S, Verma A, Farragher T, Forde D, Holmes L, Cresswell K, Williams S, Arru P, Howlett E, Turner-Uaandja H, MacGregor I, Grey T, Arain Z, Scahill M, Starling B. Understanding who is and isn't involved and engaged in health research: capturing and analysing demographic data to diversify patient and public involvement and engagement. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:30. [PMID: 37158951 PMCID: PMC10165585 DOI: 10.1186/s40900-023-00434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Patient and public involvement and engagement (PPIE) can improve the relevance, quality, ethics and impact of research thus contributing to high quality research. Currently in the UK, people who get involved in research tend to be aged 61 years or above, White and female. Calls for greater diversity and inclusion in PPIE have become more urgent especially since the COVID-19 pandemic, so that research can better address health inequalities and be relevant for all sectors of society. Yet, there are currently no routine systems or requirements to collect or analyse the demographics of people who get involved in health research in the UK. The aim of this study was to develop to capture and analyse the characteristics of who does and doesn't take part in patient and public involvement and engagement (PPIE) activities. METHODS As part of its strategic focus on diversity and inclusion, Vocal developed a questionnaire to assess the demographics of people taking part in its PPIE activities. Vocal is a non-profit organisation which supports PPIE in health research across the region of Greater Manchester in England. The questionnaire was implemented across Vocal activities between December 2018 and March 2022. In that time. Vocal was working with approximately 935 public contributors. 329 responses were received: a return rate of 29.3%. Analysis of findings and comparison against local population demographic data, and available national data related to public contributors to health research, was performed. RESULTS Results show that it is feasible to assess the demographics of people who take part in PPIE activities, through a questionnaire system. Further, our emerging data indicate that Vocal are involving people from a wider range of ages and with a greater diversity of ethnic backgrounds in health research, as compared to available national data. Specifically, Vocal involves more people of Asian, African and Caribbean heritage, and includes a wider range of ages in its PPIE activities. More women than men are involved in Vocal's work. CONCLUSION Our 'learn by doing' approach to assessing who does and doesn't take part in Vocal's PPIE activities has informed our practice and continues influence our strategic priorities for PPIE. Our system and learning reported here may be applicable and transferable to other similar settings in which PPIE is carried out. We attribute the greater diversity of our public contributors to our strategic priority and activities to promote more inclusive research since 2018.
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Affiliation(s)
- Annie Keane
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Safina Islam
- Ahmed Iqbal Ullah Race Relations Resource Centre and Education Trust (Previously at Vocal), University of Manchester, Manchester, UK
| | - Suzanne Parsons
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, NIHR Clinical Research Facility, Manchester University NHS Foundation Trust, Manchester, UK
| | - Arpana Verma
- Division of Population Health, Health Services Research and Primary Care and Manchester Urban Collaboration, University of Manchester, Manchester, UK
| | - Tracey Farragher
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Davine Forde
- Manchester BME Network CIC (Public Contributor and Community Partner), Manchester, UK
| | - Leah Holmes
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Katharine Cresswell
- Science Policy and Research Programme (Previously at Vocal), National Institute for Health and Care Excellence, City Tower, Piccadilly Plaza, Manchester, M1 4BT, UK
| | - Susannah Williams
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Paolo Arru
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Emily Howlett
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Hannah Turner-Uaandja
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, NIHR Clinical Research Facility, Manchester University NHS Foundation Trust, Manchester, UK
| | - Issy MacGregor
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Tracy Grey
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Zahra Arain
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Maura Scahill
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK
| | - Bella Starling
- Vocal, NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, The Nowgen Centre, Grafton Street, Manchester, M13 9WU, UK.
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Cartwright C, Rahman A, Islam S, Lockyer B, Roper E, Worcester M, Zarate M, McEachan R. People powered research: what do communities identify as important for happy and healthy children and young people? A multi-disciplinary community research priority setting exercise in the City of Bradford, United Kingdom (UK). Int J Equity Health 2023; 22:71. [PMID: 37095507 PMCID: PMC10125860 DOI: 10.1186/s12939-023-01881-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: 03/21/2022] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Involving communities in research priority setting can increase the relevance and efficiency of research, leading to better health outcomes. However these exercises often lack clarity in how communities are involved and the extent to which priorities are acted upon is unclear. Seldom-heard groups, for example ethnic minorities may experience barriers to participation. We report methods and outcomes of an inclusive co-produced community research priority setting exercise within the multicultural and deprived city of Bradford, UK. The aim was to identify priorities for keeping children happy and healthy and was undertaken by the Born in Bradford (BiB) research programme to inform future research agendas. METHODS A 12 member multi-disciplinary, multi-ethnic community steering group led the process using a modified James Lind Alliance approach between December 2018-March 2020. Research priorities were collected through a widely distributed paper and online survey. Respondents were asked to list three important things to keep children i) happy, ii) healthy and what needs to change to improve either health or happiness. Free text data were coded iteratively by community researchers, and shared priorities were co-produced in a series of workshops and meetings with the community steering group and community members. RESULTS Five hundred eighty-eight respondents to the survey identified 5748 priorities, which were coded into 22 themes. These covered a range of individual, social and wider socioeconomic, environmental and cultural priorities. Diet/nutrition and exercise were most commonly identified as important for health, including what needs to change to improve health. For happiness, home life and family relationships, listening to children, and education/activities were the most commonly identified. Community assets were identified as important to change for both health and happiness. From the survey response the steering group developed 27 research questions. There were mapped onto existing and planned research agendas within BiB. CONCLUSIONS Communities identified both structural and individual factors as important priorities for health and happiness. We demonstrate how communities can be involved in priority setting using a co-productive approach in the hope this can be used as a model for others. The resulting shared research agenda will shape future research to improve the health of families living in Bradford.
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Affiliation(s)
- Christopher Cartwright
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK.
| | - Aamnah Rahman
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Shahid Islam
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Bridget Lockyer
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Euroline Roper
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Meegan Worcester
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Melany Zarate
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Rosemary McEachan
- Born in Bradford, Braford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
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Smith MY, Janssens R, Jimenez-Moreno AC, Cleemput I, Muller M, Oliveri S, Simons G, Strammiello V, Huys I, Falahee M. Patients as research partners in preference studies: learnings from IMI-PREFER. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:21. [PMID: 37029449 PMCID: PMC10080166 DOI: 10.1186/s40900-023-00430-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND There is growing recognition of the importance of patient and public stakeholder involvement (PPI) in patient preference research. However, limited evidence exists regarding the impact, barriers and enablers of PPI in preference studies. The Innovative Medicines Initiative (IMI)-PREFER project conducted a series of preference case studies which incorporated PPI. OBJECTIVE To describe: (1) how PPI was operationalized in the PREFER case studies, (2) the impact of PPI, and (3) factors that served to impede and facilitate PPI. METHODS We reviewed the PREFER final study reports to determine how patient partners were involved. We conducted a thematic framework analysis to characterize the impact of PPI and then administered a questionnaire to the PREFER study leads to identify barriers and facilitators to effective PPI. RESULTS Eight PREFER case studies involved patients as research partners. Patient partners were involved in activities spanning all phases of the patient preference research process, including in study design, conduct and dissemination. However, the type and degree of patient partner involvement varied considerably. Positive impacts of PPI included improvements in the: (1) quality of the research and research process; (2) patient partner empowerment; (3) study transparency and dissemination of results; (4) research ethics, and (5) trust and respect between the research team and the patient community. Of the 13 barriers identified, the 3 most frequently reported were inadequate resources, insufficient time to fully involve patient partners, and uncertainty regarding how to operationalize the role of 'patient partner. Among the 12 facilitators identified, the two most frequently cited were (1) having a clearly stated purpose for involving patients as research partners; and (2) having multiple patient partners involved in the study. CONCLUSION PPI had many positive impacts on the PREFER studies. Preference study leads with prior PPI experience reported a greater number of positive impacts than those with no such experience. In light of the numerous barriers identified, multi-faceted implementation strategies should be considered to support adoption, integration and sustainment of PPI within preference research. Additional case studies of patient partner involvement in preference research are needed as well to inform best practices in this area.
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Affiliation(s)
- Meredith Y Smith
- Evidera, Inc, PPD, a Part of Thermo Fisher Scientific, 6 Plainfield Street, Boston, MA, 02130, USA.
