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Hayvon JC. Systematic synthesis of intersectional best practices: knowledge translation for circumpolar indigenous disability. Int J Circumpolar Health 2024; 83:2333075. [PMID: 38590199 PMCID: PMC11005870 DOI: 10.1080/22423982.2024.2333075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/15/2024] [Indexed: 04/10/2024] Open
Abstract
Numerous theories, models, and frameworks (TMFs) currently exist for knowledge translation (KT), with scholarship that is increasingly inclusive of populations experiencing health inequalities. This study proposes two objectives: 1) exploring a nine-step method for synthesising best practices, acknowledging existing syntheses in the form of tailored-databases and review-style publications; and 2) collating best practices to inform KT that is inclusive to indigenous individuals living with disabilities in circumpolar regions. The resulting synthesis emphasises 10 best practices: explicitly connect the accountability of stakeholders to the wellbeing of the people they serve; recognise entanglement with existing neoliberal systems; assess impacts of KT on indigenous treatment providers; employ personal outreach visits; rectify longstanding delegitimization; avoid assuming the target group to be homogeneous, critically examine inequitable distribution of benefits and risks; consider how emphasis on a KT initiative can distract from historical and systemic inequalities; target inequitable, systemic social and economic forces; consider how KT can also be mobilised to gain power and control; assess what is selected for KT, and how it intersects with power position of external stakeholders and internal champions; and, allow people access-to-knowledge which changes inequitable systems.
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Affiliation(s)
- John C. Hayvon
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Fakolade A, Jackson A, Cardwell KL, Finlayson M, O'Sullivan TL, Tomasone JR, Pilutti LA. DigiTRAC: Qualitative insights from knowledge users to inform the development of a Digital Toolkit for enhancing resilience among multiple sclerosis caregivers. Mult Scler Relat Disord 2024; 88:105736. [PMID: 38954857 DOI: 10.1016/j.msard.2024.105736] [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: 04/13/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Resilience-promoting resources are critically needed to support positive caregiving experiences for multiple sclerosis (MS) caregivers. A digital toolkit offers a flexible way to access and use evidence-based resources that align with MS caregivers' interests and needs over time. OBJECTIVE We explored the perspectives of key knowledge users regarding content areas, features, and other considerations to inform an MS caregiver resilience digital toolkit. METHODS Twenty-two individuals completed a demographic survey as part of this study: 11 MS family caregivers, 7 representatives of organizations providing support services for people with MS and/or caregivers, and 4 clinicians. We conducted nine semi-structured individual interviews and two focus groups. Data were analyzed using content analysis. RESULTS Participants recommended that a digital toolkit should include content focused on promoting MS caregivers' understanding of the disease, its trajectory and available management options, and enhancing caregiving skills and caregivers' ability to initiate and maintain behaviours to promote their own well-being. Features that allow for tracking and documenting care recipients' and caregivers' experiences, customization of engagement, and connectivity with other sources of support were also recommended. Participants suggested a digital toolkit should be delivered through an app with web browser capabilities accessible on smartphones, tablets, or laptops. They also acknowledged the need to consider how users' previous technology experiences and issues related to accessibility, usability, privacy and security could influence toolkit usage. CONCLUSION These findings will guide future toolkit development and evaluation. More broadly, this study joins the chorus of voices calling for critical attention to the well-being of MS family caregivers.
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Affiliation(s)
- Afolasade Fakolade
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada; Providence Care Hospital, 752 King Street West, Kingston, ON, K7L 4 X 3, Canada.
| | - Alexandra Jackson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Katherine L Cardwell
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Tracey L O'Sullivan
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; LIFE Research Institute, Thompson Hall, 25 University Private, room 227, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, 200 Division Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road Ottawa, ON, K1H 8M5, Canada
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Teodorowski P, Tahir N, Ahmed S. Evaluation of Public Involvement in Doctoral Research Using a Four-Dimensional Theoretical Framework. Health Expect 2024; 27:e14149. [PMID: 39016094 PMCID: PMC11252835 DOI: 10.1111/hex.14149] [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: 10/09/2023] [Revised: 05/13/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Working together and co-production with public advisors have become popular among health researchers. This practice extends to doctoral researchers who involve public advisors at different stages of their research or throughout their doctoral journey. OBJECTIVE A doctoral researcher and two public advisors jointly evaluated public involvement in doctoral research. METHODS Using the established public involvement evaluation framework by Gibson and colleagues, public advisors and a doctoral researcher mapped and evaluated their experiences of public involvement in doctoral research. The four-dimensional framework allowed the authors to reflect on (1) the strength of the public voice, (2) the number of ways in which public advisors had an opportunity to get involved, (3) whether the discussion was about the public or organisation's (doctoral researcher, university or funder) concerns and (4) if the organisation changed or resisted feedback. Results are presented in a diagrammatic and narrative way. RESULTS Public advisors saw themselves as having a stronger voice in doctoral research than the doctoral researcher perceived. All agreed that there existed multiple ways for public advisors to be involved. Public advisors' feedback was taken on board, but it was also limited due to restrictions of what the doctoral programme allowed. CONCLUSION Public advisors ensured that the doctoral research was more relevant to the public. The ongoing involvement also shaped the doctoral researcher's thinking and views. PATIENT AND PUBLIC INVOLVEMENT Two public advisors were involved throughout the 3 years of this doctoral research. They co-evaluated this involvement and are co-authors of this paper.
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Affiliation(s)
- Piotr Teodorowski
- Faculty of Health Sciences and SportUniversity of StirlingStirlingUK
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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] [MESH Headings] [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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Genuis SK, Luth W, Magnussen C, Vande Velde C, Taylor D, Johnston WS. Patient engagement in research: lessons learned from CAPTURE ALS, a longitudinal observational ALS study. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:634-643. [PMID: 38519870 DOI: 10.1080/21678421.2024.2328599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE There are compelling ethical and practical reasons for patient engagement in research (PEIR), however, evidence for best practices remains limited. We investigated PEIR as implemented in CAPTURE ALS, a longitudinal observational study, from study inception through the first 2.5 years of operations. METHODS Data were drawn from three engagement initiatives: a community-led letter-writing campaign; consultation with patient and caregiver focus groups; and a study-embedded 'participant partner advisory council' (PPAC). Data were derived retrospectively from study documentation. We used the International Association of Public Participation (IAP2) participation spectrum as a framework for investigation. RESULTS 2401 letters from community members to the Canadian government affirmed study objectives and advocated for funding. Feedback from focus group consultation influenced study design and supported the study's data-sharing plan. PPAC collaboration shaped all aspects of the study. Contributions included: co-creation of governance documents, input on study protocols and public-facing communication, and development of engagement webinars for study participants and feedback surveys. Effective communication practices fostered collaboration and helped avoid tokenistic engagement. CAPTURE ALS encompassed all IAP2 participation levels. CONCLUSIONS CAPTURE ALS was shaped by meaningful engagement initiatives over the course of the study. Lessons learned included: begin early and embed PEIR within research; build relationships and foster mutual learning; be flexible, open to adaptation, and seek diversity. Primary challenges included funding for early implementation, time needed to maintain relationships, and attrition due to disease progression. All IAP2 participation levels contributed to meaningful PEIR. 'Empowerment' was demonstrated through advocacy.
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Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Claire Magnussen
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
| | | | | | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Carroll P, Smith É, Dervan A, McCarthy C, Woods I, Beirne C, Harte G, O'Flynn D, Quinlan J, O'Brien FJ, Flood M, Moriarty F. The Development of Principles for Patient and Public Involvement (PPI) in Preclinical Spinal Cord Research: A Modified Delphi Study. Health Expect 2024; 27:e14130. [PMID: 38962988 PMCID: PMC11222973 DOI: 10.1111/hex.14130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/07/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION There is currently limited guidance for researchers on Patient and Public Involvement (PPI) for preclinical spinal cord research, leading to uncertainty about design and implementation. This study aimed to develop evidence-informed principles to support preclinical spinal cord researchers to incorporate PPI into their research. METHODS This study used a modified Delphi method with the aim of establishing consensus on a set of principles for PPI in spinal cord research. Thirty-eight stakeholders including researchers, clinicians and people living with spinal cord injury took part in the expert panel. Participants were asked to rate their agreement with a series of statements relating to PPI in preclinical spinal cord research over two rounds. As part of Round 2, they were also asked to rate statements as essential or desirable. RESULTS Thirty-eight statements were included in Round 1, after which five statements were amended and two additional statements were added. After Round 2, consensus (> 75% agreement) was reached for a total of 27 principles, with 13 rated as essential and 14 rated as desirable. The principles with highest agreement related to diversity in representation among PPI contributors, clarity of the purpose of PPI and effective communication. CONCLUSION This research developed a previously unavailable set of evidence-informed principles to inform PPI in preclinical spinal cord research. These principles provide guidance for researchers seeking to conduct PPI in preclinical spinal cord research and may also inform PPI in other preclinical disciplines. PATIENT AND PUBLIC INVOLVEMENT STATEMENT This study was conducted as part of a project aiming to develop PPI in preclinical spinal cord injury research associated with an ongoing research collaboration funded by the Irish Rugby Football Union Charitable Trust (IRFU CT) and the Science Foundation Ireland Centre for Advanced Materials and BioEngineering Research (SFI AMBER), with research conducted by the Tissue Engineering Research Group (TERG) at the RCSI University of Medicine and Health Sciences. The project aims to develop an advanced biomaterials platform for spinal cord repair and includes a PPI Advisory Panel comprising researchers, clinicians and seriously injured rugby players to oversee the work of the project. PPI is included in this study through the involvement of members of the PPI Advisory Panel in the conceptualisation of this research, review of findings, identification of key points for discussion and preparation of the study manuscript as co-authors.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
| | | | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
| | | | - Geoff Harte
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union Charitable TrustDublinIreland
| | - John Quinlan
- Tallaght University Hospital, TallaghtDublinIreland
| | - Fergal J. O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
| | - Michelle Flood
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative MedicineRCSI University of Medicine and Health SciencesDublinIreland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD)RCSI University of Medicine and Health SciencesDublinIreland
- RCSI PPI Ignite Network Officepart of the National PPI Ignite Network based at the University of GalwayGalwayIreland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular ScienceRCSI University of Medicine and Health SciencesDublinIreland
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Gamel B, Albon D, Bandla S, Davison DW, Flath J, Sabadosa KA, Seid M, Silva L, Ong T. Interventions to improve system-level coproduction in the Cystic Fibrosis Learning Network. BMJ Open Qual 2024; 13:e002860. [PMID: 39067867 DOI: 10.1136/bmjoq-2024-002860] [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: 04/03/2024] [Accepted: 07/03/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Coproduction is defined as patients and clinicians collaborating equally and reciprocally in healthcare and is a crucial concept for quality improvement (QI) of health services. Learning Health Networks (LHNs) provide insights to integrate coproduction with QI efforts from programmes from various health systems. OBJECTIVE We describe interventions to develop and maintain patient and family partner (PFP) coproduction, measured by PFP-reported and programme-reported scales. We aim to increase percentage of programmes with PFPs reporting active QI work within their programme, while maintaining satisfaction in PFP-clinician relationships. METHODS Conducted in the Cystic Fibrosis Learning Network (CFLN), an LHN comprising over 30 cystic fibrosis (CF) programmes, people with CF, caregivers and clinicians cocreated interventions in readiness awareness, inclusive PFP recruitment, onboarding process, partnership development and leadership opportunities. Interventions were adapted by CFLN programmes and summarised in a change package for existing programmes and the orientation of new ones. We collected monthly assessments for PFP and programme perceptions of coproduction and PFP self-rated competency of QI skills and satisfaction with programme QI efforts. We used control charts to analyse coproduction scales and run charts for PFP self-ratings. RESULTS Between 2018 and 2022, the CFLN expanded to 34 programmes with 52% having ≥1 PFP reporting active QI participation. Clinicians from 76% of programmes reported PFPs were actively participating or leading QI efforts. PFPs reported increased QI skills competency (17%-32%) and consistently high satisfaction and feeling valued in their work. CONCLUSIONS Implementing system-level programmatic strategies to engage and sustain partnerships between clinicians and patients and families with CF improved perceptions of coproduction to conduct QI work. Key adaptable strategies for programmes included onboarding and QI training, supporting multiple PFPs simultaneously and developing financial recognition processes. Interventions may be applicable in other health conditions beyond CF seeking to foster the practice of coproduction.
