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Jansson H, Luckhaus JL, Hasson H, Mazzocato P, Stenfors T, Wannheden C. Understanding Co-Creation in a Research Partnership Programme Exploring Patient-Driven Innovations: A Qualitative Longitudinal Study. Health Expect 2024; 27:e70003. [PMID: 39210782 PMCID: PMC11362650 DOI: 10.1111/hex.70003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/07/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Research indicates that successful co-creation depends on a shared understanding of co-creation and its related concepts. However, it also shows that, in practice, views on co-creation and how to do it differ. This study aims to explore how patient innovators and researchers in a partnership research programme understand co-creation and how this understanding changes over time. METHODS An explorative longitudinal qualitative study was conducted with the 'Patients in the Driver's Seat' partnership research programme. Fifty-eight interviews were performed and analysed using a reflexive thematic approach. FINDINGS Four different ways of understanding co-creation were identified. These can be instrumentally conceptualized as themes using the inputs-process-outputs model: (1) combining different perspectives, experiences and backgrounds (inputs); (2) deliberately dynamic and exploratory (process); (3) striving for equity, not equality (process); and (4) diverse value creation, tangible and intangible (outputs). Together, these themes represent the varied understandings of co-creation among partnership programme members. CONCLUSIONS Our study of patient innovators and researchers identified four distinct yet complementary understandings of co-creation. The study suggests that co-creation is the sum of its essential components, which can be divided into inputs, process, and outputs. PATIENT OR PUBLIC CONTRIBUTION This study, and the partnership programme it explored, aims to improve the relevance of research for patients and informal caregivers through an improved understanding of the concept of co-creation within research on patient innovation. All patient innovators involved in the programme were invited, as interviewees and researchers, to contribute to the study design and data analysis.
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Affiliation(s)
- Hanna Jansson
- Department of Learning, Informatics, Management and Ethics, Medical Management CentreKarolinska InstitutetStockholmSweden
| | - Jamie L. Luckhaus
- Department of Learning, Informatics, Management and Ethics, Medical Management CentreKarolinska InstitutetStockholmSweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Medical Management CentreKarolinska InstitutetStockholmSweden
- Center for Epidemiology and Community Medicine (CES), Region StockholmStockholmSweden
| | - Pamela Mazzocato
- Research, Development, Education, and Innovation UnitSödertälje HospitalSödertäljeSweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Division of LearningKarolinska InstitutetStockholmSweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Medical Management CentreKarolinska InstitutetStockholmSweden
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Mazzocato P, Luckhaus JL, Malmqvist Castillo M, Burnett J, Hager A, Oates G, Wannheden C, Savage C. A Patient-Driven Mobile Health Innovation in Cystic Fibrosis Care: Comparative Cross-Case Study. J Med Internet Res 2024; 26:e50527. [PMID: 39083342 PMCID: PMC11325108 DOI: 10.2196/50527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 04/08/2024] [Accepted: 06/20/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Patient-driven innovation in health care is an emerging phenomenon with benefits for patients with chronic conditions, such as cystic fibrosis (CF). However, previous research has not examined what may facilitate or hinder the implementation of such innovations from the provider perspective. OBJECTIVE The aim of this study was to explain variations in the adoption of a patient-driven innovation among CF clinics. METHODS A comparative multiple-case study was conducted on the adoption of a patient-controlled app to support self-management and collaboration with health care professionals (HCPs). Data collection and analysis were guided by the nonadoption, abandonment, spread, scale-up, and sustainability and complexity assessment tool (NASSS-CAT) framework. Data included user activity levels of patients and qualitative interviews with staff at 9 clinics (n=8, 88.9%, in Sweden; n=1, 11.1%, in the United States). We calculated the maximum and mean percentage of active users at each clinic and performed statistical process control (SPC) analysis to explore how the user activity level changed over time. Qualitative data were subjected to content analysis and complexity analysis and used to generate process maps. All data were then triangulated in a cross-case analysis. RESULTS We found no evidence of nonadoption or clear abandonment of the app. Distinct patterns of innovation adoption were discernable based on the maximum end-user activity for each clinic, which we labeled as low (16%-23%), middle (25%-47%), or high (58%-95%) adoption. SPC charts illustrated that the introduction of new app features and research-related activity had a positive influence on user activity levels. Variation in adoption was associated with providers' perceptions of care process complexity. A higher perceived complexity of the value proposition, adopter system, and organization was associated with lower adoption. In clinics that adopted the innovation early or those that relied on champions, user activity tended to plateau or decline, suggesting a negative impact on sustainability. CONCLUSIONS For patient-driven innovations to be adopted and sustained in health care, understanding patient-provider interdependency and providers' perspectives on what generates value is essential.