- Department of Regulatory and Quality Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
| | - Rosanne Janssens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | - Irina Cleemput
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | | | - Serena Oliveri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gwenda Simons
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | | | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Marie Falahee
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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MacArthur C, Van Hoorn R, Lavis J, Straus S, Jones N, Bayliss L, Terry AL, Law S, Victor C, Prud'homme D, Riley J, Stewart M. Training and capacity development in patient-oriented research: Ontario SPOR SUPPORT Unit (OSSU) initiatives. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:5. [PMID: 36841819 PMCID: PMC9960159 DOI: 10.1186/s40900-023-00415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In Canada, the Canadian Institutes of Health Research launched the Strategy for Patient-Oriented Research (SPOR) in 2011. The strategy defines 'patient-oriented research' as a continuum of research that engages patients as partners, focuses on patient priorities, and leads to improved patient outcomes. The overarching term 'patient' is inclusive of individuals with personal experience of a health issue as well as informal caregivers including family and friends. The vision for the strategy is improved patient experiences and outcomes through the integration of patient-oriented research findings into practice, policy, and health system improvement. Building capacity in patient-oriented research among all relevant stakeholders, namely patients, practitioners, organizational leaders, policymakers, researchers, and research funders is a core element of the strategy. MAIN BODY The objective of this paper is to describe capacity building initiatives in patient-oriented research led by the Ontario SPOR SUPPORT Unit in Ontario, Canada over the period 2014-2020. CONCLUSION The Ontario SPOR SUPPORT Unit Working Group in Training and Capacity Development has led numerous capacity building initiatives: developed a Capacity Building Compendium (accessed greater than 45,000 times); hosted Masterclasses that have trained hundreds of stakeholders (patients, practitioners, organizational leaders, policymakers, researchers, and trainees) in the conduct and use of patient-oriented research; funded the development of online curricula on patient-oriented research that have reached thousands of stakeholders; developed a patient engagement resource center that has been accessed by tens of thousands of stakeholders; identified core competencies for research teams and research environments to ensure authentic and meaningful patient partnerships in health research; and shared these resources and learnings with stakeholders across Canada, North America, and internationally.
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Affiliation(s)
- Colin MacArthur
- Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | - Rob Van Hoorn
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - John Lavis
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Sharon Straus
- Keenan Research Center, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Nicola Jones
- Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | | | - Amanda L Terry
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Susan Law
- Trillium Health Partners, Institute for Better Health, Mississauga, ON, Canada
| | - Charles Victor
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - John Riley
- Patient Partner, Ontario SPOR SUPPORT Unit, Toronto, ON, Canada
| | - Moira Stewart
- Schulich School of Medicine and Dentistry, London, ON, Canada
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Gould DJ, Glanville-Hearst M, Bunzli S, Choong PFM, Dowsey MM. Research Buddy partnership in a MD-PhD program: lessons learned. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:4. [PMID: 36803954 PMCID: PMC9938357 DOI: 10.1186/s40900-023-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND AIMS There is increasing recognition of the importance of patient involvement in research. In recent years, there has also been growing interest in patient partnerships with doctoral studies students. However, it can be difficult to know where to start and how to go about such involvement activities. The purpose of this perspective piece was to share experiential insight of the experience of a patient involvement program such that others can learn from this experience. BODY: This is a co-authored perspective piece centred on the experience of MGH, a patient who has had hip replacement surgery, and DG, a medical student completing a PhD, participating in a Research Buddy partnership over the course of over 3 years. The context in which this partnership took place was also described to facilitate comparison with readers' own circumstances and contexts. DG and MGH met regularly to discuss, and work together on, various aspects of DG's PhD research project. Reflexive thematic analysis was conducted on reflections from DG and MGH regarding their experience in the Research Buddy program to synthesise nine lessons which were then corroborated with reference to published literature on patient involvement in research. These lessons were: learn from experience; tailor the program; get involved early; embrace uniqueness; meet regularly; build rapport; ensure mutual benefit; broad involvement; regularly reflect and review. CONCLUSIONS In this perspective piece, a patient and a medical student completing a PhD reflected upon their experience co-designing a Research Buddy partnership within a patient involvement program. A series of nine lessons was identified and presented to inform readers seeking to develop or enhance their own patient involvement programs. Researcher-patient rapport is foundational to all other aspects of the patient's involvement.
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Affiliation(s)
- Daniel J Gould
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia.
| | - Marion Glanville-Hearst
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Samantha Bunzli
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, QLD, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Peter F M Choong
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Michelle M Dowsey
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
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Johnson EE, Lally J, Farnworth A, Pearson F. Involving people with a lived experience when developing a proposal for Health Technology Assessment research of nonsurgical treatments for pelvic organ prolapse: Process and reflections. Health Expect 2023; 26:1127-1136. [PMID: 36779534 PMCID: PMC10154793 DOI: 10.1111/hex.13727] [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: 05/16/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/14/2023] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) is an expectation when conducting research, including Health Technology Assessment (HTA), but practical guidance for those wishing to embed PPI into the grant application process is not always easily accessible. We wanted to ensure that PPI was central when preparing a proposal for an investigator-led evidence synthesis HTA investigating nonsurgical interventions for pelvic organ prolapse (POP) in women. Here, we describe our methods. METHODS We recruited two patient co-applicants separately through an open process to help ensure that patient voice was present within our proposal's management and direction. We invited co-applicants to attend research team meetings and comment on the full proposal. We designed, recruited to and facilitated a scoping workshop, as well as undertook its subsequent evaluation. The insight shared within the workshop for patients with a lived experience of POP, including our patient co-applicants, helped us develop the scope and rationale behind our HTA proposal. We particularly considered the interventions to include within the evidence synthesis. We also considered the outcome measures for both the evidence synthesis and economic evaluation. We elicited ideas about where and how results could be disseminated. Feedback suggested the workshop was as valuable for the attendees as it was for the researchers, making them feel valued and listened to. The time spent by researchers working on the activity was substantial and not directly funded but a necessary and valuable activity in developing our potential HTA. Our work was informed using the UK Standards for Public Involvement and the Authors and Consumers Together Impacting on eVidencE (ACTIVE) framework. CONCLUSIONS PPI can be enormously valuable in both developing and strengthening research proposals. However, further guidance is needed to help researchers recognise the level and type of involvement to use at this early stage, particularly given the large time investment needed to embed meaningful PPI. PATIENT AND PUBLIC CONTRIBUTION Women with a lived experience of POP were involved at every stage of the grant application process; their involvement is documented in full throughout this work.
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Affiliation(s)
| | - Joanne Lally
- Research Design Service North East and North Cumbria, Newcastle upon Tyne, UK
| | - Allison Farnworth
- Research Design Service North East and North Cumbria, Newcastle upon Tyne, UK
| | - Fiona Pearson
- NIHR Innovation Observatory, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership. J Gen Intern Med 2022; 37:4047-4053. [PMID: 35132560 PMCID: PMC9708980 DOI: 10.1007/s11606-022-07411-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification. OBJECTIVE We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams. DESIGN Consensus development. PARTICIPANTS We involved 16 stakeholders from the international Multi-Stakeholder Engagement (MuSE) Consortium, including patients and the public, providers, payers of health services/purchasers, policy makers, programme managers, peer review editors, and principal investigators. APPROACH We engaged stakeholders in factor development and as co-authors of this manuscript. Using a modified Delphi approach, we gathered stakeholder views concerning a preliminary list of 18 factors. Over two feedback rounds, using qualitative and quantitative analysis, we concentrated these into ten factors. KEY RESULTS We present seven highly desirable factors: 'expertise or experience', 'ability and willingness to represent the stakeholder group', 'inclusivity (equity, diversity and intersectionality)', 'communication skills', 'commitment and time capacity', 'financial and non-financial relationships and activities, and conflict of interest', 'training support and funding needs'. Additionally, three factors are desirable: 'influence', 'research relevant values', 'previous stakeholder engagement'. CONCLUSIONS We present factors for research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership. Policy makers and guideline developers may benefit from considering the factors in stakeholder identification and invitation. Research funders may consider stipulating consideration of the factors in funding applications. We outline how these factors can be implemented and exemplify how their use has the potential to improve the quality and relevancy of health research.