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Affiliation(s)
- Breck Gamel
- Children's Health Cystic Fibrosis Center, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Dana Albon
- University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Srujana Bandla
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - David W Davison
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | - Michael Seid
- Pulmonary Medicine and Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Lindsay Silva
- Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA
| | - Thida Ong
- Pediatrics, University of Washington, Seattle, Washington, USA
- Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA, USA
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Zimmerman EB, Rafie C, Wenzel SG, Hosig K, Villani D, Dance J, Lee SS. Addressing opioid misuse through community-engaged strategy development: study protocol of a randomized controlled trial. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:74. [PMID: 39030561 PMCID: PMC11264802 DOI: 10.1186/s40900-024-00612-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/12/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Involving stakeholders in the research process facilitates collaboration, increasing understanding of factors influencing their wellbeing and motivating community action. Currently, there is a need for randomized controlled trials to evaluate the effectiveness of community-engaged research approaches for health, well-being, and engagement outcomes. In this study, we evaluate the effectiveness of both the SEED Method and a modified Delphi method in a participatory project to develop local strategies to address the opioid epidemic in three rural communities. The purpose of this study is to increase the level of evidence for community-engaged research methods through a randomized controlled trial. METHODS Two communities will use the SEED Method and one will use a modified Delphi method. We aim to recruit a total of 144 participants (48 per community). The evaluation team will randomize participants to an intervention group or a control group. In addition, we will collect outcome data from the participatory research team members leading the projects in each county (n = 18) and from additional community members who participate in focus groups (n = 32). The primary outcome for all participants will be the change in self-reported civic engagement as measured by the total score on the Individual Mobilization Scale. DISCUSSION In the context of participatory action to address opioid misuse in rural counties, this study will provide an understanding of the effectiveness of two community engagement methods for increasing civic engagement, as well as the extent to which participants successfully create locally tailored action strategies. The study will also explore how the observed effects differ depending on the participant's role in the project (stakeholder participant, community research team member, or focus group participant), which is an important consideration for participatory research.
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Affiliation(s)
- Emily B Zimmerman
- Center on Society and Health, Virginia Commonwealth University, Richmond, VA, USA.
| | - Carlin Rafie
- Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sophie G Wenzel
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Kathryn Hosig
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Domenique Villani
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jon Dance
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Samantha S Lee
- Center on Society and Health, Virginia Commonwealth University, Richmond, VA, USA
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Ryan L, Wenke R, Carlini J, Weir KA, Shapiro M, Baglot N, Tobiano G, Sargeant S, Hattingh L. Exploring barriers and solutions to consumer involvement in health service research using a nominal group technique. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:72. [PMID: 38992779 PMCID: PMC11241927 DOI: 10.1186/s40900-024-00604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Consumer involvement in health research is when patients, their families and caregivers work with researchers on research projects. Despite the growing expectation for health services to facilitate the involvement of consumers in research, the practical integration of this approach is an ongoing process, with limited research conducted into how Australian health services can support this practice. This study explored consumer perspectives on the barriers and solutions to enabling consumer involvement in research within an Australian tertiary hospital and health service, and staff perspectives on the solutions to facilitating consumer involvement. A prior survey had identified barriers to consumer involvement from the staff perspective. The broad aim was to inform the development of a framework to help promote consumer involvement in research within the health service. METHODS A Nominal Group Technique (NGT) was utilised with groups comprised of health service consumers and staff. Three health consumers were co-researchers in the full life-cycle of this study and are included as authors. RESULTS Ten consumers and 14 staff participated across three sessions ranging from one to three hours. For consumers, barriers to their involvement were grouped into seven domains: (1) lack of connection with researchers/research projects, (2) low research literacy, (3) structural barriers, (4) lack of acknowledgement, (5) implementation challenges, (6) inadequate information provision, and (7) representation concerns. Solutions to enabling involvement were grouped into five domains: (1) support to connect with researchers/research projects, (2) adequate information provision, (3) incentive for involvement, (4) acknowledgement, and (5) balanced representation. Staff ideas for solutions were grouped into five domains: (1) support to connect with consumers, (2) support to involve consumers, (3) access to funds to remunerate consumers, (4) more time to involve consumers, and (5) staff training. CONCLUSION Through an NGT methodology, this study delivered a nuanced comprehension of perspectives on involving consumers in research from both health service consumers and staff. These findings serve as a foundation for identifying strategies that foster enhanced and refined relationships between consumers and researchers, advancing the collaborative landscape in health research. The findings from this project offer valuable strategies for researchers to better engage consumers in research and for consumer groups to enhance their involvement. Additionally, these insights could be used by other health services to advocate for essential resources.
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Affiliation(s)
- Laura Ryan
- Gold Coast Hospital and Health Service, Allied Health Research, Southport, QLD, 4215, Australia.
| | - Rachel Wenke
- Gold Coast Hospital and Health Service, Allied Health Research, Southport, QLD, 4215, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, 4226, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
| | - Joan Carlini
- Consumer Advisory Group, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia
- Department of Marketing, Griffith Business School, Griffith University, Gold Coast Campus, Griffith, QLD, 4111, Australia
| | - Kelly A Weir
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
- The Royal Children's Hospital Melbourne, Parkville, VIC, 3052, Australia
| | - Margaret Shapiro
- Consumer Advisory Group, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia
| | - Noela Baglot
- Consumer Advisory Group, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia
| | - Georgia Tobiano
- NHMRC CRE in Wiser Wound Care, Griffith University, Griffith, QLD, 4222, Australia
- Nursing and Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia
| | - Sally Sargeant
- Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Laetitia Hattingh
- Gold Coast Hospital and Health Service, Allied Health Research, Southport, QLD, 4215, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Griffith, QLD, 4222, Australia
- School of Pharmacy, The University of Queensland, Queensland, QLD, 4102, Australia
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Potter E, Lewis C, Tilbury A, Tong J, Sipanoun P. Improving healthcare transition for young people with cancer: factors fundamental to the quality improvement journey. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:622-629. [PMID: 38954441 DOI: 10.12968/bjon.2023.0146] [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: 07/04/2024]
Abstract
BACKGROUND Young people receiving cancer treatment in the South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network usually receive care across two or more NHS trusts, meaning transition into adult services can be challenging. AIM To develop a planned, co-ordinated approach to transition across the network that meets National Institute for Health and Care Excellence guidance recommendations for transition and the cancer service specifications. METHODS A 2-year, nurse-led quality improvement (QI) project, using the principles of experience-based co-design. OUTCOMES The QI project resulted in the development of six key principles of practice; refining and testing of a benchmarking tool; initiatives to facilitate first transition conversations; and the launch of an information hub. CONCLUSION Robust QI processes, cross-network collaboration and wide stakeholder involvement required significant resource, but enabled deeper understanding of existing pathways and processes, facilitated the establishment of meaningful objectives, and enabled the testing of interventions to ensure the project outcomes met the needs of all stakeholders.
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Affiliation(s)
- Emma Potter
- Nurse Practitioner Transition and Long Term Follow Up, The Royal Marsden NHS Foundation Trust, London; South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network, London
| | | | | | - Jason Tong
- Network Manager, South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network, The Royal Marsden NHS Foundation Trust, RM Partners Cancer Alliance, London
| | - Pippa Sipanoun
- Research Fellow in Transition, University of Surrey, Guildford; Lead Practice Educator-Health Inequalities, Great Ormond Street Hospital for Children NHS Foundation Trust, London; and University College London Great Ormond Street Institute of Child Health, London
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11
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Waterland JL, Beer C, Forbes Shepherd R, Forrest LE. Exploring Consumers' Motivations and Experiences of Engaging as Partners in Cancer Research. THE PATIENT 2024; 17:471-479. [PMID: 38401039 PMCID: PMC11189992 DOI: 10.1007/s40271-023-00667-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Consumer engagement improves research quality and relevance but can be difficult to implement. This study aimed to explore the motivations and understand the barriers, if any, experienced by consumers before and when partnering with cancer research teams. METHODS Semi-structured interviews were conducted with consumers and the results analysed thematically. Two groups were recruited: consumers who were members of the consumer registry and patients who did not have previous experience of being a consumer in a researcher partnership. RESULTS Twenty-one interviews were conducted with a total of 22 participants aged between 26 and 74 years. Consumers motivation was driven by altruism to help others and personal benefits. Barriers to beginning and maintaining consumer engagement included consumers' perceptions of being appreciated by researchers and meaningful communication between researchers and consumers. CONCLUSIONS Australian policy has made important steps towards consumer engagement in research. This study showed that demonstrating an appreciation for consumers and effective communication are key areas to consider when designing implementation strategies of these policies in the cancer research space in the future.
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Affiliation(s)
- Jamie L Waterland
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Cassandra Beer
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Rowan Forbes Shepherd
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Laura E Forrest
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
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12
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Slowka S. An end to the "muffin meeting": Conceptualizing power and navigating tokenism in patient engagement for health leaders. Healthc Manage Forum 2024; 37:296-300. [PMID: 38551805 DOI: 10.1177/08404704241239862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Patient engagement is emerging as a priority for Canadian health leaders. Alongside the proliferation of patient engagement efforts in healthcare organizations and networks, awareness that tokenism can potentially occur within such efforts, as well as strategies to mitigate it, are gaining increased attention. While many actions associated with more tokenistic forms of patient engagement have been identified, this article posits there is a need to pay critical attention to the concept and role of power in enabling these actions in the first place. Of particular importance is how power and knowledge work to shape healthcare organizations and can create unequal relations with the patients they seek to engage. Drawing on the literature, this article serves as a theoretical roadmap for health leaders to think critically about power, as well as a set of prompts that can be used to reflexively consider their role in navigating power dynamics in the context of patient engagement efforts. This article contends that building awareness of power is a critical step for health leaders and organizations and that navigating power differences is a necessary leadership competency for engaging patients in decision-making throughout all stages of healthcare improvement and organizational change efforts.
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Affiliation(s)
- Steven Slowka
- London Health Sciences Centre, London, Ontario, Canada
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13
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Chiu HHL, Lee BKS, Bennett LL, Spensley JR, Dear WW, Koo W, Saunders SM, Freeborn GT. Growing a provincial patient and family engagement network to optimize kidney care. Healthc Manage Forum 2024; 37:268-275. [PMID: 38567404 PMCID: PMC11264530 DOI: 10.1177/08404704241239864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Patient and family engagement is crucial for a responsive health system and improves patient outcomes. However, few practical resources for purposeful engagement are available to health leaders. Over the past five years, BC Renal, the provincial kidney care network in British Columbia, developed, operationalized, and implemented a framework to enable meaningful patient and family engagement. An advisory committee, comprising patient partners and representatives from health authorities and the community, directs the outreach, resource development, and evaluation of patient and family engagement at BC Renal. Here, we describe how our network-wide patient engagement strategy was developed and expanded upon, and the progress so far. A 2022 survey reports that 95% were satisfied with the engagement opportunities, and narrative feedback suggests network members continue to adopt practical ways to collaborate more effectively. Health leaders, patient partners, and others continue to align operational and strategic activities to advance culture change in kidney care provincially.