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Affiliation(s)
- Pamela Mazzocato
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Södertälje Hospital, Södertälje, Sweden
| | - Jamie Linnea Luckhaus
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Participatory e-Health and Health Data, Department of Women's and Child's Health, Uppsala University, Uppsala, Sweden
| | - Moa Malmqvist Castillo
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Gabriela Oates
- Pulmonary, Allergy and Critical Care Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Carl Savage
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
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Dahlberg M, Luckhaus JL, Hasson H, Jansson H, Lek M, Savage C, Riggare S, Wannheden C. Why publish? An interview study exploring patient innovators' reasons for and experiences of scientific publishing. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:54. [PMID: 38845024 PMCID: PMC11157806 DOI: 10.1186/s40900-024-00589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/26/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Scientific publications featuring patient-driven innovations (i.e., innovations that are developed and driven by patients or informal caregivers) are increasing. By understanding patient innovators' experiences of research publication, the scientific community may be better prepared to support or partner with patient innovators. Thus, the aim of this study was to explore patient innovators' reasons for and experiences of authoring scientific publications about their innovations. METHODS Qualitative semi-structured interviews were conducted with 15 international patient innovators from three continents who had published in scientific journals. Participants were identified through a scoping review on patient-driven innovations and snowball sampling. Interviews were conducted from June to October 2022 and the data was analyzed using the Framework Method. FINDINGS Participants' reasons for publishing in scientific journals were to strengthen the roles and voices of patients and informal caregivers, and to get recognition for their innovations. Some published as a response to serendipitous opportunities. Several positive experiences were reported: collaborations defined by transparency, mutual respect, and meaningful participation; learning and competence development; and gained confidence regarding the value of lived experiences in research. Participants also reported negative experiences, such as cultural barriers manifested as conservatism in academia and power imbalances between participants and researchers, and structural barriers regarding academic affiliations and research funding. CONCLUSIONS Despite progress in increasing patient and public involvement in research and publication, our study found that patient innovators still experience barriers. This suggests that continued efforts are needed to facilitate contributions from patient innovators and other public actors to the production of relevant and meaningful research.
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Affiliation(s)
- Marie Dahlberg
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Jamie Linnea Luckhaus
- Department of Women's and Children's Health, Participatory eHealth and Health Data, Uppsala University, Uppsala, Sweden
| | - Henna Hasson
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- Center for Epidemiology and Community Medicine (CES), Region Stockholm, Stockholm, Sweden
| | - Hanna Jansson
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Madelen Lek
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Carl Savage
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Sara Riggare
- Department of Women's and Children's Health, Participatory eHealth and Health Data, Uppsala University, Uppsala, Sweden
- Uppsala University Centre for Disability Studies, Uppsala, Sweden
| | - Carolina Wannheden
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
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Figueiredo B, Sheahan J, Luo S, Bird S, Wong Lit Wan D, Xenos S, Itsiopoulos C, Jessup R, Zheng Z. Journey mapping long COVID: Agency and social support for long-hauling. Soc Sci Med 2024; 340:116485. [PMID: 38056307 DOI: 10.1016/j.socscimed.2023.116485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023]
Abstract
Long COVID, also known as Post COVID-19 condition, is defined by the WHO as the continuation or development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation. Despite many studies examining the causes and mechanisms of this disease, fewer studies have sought to understand the experience of those suffering from long COVID, or "long-haulers," This study contributes to the understanding of long-haulers (N = 14) by examining the role of agency and social support in shaping their journeys with long COVID. Drawing on a combination of interviews, questionnaires, and video diaries over a three-month period, journey mapping was used to document the participants' experiences, including symptoms, coping strategies, and lifestyle changes. Analysis of these journey maps resulted in a framework with four clusters demonstrating the importance of social support and patient agency shaping participants' Long COVID trajectory; the study contributes valuable insights into the daily lives and challenges individuals face with long COVID, informing the development of targeted support programs.
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Affiliation(s)
| | - Jacob Sheahan
- Institute for Design Informatics, University of Edinburgh, United Kingdom.
| | - Shiqi Luo
- School of Health and Biomedical Sciences, RMIT University, Australia.
| | - Stephen Bird
- School of Health and Biostatistics, Swinburne University, Australia.
| | - Dawn Wong Lit Wan
- School of Health and Biomedical Sciences, RMIT University, Australia.
| | - Sophia Xenos
- School of Health and Biomedical Sciences, RMIT University, Australia.
| | | | - Rebecca Jessup
- Staying Well, Northern Hospital, Epping, Victoria, Australia.
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Australia.
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