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Gilchrist K, Iqbal S, Vindrola-Padros C. The role of patient and public involvement in rapid qualitative studies: Can we carry out meaningful PPIE with time pressures? RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:67. [PMID: 36451246 PMCID: PMC9713187 DOI: 10.1186/s40900-022-00402-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Rapid qualitative studies conducted with patient and public involvement can help promote policy-relevant and efficient research. There is a need to understand the experiences of researchers, patients, and members of the public to guide the development of good practice and to determine the extent to which rapid qualitative research can be implemented in PPIE projects. METHODS We conducted a qualitative study to explore the experiences of research teams that carried out studies using rapid techniques with patient and public involvement. We carried out 26 interviews with researchers, coordinators, patients, carers, service users and members of the public. RESULTS This study identified needs which related to practical and time constraints. Rapid qualitative research tends to be limited to certain PPIE groups, and particular phases of the research process. Study findings are rarely discussed with PPIE members. The educational needs of rapid qualitative research were also identified. Researchers and PPIE members considered three main issues: a lack of training on patient involvement for researchers, rapid qualitative research training for PPIE members, and the diversity of PPIE members. CONCLUSION We found that rapid researchers were able to involve patients and members of the public in research despite time pressures. The challenges identified in this study can be used to plan future training programmes for researchers and PPIE panel members and develop strategies to recruit PPIE panel members from a wide range of backgrounds. PUBLIC CONTRIBUTION The research aim was to explore the experiences of those carrying out rapid qualitative studies with PPIE. As such, the participants of this study included patients, carers, service users and members of the public, who were interviewed individually. A lived experienced researcher and PPIE member for a hospital conducted the design, data collection and analysis of the study. The study brief was to interview researchers only. The lived-experience researcher initiated the inclusion of PPIE members as participants, therefore strengthening the study design. We shared the draft report with the PPIE participants for participant validation and to maintain a continuous feedback relationship. This led to addressing key issues in designing and involving PPIE members in more meaningful and equal ways. Whilst there is agreement on activities which centre on PPIE, there is no consensus on how to achieve these in high quality rapid qualitative studies.
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Affiliation(s)
- Katie Gilchrist
- Department of Targeted Intervention, University College London, London, UK
| | - Syka Iqbal
- Department of Psychology, University of Bradford, Bradford, UK
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Kerr C, McConnell K, Savage H, Acheson M. Implementing public involvement standards in cerebral palsy register research. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:903167. [DOI: 10.3389/fresc.2022.903167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022]
Abstract
BackgroundIn 2018, the National Institute for Health Research launched Draft Standards for Public Involvement in Research. The Northern Ireland Cerebral Palsy Register (NICPR) was competitively selected as a “test-bed” project to pilot the Draft Standards over a one-year period.AimThis perspective paper aims to describe the NICPR's experience of piloting the Draft Standards for Public Involvement in Research, highlighting successes and challenges.MethodThree of the six Draft Standards were piloted from April 2018 to April 2019: Standard 2 “working together”, Standard 4 “communications” and Standard 5, “impact”.ResultsImplementation of Standard 2 resulted in formation of a dedicated Public Involvement Group. Standard 4 was implemented by revision of the NICPR's Privacy Notice and development of the NICPR website. Standard 5 was not implemented during the test-bed pilot period.DiscussionBenefits of use of the Draft Standards in cerebral palsy register research included development of relationships, improving quality, accessibility and relevance of NICPR materials, increasing skills and confidence, networking opportunities, advocating for others and feeling empowered to shape cerebral palsy research. Challenges included administrative issues, absence of dedicated and sustained funding, limitations in the availability and applicability of public involvement training and the time required for meaningful public involvement.ConclusionsStandards for Public Involvement provide a useful framework for structuring and embedding meaningful public involvement. Sustained, authentic public involvement in cerebral palsy register research ensures that people affected by the condition are empowered to engage, inform, develop and lead research that meets their needs.
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The importance of children and young person involvement in scoping the need for a paediatric glucocorticoid-associated patient reported outcome measure. BMC Rheumatol 2022; 6:80. [PMID: 36243873 PMCID: PMC9568975 DOI: 10.1186/s41927-022-00312-9] [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: 03/27/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background For many children and young people (CYP) with paediatric rheumatic conditions, glucocorticoid medications and their associated side-effects have a substantial impact on disease experience. Whilst there are physician-rated measures of glucocorticoid toxicity, no parallel patient reported measure has been developed to date for CYP with rheumatic disease. This manuscript describes a series of public patient involvement (PPI) events to inform the development of a future paediatric glucocorticoid-associated patient reported outcome measure (PROM). Methods One large group PPI event was advertised to CYP with experience of glucocorticoid medication use and their parents through clinicians, charities and existing PPI groups. This featured education on the team’s research into glucocorticoid medication and interactive polls/structured discussion to help participants share their experiences. Further engagement was sought for PPI group work to co-develop future glucocorticoid studies, including development of a glucocorticoid associated PROM. Quantitative and qualitative feedback was collected from online questionnaires. The initiative was held virtually due to the Covid-19 pandemic. Results Nine families (n = 15) including 6 CYP joined the large group PPI event. Online pre-attendance and post-attendance questionnaires showed improvement in mean self-reported confidence [1 = not at all confident, 5 = very confident] in the following: what steroid medications are (pre = 3.9, post = 4.8), steroid side effects (pre = 3.8, post = 4.6), patient-reported outcome measures (pre = 2.0, post = 4.5), available research on steroids (pre = 2.2, post = 3.5). Five families (n = 7) were involved in a monthly PPI group who worked alongside the research team to identify priorities in glucocorticoid research, produce age-appropriate study materials, identify barriers to study participation (e.g. accessibility & convenience) and recommend appropriate modalities for dissemination. The participants found discussing shared experiences and learning about research to be the most enjoyable aspects of the initiative. Conclusions This PPI initiative provided a valuable forum for families, including young children, to share their perspectives. Here, the authors explore the effective use of PPI in a virtual setting and provide a unique case study for the involvement of CYP in PROM development. The monthly PPI group also identified a need for the development of a new PROM related to glucocorticoid medication use and provided unique insights into how such a study could be structured. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-022-00312-9.
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Evans BA, Carson‐Stevens A, Cooper A, Davies F, Edwards M, Harrington B, Hepburn J, Hughes T, Price D, Siriwardena NA, Snooks H, Edwards A. Implementing public involvement throughout the research process-Experience and learning from the GPs in EDs study. Health Expect 2022; 25:2471-2484. [PMID: 35894169 PMCID: PMC9615054 DOI: 10.1111/hex.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/26/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Public involvement in health services research is encouraged. Descriptions of public involvement across the whole research cycle of a major study are uncommon and its effects on research conduct are poorly understood. AIM This study aimed to describe how we implemented public involvement, reflect on process and effects in a large-scale multi-site research study and present learning for future involvement practice. METHOD We recorded public involvement roles and activities throughout the study and compared these to our original public involvement plan included in our project proposal. We held a group interview with study co-applicants to explore their experiences, transcribed the recorded discussion and conducted thematic analysis. We synthesized the findings to develop recommendations for future practice. RESULTS Public contributors' activities went beyond strategic study planning and management to include active involvement in data collection, analysis and dissemination. They attended management, scrutiny, planning and task meetings. They also facilitated public involvement through annual planning and review sessions, conducted a Public Involvement audit and coordinated public and patient input to stakeholder discussions at key study stages. Group interview respondents said that involvement exceeded their expectations. They identified effects such as changes to patient recruitment, terminology clarification and extra dissemination activities. They identified factors enabling effective involvement including team and leader commitment, named support contact, building relationships and demonstrating equality and public contributors being confident to challenge and flexible to meet researchers' timescales and work patterns. There were challenges matching resources to roles and questions about the risk of over-professionalizing public contributors. CONCLUSION We extended our planned approach to public involvement and identified benefits to the research process that were both specific and general. We identified good practice to support effective public involvement in health services research that study teams should consider in planning and undertaking research. PUBLIC CONTRIBUTION This paper was co-conceived, co-planned and co-authored by public contributors to contribute research evidence, based on their experiences of active involvement in the design, implementation and dissemination of a major health services research study.