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Affiliation(s)
| | | | | | | | | | - Winphia Koo
- Providence Health Care, Vancouver, British Columbia, Canada
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14
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King Z, Brown-Johnson C, Forneret A, Yang D, Malcolm E, Ginete DR, Mercado-Lara E, Zulman DM. Promoting Diversity, Equity, Inclusion, and Justice in Grantmaking for Health Care Research: A Pragmatic Review and Framework. Health Equity 2024; 8:391-405. [PMID: 39015220 PMCID: PMC11250833 DOI: 10.1089/heq.2023.0263] [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] [Accepted: 05/09/2024] [Indexed: 07/18/2024] Open
Abstract
Funders of research have an opportunity to advance health equity and social justice by incorporating principles of diversity, equity, inclusion, and justice (DEIJ) in their approach to grantmaking. We conducted a pragmatic review to identify opportunities for grantmakers in the health care sector to integrate DEIJ in their funding activities. The resulting framework discusses recommendations within three phases as follows: (1) Organizational Context (i.e., initiate DEIJ efforts within the grantmaking organization, invest in community partnerships, and establish DEIJ goals), (2) Grantmaking Process (i.e., DEIJ-specific practices related to grant design, application, proposal review processes, and support for grantees), and (3) Assessment of Process and Outcomes (i.e., measurement, evaluation, and dissemination to maximize impact of DEIJ efforts). Throughout all grantmaking phases, it is critical to partner with and engage individuals and communities that have been historically marginalized in health care and research. In this article, we describe how adoption of framework practices can leverage grantmaking to advance DEIJ for communities, researchers, and projects.
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Affiliation(s)
- Zoe King
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Cati Brown-Johnson
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Daniel Yang
- Gordon and Betty Moore Foundation, Palo Alto, California, USA
- Kaiser Permanente, Oakland, California, USA
| | - Elizabeth Malcolm
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Eunice Mercado-Lara
- Open Research Community Accelerator (ORCA), San Francisco, California, USA
- Haas School of Business, University of California, Berkeley, California, USA
| | - Donna M. Zulman
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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15
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Guinan E, Heuston C, Sheill G, Chonghaile MN, Orfali N. Health professionals' perceptions of prehabilitation before haematopoietic cell transplantation to optimise candidacy in older adults. Support Care Cancer 2024; 32:465. [PMID: 38926198 PMCID: PMC11208210 DOI: 10.1007/s00520-024-08659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE Haematologic malignancies for the most part are diseases of the elderly. Haematopoietic stem cell transplantation (HSCT) remains the only potentially curative strategy for many patients but carries substantial morbidity and mortality risks, particularly in frail or co-morbid patients. Pre-transplant optimisation of key targets through prehabilitation may have significant clinical impact. METHODS We utilised qualitative methodology (semi-structured interviews) to gain insights and understanding of the perceptions of medical, nursing and allied health professionals towards prehabilitation before haematopoietic cell transplantation to optimise candidacy in older adults. Thematic analysis was performed using a qualitative descriptive approach completed in duplicate by two researchers. RESULTS Between August and October 2023, eleven health professionals participated from four large cancer centres across the island of Ireland (n = 3 consultant haematologists, n = 7 specialist haematology nurses and n = 1 senior haematology physiotherapist). Four major themes were identified. The themes comprehensive biopsychosocial care and increasing demand for transplant in older patients highlight the unique challenges impacting older adults who receive HSCT. The multimodality pathways of care theme highlights the heterogeneity of treatment pathways across different clinical sites and disease types. This has implications for the prehabilitation: logistics and benefits theme, which indicated strong support for prehabilitation but emphasised that implementation must consider national reach and context. CONCLUSIONS There is broad national multidisciplinary interest in the development of prehabilitation programmes for patients being considered for transplant. Our results will inform the development of services in this area in consideration of national reach, malignancy-specific pathways and the unique factors associated with older age.
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Affiliation(s)
- E Guinan
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland.
- Trinity St James's Cancer Institute, Dublin, Ireland.
| | - C Heuston
- Department of Physiology, Trinity College Dublin, Dublin, Ireland
| | - G Sheill
- Trinity St James's Cancer Institute, Dublin, Ireland
- Department of Physiotherapy, St James's Hospital, Dublin, Ireland
| | - M Ní Chonghaile
- Trinity St James's Cancer Institute, Dublin, Ireland
- National Adult Stem Cell Transplant Unit, St James's Hospital, Dublin, Ireland
| | - N Orfali
- Trinity St James's Cancer Institute, Dublin, Ireland
- National Adult Stem Cell Transplant Unit, St James's Hospital, Dublin, Ireland
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16
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Määttä S, Petersson C, Gäre BA, Henriks G, Ånfors H, Lundberg C, Nilsagård Y. Experiences of co-producing person-centred and cohesive clinical pathways in the national system for knowledge-based management in Swedish healthcare: a qualitative study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:55. [PMID: 38849932 PMCID: PMC11157721 DOI: 10.1186/s40900-024-00565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/18/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND When the 21 Swedish county councils decided to collaborate in the creation of a national system for knowledge-based management, patient participation was mandatory. Patient and next-of-kin representatives (PR) co-produced person-centred and cohesive clinical pathways together with healthcare professionals (HPR). Research on co-production in healthcare at the national level is scarce. The aim of this study is to explore experiences of patient participation from the perspectives of both PRs and HPRs when co-producing clinical pathways within the Swedish nationwide healthcare system for knowledge-based management. METHODS A qualitative study was conducted. A strategic sample of nine PRs and eight HPRs were interviewed individually between August 2022 and January 2023 using a semi-structured interview guide. We analysed data using an inductive content analysis. RESULTS Three main categories were identified: (1) Finding appropriate patient representativeness; (2) Working methods that facilitate a patient perspective; and (3) Influence of the patient perspective in the clinical pathways. CONCLUSIONS The study demonstrates the importance of patient and next-of-kin participation in the construction of clinical pathways at the national level. The results provide a platform for further research on patient participation on the national level and add to studies on if and how patient participation on this level has an impact on how the clinical pathways are put into practice at the micro level, and the support provided at the meso level. The study contributes to the growing body of literature studying patient participation and co-production. TRIAL REGISTRATION Region Örebro County ID 276,940. An advisory opinion was obtained from the Swedish Ethical Review Authority (2021-05899-01).
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Affiliation(s)
- Sylvia Määttä
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christina Petersson
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Center for Learning and Innovation at Region Jönköping County, Sweden, Sweden.
| | - Boel Andersson Gäre
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Sweden and Futurum, Region Jönköping County, Jönköping, Sweden
| | - Göran Henriks
- Yerevan State University, Strategic Advisor Region Jönköping County, Yerevan, Sweden
| | - Henrik Ånfors
- Qulturum - Center for Learning and Innovation, Region Jönköping County, Jönköping, Sweden
| | | | - Ylva Nilsagård
- University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Ankomah SE, Fusheini A, Derrett S. 'Two heads are better than one'-exploring the experiences of Ghanaian communities on the role of patient and public participation in health system improvement. Health Policy Plan 2024; 39:603-612. [PMID: 38635419 PMCID: PMC11145915 DOI: 10.1093/heapol/czae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
Patient and Public Participation (PPP) is key to improving health systems. Yet, studies have shown that PPP implementations across many countries have been largely tokenistic. Particularly, in Ghana, whilst PPP is prioritized in national health policies and legislation, there appears to be little research focused on understanding PPP's role in health system improvement. The aim of this study, therefore, is to examine how PPP is working across the Ghanaian health system levels, as well as to understand the perspectives and experiences of participants on how PPP contributes to health system improvement. The qualitative study was undertaken in six communities in three districts in the Ashanti region of Ghana. Data were collected from semi-structured individual interviews. The selection of participants was purposive, based on their PPP-related roles. As a result, findings of this study may not reflect the experiences of others who are not directly involved in PPP initiatives. Thirty-five participants, mainly health service users and health professionals, were interviewed. Data were transcribed and analysed descriptively using Braun and Clarke's (2006) thematic analysis approach. Overall, participants noted PPP implementation was largely limited at higher health system levels (i.e. national, regional and district levels), but was functioning at the community level. PPP also improved access to health services, responsiveness to patient needs, community-health worker relationships, health-seeking behaviours, empowered healthcare users and improved health outcomes. The study, therefore, recommended the need to undertake PPP across all levels of the health system to maximize PPP's role in health system improvement. Finally, the study suggested prioritizing PPP, especially for resource-poor countries, to complement government's efforts in improving accessibility of healthcare services to many communities and also provide a more patient-centred healthcare system responsive to patients' and public needs.
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Affiliation(s)
- Samuel Egyakwa Ankomah
- Department of Preventive and Social Medicine, Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, P.O. Box GP1563, Kumasi, Ghana
| | - Adam Fusheini
- Department of Preventive and Social Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
- Center for Health Literacy and Rural Health Promotion, P.O. Box 1934, Accra, Ghana
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
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de Carvalho Corôa R, Ben Charif A, Robitaille V, G. V. Mochcovitch D, Abdoulaye Samri M, Akpo TG, Gogovor A, Blanchette V, Gomes Souza L, Kastner K, M. Achim A, McLean RKD, Milat A, Légaré F. Strategies for involving patients and the public in scaling initiatives in health and social services: A scoping review. Health Expect 2024; 27:e14086. [PMID: 38837509 PMCID: PMC11150745 DOI: 10.1111/hex.14086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Scaling in health and social services (HSS) aims to increase the intended impact of proven effective interventions. Patient and public involvement (PPI) is critical for ensuring that scaling beneficiaries' interests are served. We aimed to identify PPI strategies and their characteristics in the science and practice of scaling in HSS. METHODS In this scoping review, we included any scaling initiative in HSS that used PPI strategies and reported PPI methods and outcomes. We searched electronic databases (e.g., Medline) from inception to 5 February 2024, and grey literature (e.g., Google). Paired reviewers independently selected and extracted eligible reports. A narrative synthesis was performed and we used the PRISMA for Scoping Reviews and the Guidance for Reporting Involvement of Patients and the Public (GRIPP2). FINDINGS We included 110 unique reports out of 24,579 records. In the past 5 years, the evidence on PPI in scaling has increased faster than in any previous period. We found 236 mutually nonexclusive PPI strategies among 120 scaling initiatives. Twenty-four initiatives did not target a specific country; but most of those that did so (n = 96) occurred in higher-income countries (n = 51). Community-based primary health care was the most frequent level of care (n = 103). Mostly, patients and the public were involved throughout all scaling phases (n = 46) and throughout the continuum of collaboration (n = 45); the most frequently reported ethical lens regarding the rationale for PPI was consequentialist-utilitarian (n = 96). Few papers reported PPI recruitment processes (n = 31) or incentives used (n = 18). PPI strategies occurred mostly in direct care (n = 88). Patient and public education was the PPI strategy most reported (n = 31), followed by population consultations (n = 30). CONCLUSIONS PPI in scaling is increasing in HSS. Further investigation is needed to better document the PPI experience in scaling and ensure that it occurs in a meaningful and equitable way. PATIENT AND PUBLIC CONTRIBUTION Two patients were involved in this review. They shared decisions on review questions, data collection instruments, protocol design, and findings dissemination. REVIEW REGISTRATION Open Science Framework on 19 August 2020 (https://osf.io/zqpx7/).
