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Modi N. Repeating the errors of the past: the hazards of a commercial human milk industry. Pediatr Res 2024; 95:1480-1482. [PMID: 38195939 PMCID: PMC11126372 DOI: 10.1038/s41390-023-03004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Neena Modi
- Professor of Neonatal Medicine, Imperial College London, Section of Neonatal Medicine, School of Public Health, Chelsea and Westminster Hospital campus, 369 Fulham Road, London, UK.
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Karlsson AW, Kragh-Sørensen A, Børgesen K, Behrens KE, Andersen T, Kidholm ML, Rothmann MJ, Ketelaar M, Janssens A. Roles, outcomes, and enablers within research partnerships: A rapid review of the literature on patient and public involvement and engagement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:43. [PMID: 37322525 PMCID: PMC10268359 DOI: 10.1186/s40900-023-00448-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Recent studies mention a need to investigate partnership roles and dynamics within patient and public involvement and engagement (PPIE) in health research, and how impact and outcomes are achieved. Many labels exist to describe involvement processes, but it is unknown whether the label has implications on partnerships and outcomes. This rapid review investigates how roles between patients, relatives and researchers in a broad variety of PPIE activities in health research are described in peer reviewed papers and explores what enables these partnerships. METHODS Rapid review of articles published between 2012 and February 2022 describing, evaluating, or reflecting on experiences of PPIE in health research. All research disciplines and research areas were eligible. Four databases (Medline, Embase, PsychInfo and CINAHL) were searched between November 2021 and February 2022. We followed PRISMA guidelines and extracted descriptive factors: year, origin, research area and discipline, study focus, framework used and co-authorship. On a selection of articles, we performed a narrative analysis of partnership roles using Smits et al.'s. Involvement Matrix. Lastly, we performed a meta synthesis of reported enablers and outcomes of the partnerships. Patients and Relatives (PRs) have been involved in the whole rapid review process and are co-authors of this article. RESULTS Seventy articles from various research disciplines and areas were included. Forty articles were selected for a narrative analysis of the role description of PRs and researchers, and a meta synthesis of enablers and outcomes. Most articles described researchers as decision-makers throughout the research cycle. PRs most often were partners when they were included as co-authors; they were mostly partners in the design, analysis, write-up, and dissemination stages. Enablers of partnerships included: PR training, personality of PRs and communication skills, trust, remuneration and time. CONCLUSIONS Researchers' decision-making roles gives them control of where and when to include PRs in their projects. Co-authorship is a way of acknowledging patients' contributions which may lead to legitimation of their knowledge and the partnership. Authors describe common enablers, which can help future partnership formation.
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Affiliation(s)
- Anne Wettergren Karlsson
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Anne Kragh-Sørensen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Kirsten Børgesen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Karsten Erik Behrens
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Torben Andersen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Maiken Langhoff Kidholm
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Mette Juel Rothmann
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Center for Innovative Medical Innovation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Astrid Janssens
- Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark.
- University of Exeter Medical School, Exeter, UK.
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Moss B, Lammons W, Geiger I, Koestenzer J, Mader S, Coutinho E, Kamphuis J, Soiron S, Bergmüller E, Modi N. A pressing need for research to reduce nutritional uncertainties in preterm infant care: Findings from a European roundtable discussion with parent representatives. Early Hum Dev 2023; 179:105729. [PMID: 36921385 DOI: 10.1016/j.earlhumdev.2023.105729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Other than for agreement that own mother's milk is the optimum feed, nutritional practice for very preterm babies varies widely. As part of the development of a randomised controlled trial to address preterm nutrition uncertainties, and with the help of the European Foundation for the Care of Newborn Infants (EFCNI), we sought the views of parents across Europe. METHODS We held two roundtable discussions about the proposed trial, inviting the participation of parents and preterm adults through EFCNI. We sought their views and prior knowledge of preterm nutrition uncertainties, treatment comparisons and opinions on specific aspects of design such as cluster versus individual randomisation. We used thematic Framework Analysis to explore the data. RESULTS There were 11 participants (two men and nine women) from six European countries. Nine were parents and two were preterm adults. Participants strongly supported the need for research to improve care. However, we found little knowledge of methods to resolve uncertainties in care, and wide variation in information provided to parents during their baby's neonatal unit stay. No parent recalled a member of the clinical staff having told them about nutrition uncertainties. CONCLUSIONS Present-day best practice is to involve parents, patients, and the public in all stages of clinical research from design to dissemination and implementation. To strengthen involvement and participation we suggest there is need to improve knowledge of research methods. Clinicians may find it helpful to receive training on how to explain clinical uncertainties, and methods to resolve these.