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Affiliation(s)
- Bridie Angela Evans
- Swansea University Medical SchoolSwansea UniversitySwanseaUK
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
| | - Andrew Carson‐Stevens
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
| | - Alison Cooper
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
| | - Freya Davies
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
| | - Michelle Edwards
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
| | - Barbara Harrington
- Public Contributor, c/o Swansea University Medical SchoolSwansea UniversitySwanseaUK
| | - Julie Hepburn
- Public Contributor, c/o Swansea University Medical SchoolSwansea UniversitySwanseaUK
| | | | - Delyth Price
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
| | | | - Helen Snooks
- Swansea University Medical SchoolSwansea UniversitySwanseaUK
- Swansea University Medical School, PRIME Centre WalesSwansea UniversitySwanseaUK
| | - Adrian Edwards
- Division of Population Medicine, School of Medicine, PRIME Centre WalesCardiff UniversityCardiffUK
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Fineberg NA, Menchón JM, Hall N, Dell'Osso B, Brand M, Potenza MN, Chamberlain SR, Cirnigliaro G, Lochner C, Billieux J, Demetrovics Z, Rumpf HJ, Müller A, Castro-Calvo J, Hollander E, Burkauskas J, Grünblatt E, Walitza S, Corazza O, King DL, Stein DJ, Grant JE, Pallanti S, Bowden-Jones H, Ameringen MV, Ioannidis K, Carmi L, Goudriaan AE, Martinotti G, Sales CMD, Jones J, Gjoneska B, Király O, Benatti B, Vismara M, Pellegrini L, Conti D, Cataldo I, Riva GM, Yücel M, Flayelle M, Hall T, Griffiths M, Zohar J. Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet. Compr Psychiatry 2022; 118:152346. [PMID: 36029549 DOI: 10.1016/j.comppsych.2022.152346] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023] Open
Abstract
Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.
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Affiliation(s)
- Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Natalie Hall
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche", University of Milan, Milan, Italy
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, and Wu Tsai Institute, Yale University, New Haven, USA, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Giovanna Cirnigliaro
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hans Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, Research Group S:TEP (Substance use and related disorders: Treatment, Epidemiology and Prevention) University of Lübeck, Lübeck, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, 00135 Palanga, Lithuania
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ornella Corazza
- Department of Clinical Pharmacological and Biological Science, University of Hertfordshire
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, Australia
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Stefano Pallanti
- Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA; INS Istituto di Neuroscienze, Florence, Italy
| | | | - Michael Van Ameringen
- Deptartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Lior Carmi
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel; Reichman University, The Data Science Institution, Herzliya, Israel
| | - Anna E Goudriaan
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research & Arkin, the Netherlands
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Célia M D Sales
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; Center for Psychology at University of Porto (CPUP), University of Porto, Porto, Portugal
| | - Julia Jones
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | | | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beatrice Benatti
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Matteo Vismara
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dario Conti
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluigi M Riva
- School of Information and Communication Studies, University College Dublin
| | - Murat Yücel
- Brain Park, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | | | - Joseph Zohar
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel
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Renwick L, McWilliams C, Schaff O, Russell L, Ramsdale S, Morris RL. Stakeholder identified research priorities for early intervention in psychosis. Health Expect 2022; 25:2960-2970. [PMID: 36129063 DOI: 10.1111/hex.13604] [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: 01/25/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public resources to answer pertinent research questions about the impact of illness and treatment on people with mental health problems are limited. To target funds effectively and efficiently and maximize the health benefits to populations, prioritizing research areas is needed. Research agendas are generally driven by researcher and funder priorities, however, there is growing recognition of the need to include user-defined research priorities to make research more relevant, needs-based and efficient. OBJECTIVE To gain consensus on top priorities for research into early intervention in psychosis through a robust, democratic process for prioritization enlisting the views of key stakeholders including users, carers and healthcare professionals. We also sought to determine which user-prioritized questions were supported by scientific evidence. DESIGN AND METHODS We used a modified nominal group technique to gain consensus on unanswered questions that were obtained by survey and ranked at successive stages by a steering group comprising users, carer representatives and clinicians from relevant disciplines and stakeholder bodies. We checked each question posed in the survey was unanswered in research by reviewing evidence in five databases (Medline, Cinahl, PsychInfo, EMBASE and Cochrane Database). RESULTS Two hundred and eighty-three questions were submitted by 207 people. After checking for relevance, reframing and examining for duplicates, 258 questions remained. We gained consensus on 10 priority questions; these largely represented themes around access and engagement, information needs before and after treatment acceptance, and the influence of service-user (SU) priorities and beliefs on treatment choices and effectiveness. A recovery SUtheme identified specific self-management questions and more globally, a need to fully identify factors that impact recovery. DISCUSSION AND CONCLUSIONS Published research findings indicated that the priorities of service users, carers and healthcare professionals were aligned with researchers' and funders' priorities in some areas and misaligned in others providing vital opportunities to develop research agendas that more closely reflect users' needs. PATIENT AND PUBLIC CONTRIBUTION Initial results were presented at stakeholder workshops which included service-users, carers, health professionals and researchers during a consensus workshop to prioritize research questions and allow the opportunity for feedback. Patient and public representatives formed part of the steering group and were consulted regularly during the research process.
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Affiliation(s)
- Laoise Renwick
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Caitlin McWilliams
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Olivia Schaff
- The Education Campus - Oxford Road, Central Manchester Foundation NHS Trust Library Services, Manchester, UK
| | - Laura Russell
- The Education and Research Centre - Wythenshawe Hospital, Central Manchester Foundation NHS Trust, Manchester, UK
| | - Susan Ramsdale
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Rebecca Lauren Morris
- NIHR Greater Manchester Patient Safety Translation Research Centre,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Manchester, UK
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Horwood J, Pithara C, Lorenc A, Kesten JM, Murphy M, Turner A, Farr M, Banks J, Redwood S, Lambert H, Donovan JL. The experience of conducting collaborative and intensive pragmatic qualitative (CLIP-Q) research to support rapid public health and healthcare innovation. FRONTIERS IN SOCIOLOGY 2022; 7:970333. [PMID: 36189441 PMCID: PMC9520785 DOI: 10.3389/fsoc.2022.970333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/29/2022] [Indexed: 06/16/2023]
Abstract
A key challenge for qualitative methods in applied health research is the fast pace that can characterize the public health and health and care service landscape, where there is a need for research informed by immediate pragmatic questions and relevant findings are required quickly to inform decision-making. The COVID-19 pandemic accelerated the pace at which evidence was needed to inform urgent public health and healthcare decision-making. This required qualitative researchers to step up to the challenge of conducting research at speed whilst maintaining rigor and ensuring the findings are credible. This article illustrates how working with multidisciplinary, collaborative teams and the tailoring of qualitative methods to be more pragmatic and efficient can provide timely and credible results. Using time-limited case studies of applied qualitative health research drawn from the work of the Behavioral and Qualitative Science Team from the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), we illustrate our collaborative and intensive pragmatic qualitative (CLIP-Q) approach. CLIP-Q involves (i) collaboration at all stages of the design, conduct and implementation of projects and, where possible, co-production with people with lived experience, (ii) an intensive team-based approach to data collection and analysis at pace, and (iii) pragmatic study design and efficient strategies at each stage of the research process. The case studies include projects conducted pre COVID-19 and during the first wave of the pandemic, where urgent evidence was required in weeks rather than months to inform rapid public health and healthcare decision making.
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Affiliation(s)
- Jeremy Horwood
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
| | - Christalla Pithara
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ava Lorenc
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Joanna M. Kesten
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
| | - Mairead Murphy
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The South West Academic Health Science Network, Exeter, United Kingdom
| | - Andrew Turner
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Michelle Farr
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon Banks
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sabi Redwood
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Helen Lambert
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
| | - Jenny L. Donovan
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - NIHR ARC West Behavioural and Qualitative Science Team
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Thomson A, Peasgood E, Robertson S. The Youth Patient and Public Involvement Café-A youth-led model for meaningful involvement with children and young people. Health Expect 2022; 25:2893-2901. [PMID: 36065124 DOI: 10.1111/hex.13597] [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: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION There are few meaningful frameworks or toolkits that exist for involvement with young people. Coproduction is a more recent patient and public involvement (PPI) approach that emphasizes the importance of power-sharing, to set young people as equal partners in the research process. This paper explores the successes and challenges encountered by one coproduced PPI space for young people. METHODS This paper is written by a team of young people who developed and worked on the Youth PPI Café over a period of 18 months. It explores how we developed a youth-led space for involvement in research. The authors have reflected on their experiences, providing examples of how youth PPI and coproduction were delivered in the NHS, in practice. RESULTS By working 'with' young people, rather than 'for' them, we offer insights into the successes and challenges of an entirely youth-led involvement space. Despite being effective in shaping mental health research for children and young people, we faced challenges with tokenism, resourcing and diversity and inclusion. CONCLUSIONS Involving youth meaningfully in research has the potential to inform studies at a macro- and microlevel, enabling positive change within research and within the systems that support young people. PATIENT OR PUBLIC CONTRIBUTION Young people aged 16-24 years with lived experience were included at every stage of this project, from formulation to the delivery and development of the group, to the preparation of this manuscript and its dissemination. Sussex Partnership NHS Foundation Trust's charity 'Heads On' provided funding for this study.