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Affiliation(s)
- Roberta de Carvalho Corôa
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | | | | | - Diogo G. V. Mochcovitch
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
| | | | - Talagbe Gabin Akpo
- Faculty of Business AdministrationUniversité LavalQuebec CityQuebecCanada
- Institut National de la Recherche ScientifiqueUniversité LavalQuebec CityQuebecCanada
| | - Amédé Gogovor
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | - Virginie Blanchette
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Department of Human Kinetics and Podiatric MedicineUniversité du Québec à Trois‐RivièresTrois‐RivièresQuebecCanada
| | - Lucas Gomes Souza
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | | | - Amélie M. Achim
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- CERVO Brain Research CentreQuebec CityQuebecCanada
| | - Robert K. D. McLean
- International Development Research CentreOttawaOntarioCanada
- Faculty of Medicine and Health SciencesStellenbosch UniversityStellenboschWestern CapeSouth Africa
| | - Andrew Milat
- School of Public HealthUniversity of SydneySydneyNew South WalesAustralia
- Sydney Health PartnersSydneyNew South WalesAustralia
| | - France Légaré
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- Centre de Recherche du CHU de Québec ‐ Université LavalQuebec CityQuebecCanada
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Li M, Ma X, Xu H, Han M, Gou L, Du H, Wei L, Zhang D. Assessment of the quality, diagnosis, and therapeutic recommendations of clinical practice guidelines on patients with Helicobacter pylori infection: A systematic review. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:627-645. [PMID: 38307489 DOI: 10.1016/j.gastrohep.2024.01.006] [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: 07/25/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
We conducted this study to systematically review and assess the current clinical practice guidelines (CPGs) related to the diagnosis and treatment of Helicobacter pylori (H. pylori) infection. The aim was to evaluate the quality of these included CPGs and provide clinicians with a convenient and comprehensive reference for updating their own CPGs. We searched four databases to identify eligible CPGs focusing on H. pylori diagnosis and treatment recommendations. The results were presented using evidence mappings. Quality and clinical applicability were assessed comprehensively using AGREE-II and AGREE-REX. Statistical tests, specifically Bonferroni tests, were employed to compare the quality between evidence-based guidelines and consensus. A total of 30 eligible CPGs were included, comprising 17 consensuses and 13 guidelines. The quality showed no statistical significance between consensuses and guidelines, mainly within the moderate to low range. Notably, recommendations across CPGs exhibited inconsistency. Nevertheless, concerning diagnosis, the urea breath test emerged as the most frequently recommended method for testing H. pylori. Regarding treatment, bismuth quadruple therapy stood out as the predominantly recommended eradication strategy, with high-dose dual therapy being a newly recommended option. Our findings suggest the need for specific organizations to update their CPGs on H. pylori or refer to recently published CPGs. Specifically, CPGs for pediatric cases require improvement and updating, while a notable absence of CPGs for the elderly was observed. Furthermore, there is a pressing need to improve the overall quality of CPGs related to H. pylori. Regarding recommendations, additional evidence is essential to elucidate the relationship between H. pylori infection and other diseases and refine test indications. Clinicians are encouraged to consider bismuth quadruple or high-dose dual therapy, incorporating locally sensitive antibiotics, as empirical radical therapy. .
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Affiliation(s)
- Muyang Li
- The Second Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xueni Ma
- The Second Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Huimei Xu
- The Second Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Mengyu Han
- The Second Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Lingzhu Gou
- The Second Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Hongwei Du
- Department of Gastroenterology, The Second People's Hospital of Lanzhou, Lanzhou City, Gansu Province, China
| | - Lina Wei
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China
| | - Dekui Zhang
- Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China.
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Visser M, ‘t Hart N, de Mul M, Weggelaar‐Jansen AM. The Perspectives of Healthcare Professionals and Managers on Patient Involvement in Care Pathway Development: A Discourse Analysis. Health Expect 2024; 27:e14101. [PMID: 38855873 PMCID: PMC11163266 DOI: 10.1111/hex.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND The WHO advocates patient and public involvement as an ethical imperative, due to the value of the lived experience of patients. A deeper understanding of the shared meanings and underlying beliefs of healthcare professionals and managers for and against including patients in care pathway development. OBJECTIVE To explore the considerations of healthcare professionals and managers on the involvement of patients and public in care pathway development. METHODS In a medical rehabilitation centre we conducted a single case study that was part of a 2-year action research programme on blended care pathway development. Following 14 semistructured interviews with healthcare professionals and managers, we analysed their discourses on the value of patient involvement as well as the potential threats and opportunities. RESULTS We identified four discourses. Patient as expert frames involvement as relevant, as adding new perspectives and as required to fully understand the patient's needs. Skills and representation is based on the construct that obtaining valuable insights from patients requires certain skills and competences. Self-protection focusses on personal, interprofessional objections to patient involvement. Professional knows best reveals expertise-related reasons for avoiding or postponing involvement. CONCLUSION These discourses explain why patient and public involvement in care pathway development is sometimes postponed, limited in scope and level of participation, and/or avoided. The following strategies might minimise the paralysing effect of these discourses: strengthen the capabilities of all stakeholders involved; use a mix of complementary techniques to gain involvement in distinct phases of care pathway development; and create/facilitate a safe environment. Put together, these strategies would foster ongoing, reciprocal learning that could enhance patient involvement. PATIENT OR PUBLIC CONTRIBUTION This study belonged to an action research programme on blended care pathway development (developing an integrated, coordinated patient care plan that combines remote, digital telehealth applications, self-management tools and face-to-face care). Multidisciplinary teams took a quality collaborative approach to quality improvement (considering patients as stakeholders) to develop 11 blended care pathways. Although professionals and managers were instructed to invite patients onto their teams and to attend care pathway design workshops, few teams (3/11) actually did. Unravelling why this happened will help improve patient and public involvement in care pathway development.
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Affiliation(s)
- Mildred Visser
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Naomi ‘t Hart
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Marleen de Mul
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Anne Marie Weggelaar‐Jansen
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
- Clinical InformaticsEindhoven University of TechnologyEindhovenThe Netherlands
- Tranzo, Tilburg School of Social and Behavioural SciencesTilburg UniversityTilburgThe Netherlands
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de Weger E, Drewes H, Luijkx K, Baan C. Tracking the Development of Community Engagement Over Time: Realist Qualitative Study. J Particip Med 2024; 16:e47500. [PMID: 38748458 PMCID: PMC11137424 DOI: 10.2196/47500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/30/2023] [Accepted: 11/12/2023] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND A growing interest in engaging communities in the development of health care services and communities has not automatically led to progress or consensus as to how to engage communities successfully, despite the evidence base showing how to leverage enablers and alleviate barriers. OBJECTIVE To bridge the gap between the evidence base and which community engagement (CE) approaches have actually been applied in practice over time, this study aims to investigate how CE approaches have changed over the past 4 years in 6 different regions in the Netherlands and citizens' and professionals' experiences underlying these changes. METHODS For the last stage of a multiple case study following the development of CE approaches in 6 different regions in the Netherlands, a realist qualitative case study was conducted. To investigate how CE approaches had changed over the past 4 years, data from the entire 4 years of the study were used, including documents, interview transcripts, and observations. To examine citizens' and professionals' experiences underlying these changes, new interviews were conducted. The latest interview results were discussed with a panel to ensure the results had face validity. RESULTS The regions had implemented different types of CE approaches over the past 4 years and were adapting these approaches over time. Many of the (remaining) approaches may be operating on a smaller scale. The study identified the following overarching themes along which CE had been adapted: fewer region-wide approaches and more community-focused approaches, more focus on building relationships with (already engaged) citizens and community-led initiatives, and more focus on practical and tangible health promotion and social cohesion activities and less focus on complex "abstract" programs. The study identified a further 4 overarching themes highlighting citizens' and professionals' experiences underlying these changes in the CE approaches: a lack of engagement environment, need for facilitative leadership from organizations, need for a clear and shared vision underscoring the importance of CE, and misalignment between citizens' and professionals' perspectives and motivations for CE. All participants had experienced the engagement environment as insufficient. To support CE, professionals experienced the need to develop and receive more facilitative leadership and to develop approaches better equipped to involve citizens in the decision-making process. Citizens experienced the need to better align citizens' and professionals' motivations and aims for CE approaches and to receive longer-term financial support for their community-led initiatives. CONCLUSIONS This study suggests that CE has not yet been embedded within organizational cultures. This has arguably meant that the (remaining) CE approaches are operating on a smaller scale. To enable the further development of CE approaches, an investment in the engagement environment and a shared vision is required. Only then could CE within the regions move beyond the more seemingly smaller-scale CE approaches.
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Affiliation(s)
- Esther de Weger
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Katrien Luijkx
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - Caroline Baan
- Department of Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
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Haar T, Brownlow C, Hall G, Heyworth M, Lawson W, Poulsen R, Reinisch T, Pellicano E. 'We have so much to offer': Community members' perspectives on autism research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241248713. [PMID: 38741516 DOI: 10.1177/13623613241248713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
LAY ABSTRACT Autism research is changing. Autistic activists and researchers want Autistic people in the community to have more of a say about what is researched and how. But we haven't asked people in the community what they think. This study used the information obtained from 55 community members, including Autistic people, their families, and professionals working with Autistic people, from an existing study on their priorities for autism research. We re-looked at what was said to see if we could understand community members' views and experiences of autism research. People agreed strongly that research can play a powerful role in shaping good Autistic lives. They also felt that big changes were needed for research to do this. Some of these changes were that researchers should stop thinking about autism narrowly and in a negative way, where Autistic people are seen as the problem. Researchers need to think more about how to improve systems, experiences and how other people respond to Autistic people. They also want the autism community to be more involved in what is researched and how it is researched. The findings from our study here highlight the potential for research to be positive when Autistic people and their families are listened to, approached with understanding, and are respected and valued as individuals in the research process.
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Affiliation(s)
- Tori Haar
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | - Charlotte Brownlow
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- University of Southern Queensland, Australia
| | - Gabrielle Hall
- Macquarie University, Australia
- ORIMA Research, Australia
| | - Melanie Heyworth
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | - Wenn Lawson
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Rebecca Poulsen
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | | | - Elizabeth Pellicano
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- University College London, UK
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Rao S, Dimitropoulos G, Jardine R, Quickstad J, Satam L, Qureshi M, Bui T, Todorova AA, Tumaneng Y, Suthakaran A, Dalley K, Smith S, Patten SB. Primus Inter PARES: First among equals-practical strategies for young adult PAtient RESearch partners (PARES) by young adult PARES. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:45. [PMID: 38720386 PMCID: PMC11077772 DOI: 10.1186/s40900-024-00576-0] [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: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures. MAIN BODY The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them. CONCLUSION This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose.
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Affiliation(s)
- Sandy Rao
- Faculty of Social Work, University of Calgary, Calgary, Canada.
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada.