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Affiliation(s)
- Becky Moss
- Section of Neonatal Medicine, School of Public Health, Imperial College London, Chelsea and Westminster Hospital campus, 369 Fulham Road, London SW10 9NH, UK.
| | - Will Lammons
- Section of Neonatal Medicine, School of Public Health, Imperial College London, Chelsea and Westminster Hospital campus, 369 Fulham Road, London SW10 9NH, UK
| | - Isabel Geiger
- European Foundation for the Care of Newborn Infants, Hoffmanstrasse 7a, 81379 Munich, Germany
| | - Johanna Koestenzer
- European Foundation for the Care of Newborn Infants, Hoffmanstrasse 7a, 81379 Munich, Germany
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, Hoffmanstrasse 7a, 81379 Munich, Germany
| | | | | | | | | | - Neena Modi
- Section of Neonatal Medicine, School of Public Health, Imperial College London, Chelsea and Westminster Hospital campus, 369 Fulham Road, London SW10 9NH, UK
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Lammons WB, Moss B, Bignell C, Gale C, MacBride A, Ribas R, Battersby C, Modi N. Involving multiple stakeholders in assessing and reviewing a novel data visualisation tool for a national neonatal data asset. BMJ Health Care Inform 2023; 30:e100694. [PMID: 36720494 PMCID: PMC9890751 DOI: 10.1136/bmjhci-2022-100694] [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: 10/24/2022] [Accepted: 01/07/2023] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES We involved public and professional stakeholders to assess a novel data interrogation tool, the Neonatal Health Intelligence Tool, for a National Data Asset, the National Neonatal Research Database. METHODS We recruited parents, preterm adults, data managers, clinicians, network managers and researchers (trialists and epidemiologists) for consultations demonstrating a prototype tool and semi-structured discussion. A thematic analysis of consultations is reported by stakeholder group. RESULTS We held nine on-line consultations (March-December 2021), with 24 stakeholders: parents (n=8), preterm adults (n=2), data managers (n=3), clinicians (n=3), network managers (n=2), triallists (n=3) and epidemiologists (n=3). We identified four themes from parents/preterm adults: struggling to consume information, Dads and data, bring data to life and yearning for predictions; five themes from data managers/clinicians/network managers: benchmarking, clinical outcomes, transfers and activity, the impact of socioeconomic background and ethnicity, and timeliness of updates and widening availability; and one theme from researchers: interrogating the data. DISCUSSION Other patient and public involvement (PPI) studies have reported that data tools generate concerns; our stakeholders had none. They were unanimously supportive and enthusiastic, citing visualisation as the tool's greatest strength. Stakeholders had no criticisms; instead, they recognised the tool's potential and wanted more features. Parents saw the tool as an opportunity to inform themselves without burdening clinicians, while clinicians welcomed an aid to explaining potential outcomes to parents. CONCLUSION All stakeholder groups recognised the need for the tool, praising its content and format. PPI consultations with all key groups, and their synthesis, illustrated desire for additional uses from it.
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Affiliation(s)
- William Bishop Lammons
- Department of Applied Health Research, UCL, London, UK
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | - Becky Moss
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | - Charlie Bignell
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | - Chris Gale
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | | | - Ricardo Ribas
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | - Cheryl Battersby
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
| | - Neena Modi
- Section of Neonatal Medicine, School of Primary Care and Public Health, Imperial College London, London, UK
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A report on parent involvement in planning a randomised controlled trial in neonatology and lactation – insights for current and future research. Int Breastfeed J 2022; 17:69. [PMID: 36104819 PMCID: PMC9472727 DOI: 10.1186/s13006-022-00509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patient and Public Involvement (PPI) is a rich and valuable part of the process of planning, designing, carrying out and disseminating research. It is important to communicate PPI findings in detail so that the contributions of those involved are fully utilised and disseminated. The extended and iterative PPI process used within a neonatal randomised controlled trial related to the expression of breastmilk after very preterm birth is reported here. Methods Seven iterative stages of PPI were used. Stage 1 was informal PPI using historical interaction with parents and publicly available resources. Stage 2 was an online questionnaire open to parents of premature babies and advertised via a charity collaborator. Stage 3 was partnership with a charity collaborator. Stage 4 was a set of online panels focusing on study design and documents. Stage 5 was an interactive exercise to modify the trial intervention. Stage 6 is the presence of PPI contributors on the trial steering committee. Stage 7 is a dissemination panel. At each stage attention was paid to the diversity of participants involved, with strategies to increase the involvement of parents from under-reached groups. Results Six hundred and seventy-five participants responded at Stage 2, six parents were involved at Stage 4 and 12 parents at Stage 5. PPI contributed to the choice of study question, outcomes and produced a set of questions for future research. PPI impacted on the study design, with specific emphasis on reducing participant distress related to lactation, and reducing the burden of being involved in research at a time of significant stress. Conclusions PPI had a far-reaching influence on this neonatal randomised controlled trial during the planning and design phase, which reinforces the importance of PPI at the earliest stages of the research cycle. The online questionnaire format elicited an unexpectedly deep and broad pool of transferable insights, which will have an impact on future research focus and design in the area of lactation and prematurity. Approaches to increasing PPI involvement from under-reached populations are important and can be successful despite resource constraints. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00509-1.
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More than words: Parent, Patient and Public Involvement perspectives on language used by clinical researchers in neonatal care. Early Hum Dev 2022; 171:105611. [PMID: 35785689 DOI: 10.1016/j.earlhumdev.2022.105611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/12/2022] [Indexed: 11/21/2022]
Abstract
In this qualitative study exploring parent views of information about research studies, we found they accepted uncertainty as justification, and that three key aspects of language - words, tone, and pace - influence parents' decision about their baby's inclusion. We recommend parents are routinely involved in developing information materials.
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