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Affiliation(s)
- Abigail Thomson
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK.,Department of Experimental Psychology, The University of Oxford, Oxford, UK
| | - Edward Peasgood
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK.,East Sussex Community Voice CIC, Eastbourne, UK.,East Sussex County Council (Children's Services), Eastbourne, UK
| | - Sam Robertson
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton, UK
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Knowles SE, Walkington P, Flynn J, Darley S, Boaden R, Kislov R. Contributors are representative, as long as they agree: How confirmation logic overrides effort to achieve synthesis in applied health research. Health Expect 2022; 25:2405-2415. [PMID: 35959510 PMCID: PMC9615063 DOI: 10.1111/hex.13555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/18/2022] [Accepted: 06/03/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction The paradox of representation in public involvement in research is well recognized, whereby public contributors are seen as either too naïve to meaningfully contribute or too knowledgeable to represent ‘the average patient’. Given the underlying assumption that expertise undermines contributions made, more expert contributors who have significant experience in research can be a primary target of criticism. We conducted a secondary analysis of a case of expert involvement and a case of lived experience, to examine how representation was discussed in each. Methods We analysed a case of a Lived Experience Advisory Panel (LEAP) chosen for direct personal experience of a topic and a case of an expert Patient and Public Involvement (PPI) panel. Secondary analysis was of multiple qualitative data sources, including interviews with the LEAP contributors and researchers, Panel evaluation data and documentary analysis of researcher reports of Panel impacts. Analysis was undertaken collaboratively by the author team of contributors and researchers. Results Data both from interviews with researchers and reported observations by the Panel indicated that representation was a concern for researchers in both cases. Consistent with previous research, this challenge was deployed in response to contributors requesting changes to researcher plans. However, we also observed that when contributor input could be used to support research activity, it was described unequivocally as representative of ‘the patient view’. We describe this as researchers holding a confirmation logic. By contrast, contributor accounts enacted a synthesis logic, which emphasized multiplicity of viewpoints and active dialogue. These logics are incompatible in practice, with the confirmation logic constraining the potential for the synthesis logic to be achieved. Conclusion Researchers tend to enact a confirmation logic that seeks a monophonic patient voice to legitimize decisions. Contributors are therefore limited in their ability to realize a synthesis logic that would actively blend different types of knowledge. These different logics hold different implications regarding representation, with the synthesis logic emphasizing diversity and negotiation, as opposed to the current system in which ‘being representative' is a quality attributed to contributors by researchers. Patient or Public Contribution Patient contributors are study coauthors, partners in analysis and reporting.
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Affiliation(s)
- Sarah E Knowles
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Pat Walkington
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Jackie Flynn
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Sarah Darley
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Ruth Boaden
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Roman Kislov
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
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Nunn JS, Shafee T, Chang S, Stephens R, Elliott J, Oliver S, John D, Smith M, Orr N, Preston J, Borthwick J, van Vlijmen T, Ansell J, Houyez F, de Sousa MSA, Plotz RD, Oliver JL, Golumbic Y, Macniven R, Wines S, Borda A, da Silva Hyldmo H, Hsing PY, Denis L, Thompson C. Standardised data on initiatives-STARDIT: Beta version. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:31. [PMID: 35854364 PMCID: PMC9294764 DOI: 10.1186/s40900-022-00363-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE There is currently no standardised way to share information across disciplines about initiatives, including fields such as health, environment, basic science, manufacturing, media and international development. All problems, including complex global problems such as air pollution and pandemics require reliable data sharing between disciplines in order to respond effectively. Current reporting methods also lack information about the ways in which different people and organisations are involved in initiatives, making it difficult to collate and appraise data about the most effective ways to involve different people. The objective of STARDIT (Standardised Data on Initiatives) is to address current limitations and inconsistencies in sharing data about initiatives. The STARDIT system features standardised data reporting about initiatives, including who has been involved, what tasks they did, and any impacts observed. STARDIT was created to help everyone in the world find and understand information about collective human actions, which are referred to as 'initiatives'. STARDIT enables multiple categories of data to be reported in a standardised way across disciplines, facilitating appraisal of initiatives and aiding synthesis of evidence for the most effective ways for people to be involved in initiatives. This article outlines progress to date on STARDIT; current usage; information about submitting reports; planned next steps and how anyone can become involved. METHOD STARDIT development is guided by participatory action research paradigms, and has been co-created with people from multiple disciplines and countries. Co-authors include cancer patients, people affected by rare diseases, health researchers, environmental researchers, economists, librarians and academic publishers. The co-authors also worked with Indigenous peoples from multiple countries and in partnership with an organisation working with Indigenous Australians. RESULTS AND DISCUSSION Over 100 people from multiple disciplines and countries have been involved in co-designing STARDIT since 2019. STARDIT is the first open access web-based data-sharing system which standardises the way that information about initiatives is reported across diverse fields and disciplines, including information about which tasks were done by which stakeholders. STARDIT is designed to work with existing data standards. STARDIT data will be released into the public domain (CC0) and integrated into Wikidata; it works across multiple languages and is both human and machine readable. Reports can be updated throughout the lifetime of an initiative, from planning to evaluation, allowing anyone to be involved in reporting impacts and outcomes. STARDIT is the first system that enables sharing of standardised data about initiatives across disciplines. A working Beta version was publicly released in February 2021 (ScienceforAll.World/STARDIT). Subsequently, STARDIT reports have been created for peer-reviewed research in multiple journals and multiple research projects, demonstrating the usability. In addition, organisations including Cochrane and Australian Genomics have created prospective reports outlining planned initiatives. CONCLUSIONS STARDIT can help create high-quality standardised information on initiatives trying to solve complex multidisciplinary global problems.
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Affiliation(s)
- Jack S Nunn
- Director of Science for All (Education Charity Registered in Australia), Melbourne, Australia.
- School of Public Health, La Trobe University, Melbourne, VIC, Australia.
| | - Thomas Shafee
- School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | | | - Richard Stephens
- Patient Advocate, Co-Editor-in-Chief, 'Research Involvement and Engagement', London, UK
| | - Jim Elliott
- Public Involvement Lead at Health Research Authority (England), London, UK
| | - Sandy Oliver
- Professor of Public Policy at UCL Social Research Institute, London, UK
- University of Johannesburg, Johannesburg, South Africa
| | - Denny John
- Adjunct Professor, Ramaiah University of Applied Sciences, Bengaluru, India
- Chair, Campbell and Cochrane Economic Methods Group, London, UK
| | | | - Neil Orr
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Poche Centre Indigenous Health, The University of Sydney, Sydney, Australia
| | - Jennifer Preston
- National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | | | | | - James Ansell
- Consumers Health Forum of Australia, Deakin, Australia
| | | | - Maria Sharmila Alina de Sousa
- Independent Impact Intelligence Design & Strategy Consultant, Research Impact Academy Brazil Ambassador, Sao Paulo, Brazil
| | - Roan D Plotz
- Applied Ecology and Environmental Change Research Group, Institute for Sustainable Industries and Liveable Cities, Victoria University, Melbourne, Australia
| | | | | | - Rona Macniven
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Sydney, 2052, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, 2109, Australia
| | | | - Ann Borda
- University of Melbourne, Melbourne, Australia
- University College London, London, UK
| | - Håkon da Silva Hyldmo
- Department of Geography, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pen-Yuan Hsing
- University of Bath, Bath, UK
- MammalWeb Project, London, UK
| | - Lena Denis
- Johns Hopkins University, Baltimore, USA
| | - Carolyn Thompson
- University College London, London, UK
- Institute of Zoology, Zoological Society of London, London, UK
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Scrutinizing the collaboration criterion in research: how do policy ambitions play out in proposals and assessments? Scientometrics 2022. [DOI: 10.1007/s11192-022-04428-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractBased on a commission by one of the Swedish Research Council, which has high ambitions to strengthen the collaboration between academia and society, this study aimed to reveal how researchers describe the collaboration with partners outside the university in research proposals. Globally, collaboration is advocated to bridge research-practice gaps and address complex societal challenges. This study scrutinizes how the collaboration criterion was operationalized in all research proposals submitted to The Swedish Research Council for Health, Working Life and Welfare in 2016. A content analysis of 381 proposals and related assessments was used to identify patterns and categories. Preliminary results were subjected to discussion in a workshop with 34 researchers representing granted proposals in the material, followed by further analysis. Comparisons were made between granted and rejected proposals. The applicants had made diverse interpretations of the collaboration criterion specified in the calls under which the proposals were submitted. The few that described theoretical underpinnings for collaborative approaches used a diversity of concepts but none of them frequently. Collaboration overlapped with other sections in the proposals. There is a need to develop theoretical awareness and conceptual clarity regarding collaboration and embed collaboration in research. In the context studied, collaboration with actors outside the university does not appear to be crucial for funding.