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
| | - Rae Jardine
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Julien Quickstad
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Laetitia Satam
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Mohammad Qureshi
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Thyra Bui
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Antoaneta Alexandrova Todorova
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ysabelle Tumaneng
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Abitha Suthakaran
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Kaiden Dalley
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
| | - Stacie Smith
- Mental Health Accessibility and Policy Solutions Lab, Mississauga, ON, Canada
- Faculty of Education, Mount Saint Vincent University, Halifax, NS, Canada
| | - Scott B Patten
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Weiler‐Wichtl LJ, Schneider C, Gsell H, Maletzky A, Kienesberger A, Röhl C, Bocolli A, Gojo J, Hansl R, Zettl A, Hopfgartner M, Leiss U. Asking those who know their needs best: A framework for active engagement and involvement of childhood cancer survivors and parents in the process of psychosocial research-A workshop report. Cancer Rep (Hoboken) 2024; 7:e2071. [PMID: 38767531 PMCID: PMC11104286 DOI: 10.1002/cnr2.2071] [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: 10/23/2023] [Revised: 03/22/2024] [Accepted: 03/30/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Patient and public involvement and engagement (PPIE) in healthcare research is crucial for effectively addressing patients' needs and setting appropriate research priorities. However, there is a lack of awareness and adequate methods for practicing PPIE, especially for vulnerable groups like childhood cancer survivors. AIMS This project aimed to develop and evaluate engagement methods to actively involve pediatric oncological patients, survivors, and their caregivers in developing relevant research questions and practical study designs. METHODS AND RESULTS An interdisciplinary working group recruited n = 16 childhood cancer survivors and their caregivers to work through the entire process of developing a research question and a practicable study design. A systematic literature review was conducted to gather adequate PPIE methods which were then applied and evaluated in a series of three workshop modules, each lasting 1.5 days. The applied methods were continuously evaluated, while a monitoring group oversaw the project and continuously developed and adapted additional methods. The participants rated the different methods with varying scores. Over the workshop series, the participants successfully developed a research question, devised an intervention, and designed a study to evaluate their project. They also reported increased expertise in PPIE and research knowledge compared to the baseline. The project resulted in a practical toolbox for future research, encompassing the final workshop structure, evaluated methods and materials, guiding principles, and general recommendations. CONCLUSION These findings demonstrate that with a diverse set of effective methods and flexible support, actively involving patients, survivors, and caregivers can uncover patients' unmet disease-related needs and generate practical solutions apt for scientific evaluation. The resulting toolbox, filled with evaluated and adaptable methods (workbook, Supplement 1 and 2), equips future scientists with the necessary resources to successfully perform PPIE in the development of health care research projects that effectively integrate patients' perspectives and address actual cancer-related needs. This integration of PPIE practices has the potential to enhance the quality and relevance of health research and care, as well as to increase patient empowerment leading to sustainable improvements in patients' quality of life.
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Affiliation(s)
- Liesa J. Weiler‐Wichtl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
- KOKON – Psychosocial and Mental Health in Pediatrics LabRohrbach‐BergUpper AustriaAustria
| | | | - Hannah Gsell
- Childhood Cancer International – Europe (CCI‐E)ViennaAustria
- Survivors AustriaViennaAustria
| | - Anna‐Maria Maletzky
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
| | | | - Claas Röhl
- Survivors AustriaViennaAustria
- NF KinderViennaAustria
| | - Albina Bocolli
- Childhood Cancer International – Europe (CCI‐E)ViennaAustria
| | - Johannes Gojo
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
| | - Rita Hansl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Anna Zettl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
| | - Maximilian Hopfgartner
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
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Jung OS, Kyle MA, McCree P, Nadel HM. Patient-Centered Innovation: Involving Patients in Open Social Innovation. Med Care 2024; 62:314-318. [PMID: 38498871 PMCID: PMC10990018 DOI: 10.1097/mlr.0000000000001987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Involving patients in the health-care delivery innovation has many benefits. Open social innovation (OSI) presents a fitting lens to examine and advance patient engagement in innovation. OSI offers a participatory approach to innovation, in which diverse groups of participants collaboratively generate ideas and scale solutions on complex social challenges. PURPOSE This study: (1) describes a pilot application of OSI, in which individuals serving on a hospital's patients and family advisory councils (PFACs) were invited to participate in an innovation contest; and (2) explores the extent to which patients' beliefs about their role in innovation relate to their participation in the contest. METHODOLOGY/APPROACH We conducted an innovation contest that invited PFAC members to share ideas that would improve patient experiences and then vote on and select the ideas that they wanted to see move forward. We measured patients' beliefs about their role in innovation in a survey before the contest. RESULTS Twenty individuals submitted 27 ideas. Patients who expressed preference for more involvement in innovation were more likely to participate. CONCLUSIONS Using OSI may help expand patient engagement in innovation, particularly among those who want to be more involved but do not feel authorized to voice ideas in traditional advisory committees. PRACTICAL IMPLICATIONS OSI spurred collaboration among patients, clinicians, quality improvement staff, hospital administrators, and other stakeholders in idea generation, elaboration, and implementation. More experimentation and research are needed to understand how OSI can be leveraged to capture patients' voice and incorporate them in care delivery innovation.
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Affiliation(s)
- Olivia S. Jung
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michael Anne Kyle
- Department of Health Care Policy, Harvard Medical School, Harvard University, Boston MA
| | - Paula McCree
- Healthcare Transformation Lab, Massachusetts General Hospital, Boston, MA
| | - Hiyam M. Nadel
- Center for Innovations in Care Delivery, Massachusetts General Hospital, Boston, MA
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26
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Lipinski S, Sünkel U, Totzeck C, Dresler T, Baskow I, Bea M, Hannig R, Dziobek I. [Patient and public involvement at the German Center for Mental Health: achievements and challenges]. DER NERVENARZT 2024; 95:458-466. [PMID: 38506976 PMCID: PMC11068695 DOI: 10.1007/s00115-024-01630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Patient and public involvement (PPI) describes the participation of patients and relatives, i.e., experts by experience (EE), in the research process. The PPI has not been widely adopted in the fields of medicine and clinical psychology in Germany and there is a notable absence of institutional support. The German Center for Mental Health (DZPG), which has been under construction since May 2023, aims to achieve nationwide and cross-center implementation of PPI, constituting one of its primary objectives. Participation of EE is to be implemented in the DZPG at all levels of decision-making. OBJECTIVES The article describes the origins, development and challenges associated with the implementation of participation structures and projects in the DZPG. The central political PPI committee in the DZPG, the Trilogue Center Council (TZR), developed a comprehensive PPI strategy for the DZPG in almost 3 years of work, before the beginning of the financial support of the DZPG. Among various measures, the strategy entails establishing a far-reaching representation for EE in all decision-making bodies of the DZPG, to involve EE as reviewers in evaluating research proposals, to integrate participatory elements into all studies of the DZGG and to foster user-initiated research endeavors. The implementation of the strategy is ensured by a cross-center PPI infrastructure, the Center for PPI, and scientific PPI consultants. The Center for PPI's tasks include supporting the voice of the EE and developing instruments and guidelines for participatory research, bringing together EE and researchers for joint DZPG projects as well as the documentation and quality assurance for participatory research. One of the particular challenges for the successful implementation of the PPI strategy is the limited experience with PPI in Germany in the field of mental health research and the widespread lack of structural implementation. Currently developed solution strategies include training for researchers and EE to communicate the benefits and pathways in the realization of PPI and thus enable shared decision-making and research. In addition, extensive access to knowledge and resources for EE will be created and uniform remuneration regulations for EE will be developed. CONCLUSION A PPI strategy at the DZPG has been successfully developed and is currently being implemented by the cross-center infrastructure Center for PPI.
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Affiliation(s)
- Silke Lipinski
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinische Psychologie Sozialer Interaktion, Institut für Psychologie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Deutschland
- Aspies e. V., Berlin, Deutschland
| | - Ulrike Sünkel
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Aspies e. V., Berlin, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Christina Totzeck
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Forschungs- und Behandlungszentrum für psychische Gesundheit (FBZ), Ruhr-Universität Bochum, Bochum, Deutschland
| | - Thomas Dresler
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen, Deutschland
- LEAD Graduate School & Research Network, Universität Tübingen, Tübingen, Deutschland
| | - Irina Baskow
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Myriam Bea
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- ADHS Deutschland e. V., Berlin, Deutschland
| | - Rüdiger Hannig
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG)
- Bundesverband der Angehörigen psychisch erkrankter Menschen e. V., Bonn, Deutschland
| | - Isabel Dziobek
- Trialogischer Zentrumsrat des DZPG, German Center for Mental Health (DZPG), .
- Klinische Psychologie Sozialer Interaktion, Institut für Psychologie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Deutschland.
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Haroutounian S, Holzer KJ, Kerns RD, Veasley C, Dworkin RH, Turk DC, Carman KL, Chambers CT, Cowan P, Edwards RR, Eisenach JC, Farrar JT, Ferguson M, Forsythe LP, Freeman R, Gewandter JS, Gilron I, Goertz C, Grol-Prokopczyk H, Iyengar S, Jordan I, Kamp C, Kleykamp BA, Knowles RL, Langford DJ, Mackey S, Malamut R, Markman J, Martin KR, McNicol E, Patel KV, Rice AS, Rowbotham M, Sandbrink F, Simon LS, Steiner DJ, Vollert J. Patient engagement in designing, conducting, and disseminating clinical pain research: IMMPACT recommended considerations. Pain 2024; 165:1013-1028. [PMID: 38198239 PMCID: PMC11017749 DOI: 10.1097/j.pain.0000000000003121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 01/12/2024]
Abstract
ABSTRACT In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clinical research lifecycle. It is becoming increasingly evident that to develop research that is both meaningful to people who have the targeted condition and is feasible, there are important benefits of involving patients in the planning, conduct, and dissemination of research from its earliest stages. In fact, research funders and regulatory agencies are now explicitly encouraging, and sometimes requiring, that patients are engaged as partners in research. Although this approach has become commonplace in some fields of clinical research, it remains the exception in clinical pain research. As such, the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials convened a meeting with patient partners and international representatives from academia, patient advocacy groups, government regulatory agencies, research funding organizations, academic journals, and the biopharmaceutical industry to develop consensus recommendations for advancing patient engagement in all stages of clinical pain research in an effective and purposeful manner. This article summarizes the results of this meeting and offers considerations for meaningful and authentic engagement of patient partners in clinical pain research, including recommendations for representation, timing, continuous engagement, measurement, reporting, and research dissemination.
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Affiliation(s)
- Simon Haroutounian
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Katherine J. Holzer
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Robert D. Kerns
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT, United States
| | - Christin Veasley
- Chronic Pain Research Alliance, North Kingstown, RI, United States
| | - Robert H. Dworkin
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Dennis C. Turk
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
| | - Kristin L. Carman
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC, United States
| | - Christine T. Chambers
- Departments of Psychology & Neuroscience and Pediatrics, Dalhousie University, and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Penney Cowan
- American Chronic Pain Association, Rocklin, CA, United States
| | - Robert R. Edwards
- Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, United States
| | - James C. Eisenach
- Departments of Anesthesiology, Physiology and Pharmacology, Wake Forest University School of Medicine, Winston Salem, NC, United States
| | - John T. Farrar
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - McKenzie Ferguson
- Southern Illinois University Edwardsville, School of Pharmacy, Edwardsville, IL, United States
| | - Laura P. Forsythe
- Patient-Centered Outcomes Research Institute (PCORI), Washington, DC, United States
| | - Roy Freeman
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Jennifer S. Gewandter
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Ian Gilron
- Departments of Anesthesiology & Perioperative Medicine and Biomedical & Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Christine Goertz
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, United States
| | | | - Smriti Iyengar
- Division of Translational Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Isabel Jordan
- Departments of Psychology & Neuroscience and Pediatrics, Dalhousie University, and Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Cornelia Kamp
- Center for Health and Technology/Clinical Materials Services Unit, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Bethea A. Kleykamp
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rachel L. Knowles
- Medical Research Council (part of UK Research and Innovation), London, United Kingdom
| | - Dale J. Langford
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, United States
| | - Sean Mackey
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical Center, Stanford, CA, United States
| | | | - John Markman
- Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Kathryn R. Martin
- Aberdeen Centre for Arthritis and Musculoskeletal Health, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Ewan McNicol
- Massachusetts College of Pharmacy and Health Sciences, Boston, MA, United States
| | - Kushang V. Patel
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
| | - Andrew S.C. Rice
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Michael Rowbotham
- Departments of Anesthesia and Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Friedhelm Sandbrink
- National Pain Management, Opioid Safety, and Prescription Drug Monitoring Program, Specialty Care Program Office, Veterans Health Administration, Washington, DC, United States
| | | | - Deborah J. Steiner
- Global Pain, Pain & Neurodegeneration, Eli Lilly and Company, Indianapolis, IN, United States
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany
- Department of Neurophysiology, Mannheim Center for Translational Neuroscience MCTN, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg, Germany
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28
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Carroll P, Dervan A, McCarthy C, Woods I, Beirne C, Harte G, O’Flynn D, O’Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Quinlan J, Smith É, Moriarty F, O’Brien FJ, Flood M. The role of Patient and public involvement (PPI) in pre-clinical spinal cord research: An interview study. PLoS One 2024; 19:e0301626. [PMID: 38683786 PMCID: PMC11057720 DOI: 10.1371/journal.pone.0301626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Patient and public involvement in research (PPI) has many benefits including increasing relevance and impact. While using PPI in clinical research is now an established practice, the involvement of patients and the public in pre-clinical research, which takes place in a laboratory setting, has been less frequently described and presents specific challenges. This study aimed to explore the perspectives of seriously injured rugby players' who live with a spinal cord injury on PPI in pre-clinical research. METHODS Semi-structured interviews were conducted via telephone with 11 seriously injured rugby players living with spinal cord injury on the island of Ireland. A purposive sampling approach was used to identify participants. Selected individuals were invited to take part via gatekeeper in a charitable organisation that supports seriously injured rugby players. Interviews were transcribed verbatim and analysed thematically. FINDINGS Six themes were identified during analysis: 'appreciating potential benefits of PPI despite limited knowledge', 'the informed perspectives of people living with spinal cord injury can improve pre-clinical research relevance', 'making pre-clinical research more accessible reduces the potential for misunderstandings to occur', 'barriers to involvement include disinterest, accessibility issues, and fear of losing hope if results are negative', 'personal contact and dialogue helps people feel valued in pre-clinical research, and 'PPI can facilitate effective dissemination of pre-clinical research as desired by people living with spinal cord injury.' CONCLUSION People affected by spinal cord injury in this study desire further involvement in pre-clinical spinal cord injury research through dialogue and contact with researchers. Sharing experiences of spinal cord injury can form the basis of PPI for pre-clinical spinal cord injury research.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Adrian Dervan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine (Royal College of Physicians in Ireland & RCSI), Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Dónal O’Flynn
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Cian O’Connor
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Tara McGuire
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Liam M. Leahy
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Martyna Stasiewicz
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Jack Maughan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dublin, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J. O’Brien
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
- PPI Ignite Network, Galway, Ireland
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Hellstrand Tang U, Smith F, Karilampi UL, Gremyr A. Exploring the Role of Complexity in Health Care Technology Bottom-Up Innovations: Multiple-Case Study Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability Complexity Assessment Tool. JMIR Hum Factors 2024; 11:e50889. [PMID: 38669076 PMCID: PMC11087855 DOI: 10.2196/50889] [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: 07/18/2023] [Revised: 02/24/2024] [Accepted: 03/02/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND New digital technology presents new challenges to health care on multiple levels. There are calls for further research that considers the complex factors related to digital innovations in complex health care settings to bridge the gap when moving from linear, logistic research to embracing and testing the concept of complexity. The nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework was developed to help study complexity in digital innovations. OBJECTIVE This study aims to investigate the role of complexity in the development and deployment of innovations by retrospectively assessing challenges to 4 digital health care innovations initiated from the bottom up. METHODS A multicase retrospective, deductive, and explorative analysis using the NASSS complexity assessment tool LONG was conducted. In total, 4 bottom-up innovations developed in Region Västra Götaland in Sweden were explored and compared to identify unique and shared complexity-related challenges. RESULTS The analysis resulted in joint insights and individual learning. Overall, the complexity was mostly found outside the actual innovation; more specifically, it related to the organization's readiness to integrate new innovations, how to manage and maintain innovations, and how to finance them. The NASSS framework sheds light on various perspectives that can either facilitate or hinder the adoption, scale-up, and spread of technological innovations. In the domain of condition or diagnosis, a well-informed understanding of the complexity related to the condition or illness (diabetes, cancer, bipolar disorders, and schizophrenia disorders) is of great importance for the innovation. The value proposition needs to be clearly described early to enable an understanding of costs and outcomes. The questions in the NASSS complexity assessment tool LONG were sometimes difficult to comprehend, not only from a language perspective but also due to a lack of understanding of the surrounding organization's system and its setting. CONCLUSIONS Even when bottom-up innovations arise within the same support organization, the complexity can vary based on the developmental phase and the unique characteristics of each project. Identifying, defining, and understanding complexity may not solve the issues but substantially improves the prospects for successful deployment. Successful innovation within complex organizations necessitates an adaptive leadership and structures to surmount cultural resistance and organizational impediments. A rigid, linear, and stepwise approach risks disregarding interconnected variables and dependencies, leading to suboptimal outcomes. Success lies in embracing the complexity with its uncertainty, nurturing creativity, and adopting a nonlinear methodology that accommodates the iterative nature of innovation processes within complex organizations.
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Affiliation(s)
- Ulla Hellstrand Tang
- Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Frida Smith
- Regional Cancer Centre West, Gothenburg, Sweden
- Department of Technology Management and Economics, Collaborative Plattform for Healthcare Improvement, Chalmers University of Technology, Gothenburg, Sweden
| | - Ulla Leyla Karilampi
- Department of Schizophrenia Spectrum Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andreas Gremyr
- Department of Schizophrenia Spectrum Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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30
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McCoy M, Shorting T, Mysore VK, Fitzgibbon E, Rice J, Savigny M, Weiss M, Vincent D, Hagarty M, MacLeod KK, Ernecoff NC, Pattison R, Kornberg M, Bruni A, Bush SH, Kuluski K, Fiset V, Li C, Parsons HA, Lalumière G, Connolly T, Webber C, Isenberg SR. Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home (ACEPATH): Codesigning an intervention to improve patient and family caregiver experiences. Health Expect 2024; 27:e14002. [PMID: 38549352 PMCID: PMC10979115 DOI: 10.1111/hex.14002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Returning home from the hospital for palliative-focused care is a common transition, but the process can be emotionally distressing and logistically challenging for patients and caregivers. While interventions exist to aid in the transition, none have been developed in partnership with patients and caregivers. OBJECTIVE To undergo the initial stages of codesign to create an intervention (Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home [ACEPATH]) to improve the experience of hospital-to-home transitions for adult patients receiving palliative care and their caregiver(s). METHODS The codesign process consisted of (1) the development of codesign workshop (CDW) materials to communicate key findings from prior research to CDW participants; (2) CDWs with patients, caregivers and healthcare providers (HCPs); and (3) low-fidelity prototype testing to review CDW outputs and develop low-fidelity prototypes of interventions. HCPs provided feedback on the viability of low-fidelity prototypes. RESULTS Three patients, seven caregivers and five HCPs participated in eight CDWs from July 2022 to March 2023. CDWs resulted in four intervention prototypes: a checklist, quick reference sheets, a patient/caregiver workbook and a transition navigator role. Outputs from CDWs included descriptions of interventions and measures of success. In April 2023, the four prototypes were presented in four low-fidelity prototype sessions to 20 HCPs. Participants in the low-fidelity prototype sessions provided feedback on what the interventions could look like, what problems the interventions were trying to solve and concerns about the interventions. CONCLUSION Insights gained from this codesign work will inform high-fidelity prototype testing and the eventual implementation and evaluation of an ACEPATH intervention that aims to improve hospital-to-home transitions for patients receiving a palliative approach to care. PATIENT OR PUBLIC CONTRIBUTION Patients and caregivers with lived experience attended CDWs aimed at designing an intervention to improve the transition from hospital to home. Their direct involvement aligns the intervention with patients' and caregivers' needs when transitioning from hospital to home. Furthermore, four patient/caregiver advisors were engaged throughout the project (from grant writing through to manuscript writing) to ensure all stages were patient- and caregiver-centred.
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Affiliation(s)
| | | | - Vinay Kumar Mysore
- Parsons School of Design, The New SchoolNew YorkNew YorkUSA
- OpenBoxBrooklynNew YorkUSA
| | | | - Jill Rice
- Bruyère Research InstituteOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | | | | | | | - Meaghen Hagarty
- The Ottawa HospitalOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
| | - Krystal Kehoe MacLeod
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- Department of Family MedicineUniversity of OttawaOttawaOntarioCanada
| | | | | | | | | | - Shirley H. Bush
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Kerry Kuluski
- Institute for Better Health, Trillium Health PartnersMississaugaOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Valerie Fiset
- Champlain Hospice Palliative Care ProgramOttawaOntarioCanada
- School of Nursing, University of OttawaOttawaOntarioCanada
| | - Cecilia Li
- The Ottawa HospitalOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
| | - Henrique A. Parsons
- The Ottawa HospitalOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Geneviève Lalumière
- Bruyère Continuing CareOttawaOntarioCanada
- Regional Palliative Consultation Team (RPCT)OttawaOntarioCanada
| | - Tara Connolly
- Accessibility InstituteCarleton UniversityOttawaOntarioCanada
| | - Colleen Webber
- Bruyère Research InstituteOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Sarina R. Isenberg
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
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31
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Stanworth JO, Hsu RS, Stanworth PA, Kemp JM, Tzen R, Wu HH. When Culture Matters: Using Compliments and Complaints to Define and Influence Chinese Patients' Satisfaction. HEALTH COMMUNICATION 2024; 39:136-147. [PMID: 36572566 DOI: 10.1080/10410236.2022.2160098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Despite patients' cultural background influencing their satisfaction with medical care the majority of studies draw on assumptions and models from the Western world. We move attention to the East Asian world by investigating the attributes of Chinese patients' satisfaction with their hospital in-patient care. Our research design is an exploratory qualitative study of 577 incidents of Chinese hospital in-patients' complaints and compliments. The data were drawn from a sample of reports of patients' satisfaction with their care in a district general hospital over a five-year period. Analysis focused on satisfactory and dissatisfactory events to derive attributes involved. We find patients in Chinese culture evaluate satisfaction with their care using eight attributes: professionalism, efficiency, chīn-chièh, respect, patience, responsibility, value and ethics. We explore how Chinese patients' values and beliefs toward medicine and care-giving construct distinct meanings around these attributes. By synthesizing our findings with those in the literature we propose generic attributes which can form the basis of measures of Chinese patient satisfaction and inform training in cultural competence.