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Morel T, Cleanthous S, Andrejack J, Barker RA, Blavat G, Brooks W, Burns P, Cano S, Gallagher C, Gosden L, Siu C, Slagle AF, Trenam K, Boroojerdi B, Ratcliffe N, Schroeder K. Patient Experience in Early-Stage Parkinson's Disease: Using a Mixed Methods Analysis to Identify Which Concepts Are Cardinal for Clinical Trial Outcome Assessment. Neurol Ther 2022; 11:1319-1340. [PMID: 35778541 PMCID: PMC9338202 DOI: 10.1007/s40120-022-00375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/01/2022] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Qualitative research on patient experiences in early-stage Parkinson's disease (PD) is limited. It is increasingly acknowledged that clinical outcome assessments used in trials do not fully capture the range of symptoms/impacts that are meaningful to people with early-stage PD. We aimed to conceptualize the patient experience in early-stage PD and identify, from the patient perspective, those cardinal symptoms/impacts which might be more useful to measure in clinical trials. METHODS In a mixed-methods analysis, 50 people with early-stage PD and nine relatives were interviewed. Study design and results interpretation were led by a multidisciplinary group of patient, clinical, regulatory, and outcome measurements experts, and patient organization representatives. Identification of the cardinal concepts was informed by the relative frequency of reported concepts combined with insights from patient experts and movement disorder specialists. RESULTS A conceptual model of the patient experience of early-stage PD was developed. Concept elicitation generated 145 unique concepts mapped across motor and non-motor symptoms, function, and impacts. Bradykinesia/slowness (notably in the form of "functional slowness"), tremor, rigidity/stiffness, mobility (particularly fine motor dexterity and subtle gait abnormalities), fatigue, depression, sleep/dreams, and pain were identified as cardinal in early-stage PD. "Functional slowness" (related to discrete tasks involving the upper limbs, complex mobility tasks, and general activities) was deemed to be more relevant than "difficulty" to patients with early-stage PD, who report being slower at completing tasks rather than encountering significant impairment with task completion. CONCLUSION Patient experiences in early-stage PD are complex and wide-ranging, and the currently available patient-reported outcome (PRO) instruments do not evaluate many early-stage PD concepts such as functional slowness, fine motor skills, and subtle gait abnormalities. The development of a new PRO instrument, created in conjunction with people with PD, that fully assesses symptoms and the experience of living with early-stage PD, is required.
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Affiliation(s)
| | | | - John Andrejack
- Patient Author, Parkinson's Foundation, New York, NY, USA
| | | | | | - William Brooks
- Patient Author, Parkinson's Foundation, New York, NY, USA
| | - Paul Burns
- Patient Author, Parkinson's UK, London, UK
| | - Stefan Cano
- Modus Outcomes, a Division of Thread, London, UK
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Beckmann S, Mauthner O, Schick L, Rochat J, Lovis C, Boehler A, Binet I, Huynh-Do U, De Geest S. A National Survey Comparing Patients' and Transplant Professionals' Research Priorities in the Swiss Transplant Cohort Study. Transpl Int 2022; 35:10255. [PMID: 35664427 PMCID: PMC9156624 DOI: 10.3389/ti.2022.10255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022]
Abstract
We aimed to identify, assess, compare and map research priorities of patients and professionals in the Swiss Transplant Cohort Study. The project followed 3 steps. 1) Focus group interviews identified patients' (n = 22) research priorities. 2) A nationwide survey assessed and compared the priorities in 292 patients and 175 professionals. 3) Priorities were mapped to the 4 levels of Bronfenbrenner's ecological framework. The 13 research priorities (financial pressure, medication taking, continuity of care, emotional well-being, return to work, trustful relationships, person-centredness, organization of care, exercise and physical fitness, graft functioning, pregnancy, peer contact and public knowledge of transplantation), addressed all framework levels: patient (n = 7), micro (n = 3), meso (n = 2), and macro (n = 1). Comparing each group's top 10 priorities revealed that continuity of care received highest importance rating from both (92.2% patients, 92.5% professionals), with 3 more agreements between the groups. Otherwise, perspectives were more diverse than congruent: Patients emphasized patient level priorities (emotional well-being, graft functioning, return to work), professionals those on the meso level (continuity of care, organization of care). Patients' research priorities highlighted a need to expand research to the micro, meso and macro level. Discrepancies should be recognized to avoid understudying topics that are more important to professionals than to patients.
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Affiliation(s)
- Sonja Beckmann
- Department Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland,Center Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Oliver Mauthner
- Department Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland,University Department of Geriatric Medicine Felix Platter, Basel, Switzerland
| | | | - Jessica Rochat
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Isabelle Binet
- Service of Nephrology and Transplantation Medicine, Cantonal Hospital, St. Gallen, Switzerland
| | - Uyen Huynh-Do
- Department of Nephrology and Hypertension, Inselspital, University of Bern, Bern, Switzerland
| | - Sabina De Geest
- Department Public Health, Institute of Nursing Science, University of Basel, Basel, Switzerland,Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium,*Correspondence: Sabina De Geest,
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Jones H, Webb L, Dyson M, Nazarpour K. Towards User-Centred Prosthetics Research Beyond the Laboratory. Front Neurosci 2022; 16:863833. [PMID: 35495033 PMCID: PMC9048479 DOI: 10.3389/fnins.2022.863833] [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: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to explore a range of perspectives on how academic research and clinical assessment of upper-limb prosthetics could happen in environments outside of laboratories and clinics, such as within peoples' homes. Two co-creation workshops were held, which included people who use upper limb prosthetic devices (hereafter called users), clinicians, academics, a policy stakeholder, and a representative from the upper-limb prosthetics industry (hereafter called professionals). The discussions during the workshops indicate that research and clinical assessment conducted remotely from a laboratory or clinic could inform future solutions that address user needs. Users were open to the idea of sharing sensor and contextual data from within their homes to external laboratories during research studies. However, this was dependent upon several considerations, such as choice and control over data collection. Regarding clinical assessment, users had reservations of how data may be used to inform future prosthetic prescriptions whilst, clinicians were concerned with resource implications and capacity to process user data. The paper presents findings of the discussions shared by participants during both workshops. The paper concludes with a conjecture that collecting sensor and contextual data from users within their home environment will contribute towards literature within the field, and potentially inform future care policies for upper limb prosthetics. The involvement of users during such studies will be critical and can be enabled via a co-creation approach. In the short term, this may be achieved through academic research studies, which may in the long term inform a framework for clinical in-home trials and clinical remote assessment.