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Affiliation(s)
- James O Stanworth
- Department of Business Administration, National Changhua University of Education
| | - Ryan Shuwei Hsu
- Department of Business Administration, National Chengchi University
| | - Peter A Stanworth
- Department of Neurosurgery, University Hospitals Coventry and Warwickshire NHS Trust
| | | | | | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education
- Department of M-Commerce and Multimedia Applications, Asia University
- Faculty of Education, State University of Malang
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32
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Sayani A, Cordeaux E, Wu K, Awil F, Garcia V, Hinds R, Jeji T, Khan O, Soh BL, Mensah D, Monteith L, Musawi M, Rathbone M, Robinson J, Sterling S, Wardak D, Amsdr I, Khawari M, Niwe S, Hussain A, Forster V, Maybee A. Using the Power Wheel as a transformative tool to promote equity through spaces and places of patient engagement. BMJ Open 2024; 14:e074277. [PMID: 38514144 PMCID: PMC10961587 DOI: 10.1136/bmjopen-2023-074277] [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: 03/31/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Patient engagement is the active collaboration between patient partners and health system partners towards a goal of making decisions that centre patient needs-thus improving experiences of care, and overall effectiveness of health services in alignment with the Quintuple Aim. An important but challenging aspect of patient engagement is including diverse perspectives particularly those experiencing health inequities. When such populations are excluded from decision-making in health policy, practice and research, we risk creating a healthcare ecosystem that reinforces structural marginalisation and perpetuates health inequities. APPROACH Despite the growing body of literature on knowledge coproduction, few have addressed the role of power relations in patient engagement and offered actionable steps for engaging diverse patients in an inclusive way with a goal of improving health equity. To fill this knowledge gap, we draw on theoretical concepts of power, our own experience codesigning a novel model of patient engagement that is equity promoting, Equity Mobilizing Partnerships in Community, and extensive experience as patient partners engaged across the healthcare ecosystem. We introduce readers to a new conceptual tool, the Power Wheel, that can be used to analyse the interspersion of power in the places and spaces of patient engagement. CONCLUSION As a tool for ongoing praxis (reflection +action), the Power Wheel can be used to report, reflect and resolve power asymmetries in patient-partnered projects, thereby increasing transparency and illuminating opportunities for equitable transformation and social inclusion so that health services can meet the needs and priorities of all people.
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Affiliation(s)
- Ambreen Sayani
- Women's College Hospital, Toronto, Ontario, Canada
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Kelly Wu
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Fatah Awil
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Victoria Garcia
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Ryan Hinds
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Tara Jeji
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Omar Khan
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Bee-Lee Soh
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Desiree Mensah
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Linda Monteith
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Mursal Musawi
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Marlene Rathbone
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Jill Robinson
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Staceyan Sterling
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Dean Wardak
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Isra Amsdr
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Mohadessa Khawari
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
| | - Salva Niwe
- Women's College Hospital, Toronto, Ontario, Canada
| | | | | | - Alies Maybee
- Equity- Mobilizing Partnerships in Community, Women's College Hospital, Toronto, Ontario, Canada
- Patient Advisors Network, Toronto, Ontario, Canada
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McGowan D, Morley C, Hansen E, Shaw K, Winzenberg T. Experiences of participants in the co-design of a community-based health service for people with high healthcare service use. BMC Health Serv Res 2024; 24:339. [PMID: 38486164 PMCID: PMC10938828 DOI: 10.1186/s12913-024-10788-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Incorporating perspectives of health consumers, healthcare workers, policy makers and stakeholders through co-design is essential to design services that are fit for purpose. However, the experiences of co-design participants are poorly understood. The aim of this study is to explore the experiences and perceptions of people involved in the co-design of a new service for people with high healthcare service utilisation. METHODS A methodology informed by the principles of grounded theory was used in this qualitative study to evaluate the experiences and perceptions of co-design participants. Participants were healthcare professionals, health managers and leaders and health consumers involved in the co-design of the new service in Tasmania, Australia. Semi-structured interviews were conducted, and data were iteratively and concurrently collected and analysed using constant comparative analysis. Audio/audio-visual recordings of interviews were transcribed verbatim. Transcripts, memos, and an audit trail were coded for experiences and perspectives of participants. RESULTS There were thirteen participants (5 health professionals, 6 health managers and leaders, and 2 health consumers). Codes were collapsed into six sub-themes and six themes. Themes were bureaucracy hinders co-design, importance of consumers and diversity, importance of a common purpose, relationships are integral, participants expectations inform their co-design experience and learning from co-design. CONCLUSION Most participants reported positive aspects such as having a common purpose, valuing relationships, and having a personal motivation for participating in co-design. However, there were factors which hindered the adaptation of co-design principles and the co-design process. Our research highlights that bureaucracy can hinder co-design, that including people with lived experience is essential and the need to consider various types of diversity when assembling co-design teams. Future co-design projects could use these findings to improve the co-design experience for participants, and ultimately the outcome for communities.
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Affiliation(s)
- Deirdre McGowan
- Menzies Institute for Medical Research University of Tasmania, Hobart, Australia.
| | - Claire Morley
- Menzies Institute for Medical Research University of Tasmania, Hobart, Australia
| | | | - Kelly Shaw
- Menzies Institute for Medical Research University of Tasmania, Hobart, Australia
- KP Health, Hobart, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research University of Tasmania, Hobart, Australia
- Primary Health Tasmania, Hobart, Australia
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Howley E, Soomann M, Kreins AY. Parental Engagement in Identifying Information Needs After Newborn Screening for Families of Infants with Suspected Athymia. J Clin Immunol 2024; 44:79. [PMID: 38457046 PMCID: PMC10923976 DOI: 10.1007/s10875-024-01678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Congenital athymia is a rare T-lymphocytopaenic condition, which requires early corrective treatment with thymus transplantation (TT). Athymic patients are increasingly identified through newborn screening (NBS) for severe combined immunodeficiency (SCID). Lack of relatable information resources contributes to challenging patient and family journeys during the diagnostic period following abnormal NBS results. Patient and Public Involvement and Engagement (PPIE) activities, including parental involvement in paediatrics, are valuable initiatives to improve clinical communication and parental information strategies. Parents of infants with suspected athymia were therefore invited to discuss the information they received during the diagnostic period following NBS with the aim to identify parental information needs and targeted strategies to address these adequately. Parents reported that athymia was not considered with them as a possible differential diagnosis until weeks after initial NBS results. Whilst appropriate clinical information about athymia and TT was available upon referral to specialist immunology services, improved access to easy-to-understand information from reliable sources, including from clinical nurse specialists and peer support systems, remained desirable. A roadmap concept, with written or digital information, addressing parental needs in real time during a potentially complex diagnostic journey, was proposed and is transferrable to other inborn errors of immunity (IEI) and rare diseases. This PPIE activity provides insight into the information needs of parents of infants with suspected athymia who are identified through SCID NBS, and highlights the role for PPIE in promoting patient- and family-centred strategies to improve IEI care.
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Affiliation(s)
- Evey Howley
- Department of Immunology and Gene Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Maarja Soomann
- Department of Immunology and Gene Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- Division of Immunology and the Children's Research Centre, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexandra Y Kreins
- Department of Immunology and Gene Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
- Infection Immunity and Inflammation Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK.
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Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol 2024; 195:104272. [PMID: 38272152 DOI: 10.1016/j.critrevonc.2024.104272] [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: 10/06/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Exercise has been shown to play an important role in managing chemotherapy-related side effects, preserving skeletal muscle mass, and attenuating decline in cardiorespiratory fitness associated with chemotherapy treatment, however, the feasibility of how these exercise programs are being delivered has yet to be synthesized. The objective of this review was to measure the rates of recruitment, adherence, and retention to exercise programs delivered for cancer patients during chemotherapy. METHODS Relevant studies were identified through a search of MEDLINE, Cochrane, EMBASE and CINAHL databases from January 2002 to July 2022 using keywords relating to exercise interventions during chemotherapy. Title and abstract screening, full text review, data extraction, and quality assessment were all performed independently by two reviewers. RESULTS A total of 36 studies were included in the review. The mean recruitment rate for the included studies was 62.39% (SD = 19.40; range 25.7-95%). Travel was the most common reason for declining recruitment in these trials. Adherence rates ranged from 17-109%, however the definition of adherence varied greatly between studies. Mean retention rates for the exercise groups was 84.1% (SD = 12.7; range 50-100%), with chemotherapy side effects being the most common reason why participants dropped out of these trials. CONCLUSION Multiple challenges exist for cancer patients during chemotherapy and careful consideration needs to be given when designing an exercise program for this population. Future research should include public and patient involvement to ensure exercise programs are pragmatic and patient centred.
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Affiliation(s)
- Neil Kearney
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland.
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sanela Begic
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Library, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Amacher SA, Gross S, Becker C, Arpagaus A, Urben T, Gaab J, Emsden C, Tisljar K, Sutter R, Pargger H, Marsch S, Hunziker S. Misconceptions and do-not-resuscitate preferences of healthcare professionals commonly involved in cardiopulmonary resuscitations: A national survey. Resusc Plus 2024; 17:100575. [PMID: 38375442 PMCID: PMC10875294 DOI: 10.1016/j.resplu.2024.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
Aims To assess the DNR preferences of critical care-, anesthesia- and emergency medicine practitioners, to identify factors influencing decision-making, and to raise awareness for misconceptions concerning CPR outcomes. Methods A nationwide multicenter survey was conducted in Switzerland confronting healthcare professionals with a case vignette of an adult patient with an out-of-hospital cardiac arrest (OHCA). The primary outcome was the rate of DNR Code Status vs. CPR Code Status when taking the perspective from a clinical case vignette of a 70-year-old patient. Secondary outcomes were participants' personal preferences for DNR and estimates of survival with good neurological outcome after in- and out-of-hospital cardiac arrest. Results Within 1803 healthcare professionals, DNR code status was preferred in 85% (n = 1532) in the personal perspective of the case vignette and 53.2% (n = 932) when making a decision for themselves. Main predictors for a DNR Code Status regarding the case vignette included preferences for DNR Code Status for themselves (n [%] 896 [58.5] vs. 87 [32.1]; adjusted odds ratio [OR] 2.97, 95% confidence interval [CI] 2.25-3.92; p < 0.001) and lower estimated OHCA survival (mean [±SD] 12.3% [±11.8] vs. 14.7%[±12.8]; adjusted OR 0.98, 95% CI 0.97-0.99; p = 0.001). Physicians chose a DNR order more often when compared to nurses and paramedics. Conclusions The estimation of outcomes following cardiac arrest and personal living conditions are pivotal factors influencing code status preferences in healthcare professionals. Healthcare professionals should be aware of cardiac arrest prognosis and potential implications of personal preferences when engaging in code status- and end-of-life discussions with patients and their relatives.
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Affiliation(s)
- Simon A. Amacher
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - Sebastian Gross
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - Armon Arpagaus
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Tabita Urben
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Christian Emsden
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
- Post-Intensive Care Clinic, University Hospital Basel, Basel, Switzerland
| | - Kai Tisljar
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
| | - Raoul Sutter
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Hans Pargger
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Stephan Marsch
- Department of Intensive Care, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Post-Intensive Care Clinic, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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Cantarero-Arevalo L, Kaae S, Jacobsen R, Nielsen A, Slyngborg L, Smistrup N, Kastrup LM, Hämeen-Anttila K, Strömberg A, Stig Nørgaard L. Empowering patients as co-researchers in social pharmacy: Lessons learned and practical tips for meaningful partnership and impact. Res Social Adm Pharm 2024; 20:372-376. [PMID: 38158303 DOI: 10.1016/j.sapharm.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Engaging patients as co-researchers in health service research, involving them in the design, planning, and implementation rather than treating them as mere participants, can yield positive outcomes and generate value for patients' health. It also increases patients' health literacy and empowerment, leading to more meaningful studies and substantial research impact. However, deeper levels of engagement as partners throughout the research lifecycle come with ethical and methodological challenges. This commentary provides actionable advice for Patient Engagement and Involvement (PEI) in social pharmacy research through a rapid review of models, frameworks, and guidelines and by gathering lessons from four recent social pharmacy research initiatives conducted in Nordic settings. It also identifies and discusses ethical and methodological challenges to conducting authentic and sustained patient-driven research. Deeper levels of engagement where patients take the lead in shaping the social pharmacy research question(s) are rare due to the intensity of resources required. With these 24 tips and the lessons learned, we aim to make this approach more accessible to social pharmacy researchers interested in PEI.