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Affiliation(s)
- Hannah Jones
- Edinburgh Neuroprosthetics Laboratory, The University of Edinburgh, Edinburgh, United Kingdom
- Intelligent Sensing Laboratory, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lynda Webb
- Edinburgh Neuroprosthetics Laboratory, The University of Edinburgh, Edinburgh, United Kingdom
| | - Matthew Dyson
- Intelligent Sensing Laboratory, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Kianoush Nazarpour
- Edinburgh Neuroprosthetics Laboratory, The University of Edinburgh, Edinburgh, United Kingdom
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Mew L, Heaslip V, Immins T, Wainwright TW. A Patient and Public Involvement Study to Explore the Need for Further Research into the Experience of Younger Patients Undergoing Total Hip Arthroplasty. J Patient Exp 2022; 9:23743735221083166. [PMID: 35274035 PMCID: PMC8902004 DOI: 10.1177/23743735221083166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Total Hip Arthroplasty (THA) is one of the most commonly performed operations in orthopaedics. It is an operation usually performed in older patients, however the need for THA in younger patients is increasing. There is a lack of literature examining whether current recovery pathways address the specific needs of younger patients. Public and Patient Involvement (PPI) is a core aspect of good research practice and is recommended throughout the research process, including the formulation and refinement of pertinent research questions. Therefore, the explicit aim of this PPI study was to collect qualitative data from patients on the feasibility and requirement for further research into the experience of younger hip arthroplasty patients. Methods: Qualitative data was collected via an online questionnaire that was advertised on social media, requesting the input of anybody who had experienced a lower limb musculoskeletal injury or condition before the age of 50. The survey asked the respondents to describe their experiences and reflect on their priorities and goals throughout their recovery. Results: There were 71 respondents, of which 90% were female, with an average age of 43. Qualitative responses identified many concerns that were issues that could be translated across all patient ages. However, other priorities were raised that are not always recognised as important when measuring successful outcomes after a THA. Furthermore, many respondents described not feeling listened to by clinicians or treatment options not being sufficiently addressed and explored. Multiple respondents reported being told they were too young to have anything serious or that nothing could be done until they were older. Conclusions: The responses to the survey indicate that current care pathways are not fulfilling the needs and priorities in younger patients. Further research is required to explore these priorities and goals in more depth in order to understand how healthcare professionals can address them.
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Affiliation(s)
- L. Mew
- Milton Keynes University Hospital, Standing Way, Milton Keynes, MK6 5LD
- Louise Mew, Research and Development, Academic Centre, Milton Keynes University Hospital, Standing Way, Milton Keynes, MK6 5LD.
| | - V. Heaslip
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, UK
- Department of Social Work, Stavanger University, Norway
| | - T. Immins
- Orthopaedic Research Institute, Bournemouth University, UK
| | - T. W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, UK
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust
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Logan PA, Horne JC, Allen F, Armstrong SJ, Clark AB, Conroy S, Darby J, Fox C, Gladman JR, Godfrey M, Gordon AL, Irvine L, Leighton P, McCartney K, Mountain G, Robertson K, Robinson K, Sach TH, Stirling S, Wilson EC, Sims EJ. A multidomain decision support tool to prevent falls in older people: the FinCH cluster RCT. Health Technol Assess 2022; 26:1-136. [PMID: 35125131 DOI: 10.3310/cwib0236] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Falls in care home residents are common, unpleasant, costly and difficult to prevent. OBJECTIVES The objectives were to evaluate the clinical effectiveness and cost-effectiveness of the Guide to Action for falls prevention in Care Homes (GtACH) programme. DESIGN A multicentre, cluster, parallel, 1 : 1 randomised controlled trial with embedded process evaluation and economic evaluation. Care homes were randomised on a 1 : 1 basis to the GtACH programme or usual care using a secure web-based randomisation service. Research assistants, participating residents and staff informants were blind to allocation at recruitment; research assistants were blind to allocation at follow-up. NHS Digital data were extracted blindly. SETTING Older people's care homes from 10 UK sites. PARTICIPANTS Older care home residents. INTERVENTION The GtACH programme, which includes care home staff training, systematic use of a multidomain decision support tool and implementation of falls prevention actions, compared to usual falls prevention care. OUTCOMES The primary trial outcome was the rate of falls per participating resident occurring during the 90-day period between 91 and 180 days post randomisation. The primary outcome for the cost-effectiveness analysis was the cost per fall averted, and the primary outcome for the cost-utility analysis was the incremental cost per quality adjusted life-year. Secondary outcomes included the rate of falls over days 0-90 and 181-360 post randomisation, activity levels, dependency and fractures. The number of falls per resident was compared between arms using a negative binomial regression model (generalised estimating equation). RESULTS A total of 84 care homes were randomised: 39 to the GtACH arm and 45 to the control arm. A total of 1657 residents consented and provided baseline measures (mean age 85 years, 32% men). GtACH programme training was delivered to 1051 staff (71% of eligible staff) over 146 group sessions. Primary outcome data were available for 630 GtACH participants and 712 control participants. The primary outcome result showed an unadjusted incidence rate ratio of 0.57 (95% CI 0.45 to 0.71; p < 0.01) in favour of the GtACH programme. Falls rates were lower in the GtACH arm in the period 0-90 days. There were no other differences between arms in the secondary outcomes. Care home staff valued the training, systematic strategies and specialist peer support, but the incorporation of the GtACH programme documentation into routine care home practice was limited. No adverse events were recorded. The incremental cost was £20,889.42 per Dementia Specific Quality of Life-based quality-adjusted life-year and £4543.69 per quality-adjusted life-year based on the EuroQol-5 dimensions, five-level version. The mean number of falls was 1.889 (standard deviation 3.662) in the GtACH arm and 2.747 (standard deviation 7.414) in the control arm. Therefore, 0.858 falls were averted. The base-case incremental cost per fall averted was £190.62. CONCLUSION The GtACH programme significantly reduced the falls rate in the study care homes without restricting residents' activity levels or increasing their dependency, and was cost-effective at current thresholds in the NHS. FUTURE WORK Future work should include a broad implementation programme, focusing on scale and sustainability of the GtACH programme. LIMITATIONS A key limitation was the fact that care home staff were not blinded, although risk was small because of the UK statutory requirement to record falls in care homes. TRIAL REGISTRATION This trial is registered as ISRCTN34353836. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Philippa A Logan
- School of Medicine, University of Nottingham, Nottingham, UK.,Community Rehabilitation Team, Nottingham CityCare Partnership, Nottingham, UK.,National Institute for Health Research Applied Research Collaboration East Midlands, Leicester General Hospital, Leicester, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Queen's Medical Centre, Nottingham, UK
| | - Jane C Horne
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Frances Allen
- School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Allan B Clark
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Simon Conroy
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Janet Darby
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Chris Fox
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - John Rf Gladman
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research Applied Research Collaboration East Midlands, Leicester General Hospital, Leicester, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Queen's Medical Centre, Nottingham, UK.,Health Care of the Elderly Directorate, Nottingham University Hospitals, Nottingham, UK
| | - Maureen Godfrey
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research Applied Research Collaboration East Midlands, Leicester General Hospital, Leicester, UK.,National Institute for Health Research Nottingham Biomedical Research Centre, Queen's Medical Centre, Nottingham, UK.,Medical School, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Lisa Irvine
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Paul Leighton
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen McCartney
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Gail Mountain
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Kate Robertson
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Katie Robinson
- School of Medicine, University of Nottingham, Nottingham, UK.,Health Care of the Elderly Directorate, Nottingham University Hospitals, Nottingham, UK
| | - Tracey H Sach
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Susan Stirling
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Erika J Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
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Staniszewska S, Hickey G, Coutts P, Thurman B, Coldham T. Co-production: a kind revolution. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:4. [PMID: 35123585 PMCID: PMC8817643 DOI: 10.1186/s40900-022-00340-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/27/2022] [Indexed: 05/16/2023]
Abstract
Carnegie UK (CUK) and National Institute for Health Research (NIHR) INVOLVE held a meeting on the co-production of research, how we work together on equal terms. We brought together public contributors and individuals from organisations focused on research. We wanted to discuss how co-production could work in research, how it could be seen as business as usual, and to think through the barriers that stop us from working together, as well as the things that can help us move forward. While we agreed that the idea of working together is important, we recognised there are still many challenges to co-production being seen as a normal activity in research and the development of a 'business case' to persuade others is still needed. We also considered the wider civic roles that Universities are adopting as important in helping co-production become normal practice. Discussion focused on issues such as power and how it works in research. We recognised that we also need to create the right conditions for co-production, changing research culture so it becomes kinder, with a focus on the development of relationships. We also recognised the need for enough time for honest, high quality conversations between patients, public contributors and researchers that take account of how power works in research. Co-production was seen as a societal 'good,' helping us live well by undertaking research together that benefits the health of the public. We also identified a range of ways we could move co-production forward, recognising we are on a journey and that current societal changes brought about by Covid-19 may result in us being more radical in how we rethink the ways we want to work in research.
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Affiliation(s)
- Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Gary Hickey
- School of Healthcare Enterprise & Innovation, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Pippa Coutts
- Carnegie UK, Andrew Carnegie House, Pittencrieff Street, Dunfermline, KY12 8AW, Fife, UK
| | - Ben Thurman
- Carnegie UK, Andrew Carnegie House, Pittencrieff Street, Dunfermline, KY12 8AW, Fife, UK
| | - Tina Coldham
- Public Contributor for Centre for Engagement and Dissemination, NIHR, Winchester, UK
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Walsh CM, Jones NL, McCreath GA, Connan V, Pires L, Chen AQH, Karoly A, Macarthur C. Co-development and Usability Testing of Research 101: A Patient-Oriented Research Curriculum in Child Health (PORCCH) E-Learning Module for Patients and Families. Front Pediatr 2022; 10:849959. [PMID: 35874594 PMCID: PMC9297034 DOI: 10.3389/fped.2022.849959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Engaging patients and families as research partners increases the relevance, quality, and impact of child health research. However, those interested in research engagement may feel underequipped to meaningfully partner. We sought to co-develop an online learning (e-learning) module, "Research 101," to support capacity-development in patient-oriented child health research amongst patients and families. METHODS Module co-development was co-led by a parent and researcher, with guidance from a diverse, multi-stakeholder steering committee. A mixed-methods usability testing approach, with three iterative cycles of semi-structured interviews, observations, and questionnaires, was used to refine and evaluate the e-learning module. Module feedback was collected during testing and a post-module interview, and with the validated System Usability Scale (SUS), and satisfaction, knowledge, and self-efficacy questionnaires. Transcripts and field notes were analyzed through team discussion and thematic coding to inform module revisions. RESULTS Thirty participants fully tested Research 101, and another 15 completed confirmatory usability testing (32 caregivers, 6 patients, and 7 clinician-researchers). Module modifications pertaining to learner-centered design, content, aesthetic design, and learner experience were made in each cycle. SUS scores indicated the overall usability of the final version was "excellent." Participants' knowledge of patient-oriented research and self-efficacy to engage in research improved significantly after completing Research 101 (p < 0.01). CONCLUSIONS Co-development and usability testing facilitated the creation of an engaging and effective resource to support the scaling up of patient-oriented child health research capacity. The methods and findings of this study may help guide the integration of co-development and usability testing in creating similar resources.
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Affiliation(s)
- Catharine M Walsh
- Division of Gastroenterology, Hepatology and Nutrition and the SickKids Research and Learning Institutes, The Hospital for Sick Children, Department of Paediatrics and the Wilson Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicola L Jones
- Division of Gastroenterology, Hepatology and Nutrition and the SickKids Research Institute, The Hospital for Sick Children, Department of Paediatrics and Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Graham A McCreath
- SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Veronik Connan
- Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Linda Pires
- Canadian Child Health Clinician Scientist Program, Toronto, ON, Canada
| | - Autumn Q H Chen
- SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Aliza Karoly
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Colin Macarthur
- SickKids Research Institute, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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Onal B, León MR, Augutis M, Mattacola E, Graham A, Hart K, Kelly E, Scheel-Sailer A, Taylor J. Health and LifeDomain ResearchPriorities in Children, Adolescents and Young Adults With Pediatric-Onset Spinal Cord Injury: A National Cross-Sectional Survey in England. Top Spinal Cord Inj Rehabil 2022; 28:91-110. [PMID: 35521061 PMCID: PMC9009198 DOI: 10.46292/sci21-00053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Although feedback from people with adult-onset spinal cord injury (SCI) has been considered in developing research programs, little is known about pediatric-onset SCI priorities. Objectives To describe the health and life (H&L) domain research priorities of youth with pediatric-onset SCI living in England. Methods Youth with pediatric-onset SCI (≥6 months) were recruited from five English rehabilitation centers and invited with their parents/caregivers to complete the age-appropriate surveys designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) collaboration. Results A total of 73 surveys were received (32 from participants with SCI and 41 from their parents/caregivers), providing information on 47 individuals with SCI: 2- to 7-year-olds (29.8%), 8- to 12-year-olds (19.2%), 13- to 17-year-olds (17.0%), and 18 to 25-year-olds (34.0%). The top three research priorities reported by parents/caregivers of 2- to 12-year-old and 13- to 25-year-olds were pain (81%/89%), physical function (91%/83%) and health care access (78%/78%). Eighty-nine percent of 8- to 12-year-olds emphasized schooling, peer relationships, and general mood as their research priorities. The top three research priorities for Health or Life domains reported by 13- to 25-year-olds included spasms (95%), pain (91%), pressure injuries (91%), health care access (83%), physical function (78%), and daily personal needs (74%). Conclusion Although there should be an emphasis on addressing important life domain issues for 8- to 12-year-olds with SCI, adolescents and young adults mostly prioritized health domain research priorities in addition to health care access. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive SCI research strategy in England for the pediatric population.
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Affiliation(s)
- Bashak Onal
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
,Stoke Mandeville Spinal Research, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
,Buckinghamshire Clinical Commissioning Group, Aylesbury, UK
| | - Marta Ríos León
- Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Emily Mattacola
- School of Psychology, University of Buckingham, Buckingham, UK
| | - Allison Graham
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | - Kirsten Hart
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
| | - Erin Kelly
- American Academy of Pediatrics, Itasca, Illinois, USA
| | | | | | - Julian Taylor
- National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, UK
,Stoke Mandeville Spinal Research, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
,Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
,Harris Manchester College, University of Oxford, Oxford, UK
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50
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Husereau D, Drummond M, Augustovski F, de Bekker-Grob E, Briggs AH, Carswell C, Caulley L, Chaiyakunapruk N, Greenberg D, Loder E, Mauskopf J, Mullins CD, Petrou S, Pwu RF, Staniszewska S. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 Explanation and Elaboration: A Report of the ISPOR CHEERS II Good Practices Task Force. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:10-31. [PMID: 35031088 DOI: 10.1016/j.jval.2021.10.008] [Citation(s) in RCA: 257] [Impact Index Per Article: 128.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 05/22/2023]
Abstract
Health economic evaluations are comparative analyses of alternative courses of action in terms of their costs and consequences. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, published in 2013, was created to ensure health economic evaluations are identifiable, interpretable, and useful for decision making. It was intended as guidance to help authors report accurately which health interventions were being compared and in what context, how the evaluation was undertaken, what the findings were, and other details that may aid readers and reviewers in interpretation and use of the study. The new CHEERS 2022 statement replaces the previous CHEERS reporting guidance. It reflects the need for guidance that can be more easily applied to all types of health economic evaluation, new methods and developments in the field, and the increased role of stakeholder involvement including patients and the public. It is also broadly applicable to any form of intervention intended to improve the health of individuals or the population, whether simple or complex, and without regard to context (such as healthcare, public health, education, and social care). This Explanation and Elaboration Report presents the new CHEERS 2022 28-item checklist with recommendations and explanation and examples for each item. The CHEERS 2022 statement is primarily intended for researchers reporting economic evaluations for peer-reviewed journals and the peer reviewers and editors assessing them for publication. Nevertheless, we anticipate familiarity with reporting requirements will be useful for analysts when planning studies. It may also be useful for health technology assessment bodies seeking guidance on reporting, given that there is an increasing emphasis on transparency in decision making.
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Affiliation(s)
- Don Husereau
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Ontario, Canada and Institute of Health Economics, Edmonton, Alberta, Canada (Husereau).
| | | | - Federico Augustovski
- Health Technology Assessment and Health Economics Department of the Institute for Clinical Effectiveness and Health Policy (IECS- CONICET), Buenos Aires; University of Buenos Aires, Buenos Aires; CONICET (National Scientific and Technical Research Council), Buenos Aires, Argentina
| | - Esther de Bekker-Grob
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andrew H Briggs
- London School of Hygiene and Tropical Medicine, London, England, UK
| | | | - Lisa Caulley
- Department of Otolaryngology - Head & Neck Surgery, University of Ottawa, Ontario, Canada; Clinical Epidemiology Program and Center for Journalology, Ottawa Hospital Research Institute, Ontario, Canada; Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Dan Greenberg
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Elizabeth Loder
- Harvard Medical School, Boston, MA, USA; The BMJ, London, UK
| | - Josephine Mauskopf
- RTI Health Solutions, RTI International, Research Triangle Park, NC, USA
| | - C Daniel Mullins
- School of Pharmacy, University of Maryland Baltimore, Baltimore, MD, USA
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Raoh-Fang Pwu
- National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei City, Taiwan
| | - Sophie Staniszewska
- Warwick Research in Nursing, University of Warwick Warwick Medical School, Warwick, UK
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