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Affiliation(s)
- Lourdes Cantarero-Arevalo
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, University of Copenhagen, Denmark; WHO Collaborating Centre for Research and Training in the Patient Perspective on Medicine Use, Department of Pharmacy, University of Copenhagen, Denmark.
| | - Susanne Kaae
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, University of Copenhagen, Denmark; WHO Collaborating Centre for Research and Training in the Patient Perspective on Medicine Use, Department of Pharmacy, University of Copenhagen, Denmark
| | - Ramune Jacobsen
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, University of Copenhagen, Denmark; WHO Collaborating Centre for Research and Training in the Patient Perspective on Medicine Use, Department of Pharmacy, University of Copenhagen, Denmark
| | | | | | | | | | | | | | - Lotte Stig Nørgaard
- Social and Clinical Pharmacy Research Group, Department of Pharmacy, University of Copenhagen, Denmark; WHO Collaborating Centre for Research and Training in the Patient Perspective on Medicine Use, Department of Pharmacy, University of Copenhagen, Denmark
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Mitchell S, Turner N, Fryer K, Beng J, Ogden ME, Watson M, Gardiner C, Bayly J, Sleeman KE, Evans CJ. A framework for more equitable, diverse, and inclusive Patient and Public Involvement for palliative care research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:19. [PMID: 38331966 PMCID: PMC10851547 DOI: 10.1186/s40900-023-00525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/30/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND There are marked inequalities in palliative care provision. Research is needed to understand how such inequalities can be addressed, so that everyone living with advanced illness can receive the care they need, when they need it. Research into inequalities in palliative care should be guided by Patient and Public Involvement (PPI) that includes people from diverse backgrounds, who are less likely to receive specialist services. Multi-disciplinary research partnerships, bringing together primary care (the main providers of palliative care to diverse communities) and specialist palliative care, have the potential to work together in new ways to do research to address inequalities and improve palliative care in practice. This report describes a research partnership between primary care and palliative care that aimed to: (1) create opportunities for more inclusive PPI in palliative care research, (2) co-design new resources to support more equitable, diverse and inclusive PPI for palliative care, (3) propose a new framework for inclusive PPI in palliative care research. METHODS PPI members were recruited via primary care and palliative care research networks from three diverse areas of the UK. A pragmatic, collaborative approach was taken to achieve the partnership aims. Online workshops were carried out to understand barriers to inclusive PPI in palliative care and to co-design resources. Evaluation included a "you said, we did" impact log and a short survey. The approach was informed by good practice principles from previous PPI, and existing theory relating to equity, equality, diversity, and inclusion. RESULTS In total, 16 PPI members were recruited. Most were White British (n = 10), other ethnicities were Asian (n = 4), Black African (n = 1) and British mixed race (n = 1). The research team co-ordinated communication and activities, leading to honest conversations about barriers to inclusive PPI. Resources were co-designed, including a role description for an Equity, Equality, Diversity and Inclusion Champion, a "jargon buster", an animation and an online recipe book ( http://www.re-equipp.co.uk/ ) to inform future PPI. Learning from the partnership has been collated into a new framework to inform more inclusive PPI for future palliative care research. CONCLUSION Collaboration and reciprocal learning across a multi-disciplinary primary care and palliative care research partnership led to the development of new approaches and resources. Research team commitment, shared vision, adequate resource, careful planning, relationship building and evaluation should underpin approaches to increase equality, diversity and inclusivity in future PPI for palliative care research.
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Affiliation(s)
- Sarah Mitchell
- Division of Primary Care, Palliative Care and Public Health, Leeds Institute of Health Sciences, University of Leeds, Clarendon Road, Leeds, UK.
| | - Nicola Turner
- School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Kate Fryer
- Academic Unit of Primary Medical Care, University of Sheffield, Herries Road, Sheffield, UK
| | - Jude Beng
- Academic Unit of Primary Medical Care, University of Sheffield, Herries Road, Sheffield, UK
| | - Margaret E Ogden
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
| | - Melanie Watson
- Health Sciences School, University of Sheffield, 3a Clarkehouse Rd, Sheffield, UK
| | - Clare Gardiner
- Health Sciences School, University of Sheffield, 3a Clarkehouse Rd, Sheffield, UK
| | - Joanne Bayly
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
- St Barnabas Hospices, Worthing, UK
| | - Katherine E Sleeman
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
| | - Catherine J Evans
- Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, Cicely Saunders Institute of Palliative Care, London, UK
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Wheeler B, Williams O, Meakin B, Chambers E, Beresford P, O'Brien S, Robert G. Exploring Elinor Ostrom's principles for collaborative group working within a user-led project: lessons from a collaboration between researchers and a user-led organisation. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:15. [PMID: 38287410 PMCID: PMC10826181 DOI: 10.1186/s40900-024-00548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Some research has been undertaken into the mechanisms that shape successful participatory approaches in the context of efforts to improve health and social care. However, greater attention needs to be directed to how partnerships between researchers and user-led organisations (ULOs) might best be formed, practiced, managed, and assessed. We explored whether political economist Elinor Ostrom's Nobel prize winning analysis of common pool resource management-specifically eight principles to enhance collaborative group working as derived from her empirical research-could be usefully applied within a user-led project aiming to co-design new services to support more inclusive involvement of Disabled people in decision-making processes in policy and practice. METHODS Participant observation and participatory methods over a 16-month period comprising observational notes of online user-led meetings (26 h), online study team meetings (20 h), online Joint Interpretive Forum meetings (8 h), and semi-structured one-to-one interviews with project participants (44 h) at two time points (months 6 and 10). RESULTS Initially it proved difficult to establish working practices informed by Ostrom's principles for collaborative group working within the user-led project. Several attempts were made to put a structure in place that met the needs of both the research study and the aims of the user-led project, but this was not straightforward. An important shift saw a move away from directly applying the principles to the working practices of the group and instead applying them to specific tasks the group were undertaking. This was a helpful realisation which enabled the principles to become-for most but not all participants-a useful facilitation device in the latter stages of the project. Eventually we applied the principles in a way that was useful and enabled collaboration between researchers and a ULO (albeit in unexpected ways). CONCLUSIONS Our joint reflections emphasise the importance of being reflexive and responsive when seeking to apply theories of collaboration (the principles) within user-led work. At an early stage, it is important to agree shared definitions and understanding of what 'user-led' means in practice. It is crucial to actively adapt and translate the principles in ways that make them more accessible and applicable within groups where prior knowledge of their origins is both unlikely and unnecessary.
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Affiliation(s)
- Bella Wheeler
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Oli Williams
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK
| | - Becki Meakin
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
| | - Eleni Chambers
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
- School of Allied Health Professions, Nursing and Midwifery, The University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Peter Beresford
- Shaping Our Lives National User Network CIC, 30 St Giles', Oxford, OX1 3LE, UK
- School of Health Sciences, University of East Anglia, Research Park, Norwich, NR4 7TJ, UK
| | - Sarah O'Brien
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, Waterloo, SE1 8WA, UK.
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Ankomah SE, Fusheini A, Derrett S. Unsung heroes in Ghana's healthcare system: the case of community health volunteers and community health management committee. Health Res Policy Syst 2024; 22:10. [PMID: 38225642 PMCID: PMC10789015 DOI: 10.1186/s12961-023-01099-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND In Ghana, the community-based health planning and services (CHPS) policy highlights the significance of both community health management committees (CHMCs) and community health volunteers (CHVs) in the Ghanaian health system. However, research into their specific effects on health system improvement is scarce. Some research has focussed on the roles of the CHMCs/CHVs in implementing specific targeted health interventions but not on improving the overall health system. Therefore, this research aims to examine the role of the CHMCs and CHVs in improving the Ghanaian health system. METHODS The study was conducted in three districts in the Ashanti region of Ghana. A total of 35 participants, mainly health service users and health professionals, participated in the study. Data were collected using semi-structured individual in-depth interviews. Participants were selected according to their patient-public engagement or community health activity roles. Data were transcribed and analysed descriptively using NVIVO 12 Plus. RESULTS We found that the effectiveness of CHMCs and CHVs in health systems improvement depends largely on how members are selected. Additionally, working through CHMC and CHVs improves resource availability for community health services, and using them in frontline community health activities improves health outcomes. CONCLUSIONS Overall, we recommend that, for countries with limited healthcare resources such as Ghana, leveraging the significant role of the CHMCs and CHVs is key in complementing government's efforts to improve resource availability for healthcare services. Community health management committees and CHVs are key in providing basic support to communities with limited healthcare personnel. Thus, there is a need to strengthen their capacities to improve the overall health system.
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Affiliation(s)
- Samuel Egyakwa Ankomah
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana.
| | - Adam Fusheini
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Barone MTU, Klatman E. Meaningful Engagement of People Living With Noncommunicable Diseases: Challenges and Opportunities. J Patient Exp 2024; 11:23743735231224560. [PMID: 38298200 PMCID: PMC10828565 DOI: 10.1177/23743735231224560] [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] [Indexed: 02/02/2024] Open
Abstract
Meaningful engagement of people living with health conditions means actively incorporating them in all stages of health decision-making. Despite efforts by global health agencies and governments towards meaningful engagement of people living with noncommunicable diseases (PLWNCDs), many opportunities for participation are tokenistic. PLWNCDs often report feeling excluded from technical discussions and outnumbered by other stakeholders. Participation in decision-making is a human right, and PLWNCDs must continue advocating for a "nothing about us without us" approach. They should be respected as decision-makers with voice, agency, voting power, rights, and duties. This article highlights four key themes: (1) both tokenistic participation and exclusion of PLWNCDs from technical discussions are still common; (2) the "patient" label implies passivity and can perpetuate limited participation, whereas the identifier of PLWNCDs connotes valuable knowledge associated with lived experience; (3) meaningful participation of PLWNCDs in health decision-making processes should be considered a human right; (4) PLWNCD should be empowered to continue to advocate for inclusion and be respected as decision-makers.
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Affiliation(s)
- Mark Thomaz Ugliara Barone
- Founding and Organizing Board, Intersectoral Forum to Fight NCDs in Brazil (ForumDCNTs), São Paulo, SP, Brazil
| | - Emma Klatman
- Life for a Child Program, Diabetes Australia New South Wales, Glebe, NSW, Australia
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Skovlund PC, Finderup J, Aabo S, Jensen F, Søndergaard H, Rodkjær LØ. Recommendations for successful involvement of patient partners in complex intervention research: a collaborative learning process. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:3. [PMID: 38172939 PMCID: PMC10765637 DOI: 10.1186/s40900-023-00533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Patient and public involvement in health-related research is a new discipline in Denmark. In 2021, a national conference titled 'Patient and Public Involvement in Complex Intervention Research' provided a forum for discussion between patient partners, researchers and clinicians on involving patients as partners in complex intervention research. METHODS We aimed to describe specific challenges to and initiatives for patient partner involvement in order to develop recommendations for creating successful partnerships in complex intervention research. Through a collaborative learning process, 140 researchers identified the most important challenges for them in patient partner involvement and potential initiatives to improve such involvement. At a subsequent workshop, four patient partners identified the challenges and initiatives from their perspective as patient partners. They also gave feedback on the challenges and initiatives suggested by the researchers and helped shape three recommendations for practice. Three of the patient partners were involved in writing this paper. RESULTS The five most important challenges identified by researchers were time, recruitment, ethics, power and inequality. Between four and seven initiatives to overcome these challenges were suggested. The three most important challenges identified by patient partners were communication, when you get information that is hard to handle and recruitment. They suggested three to four initiatives for improvement. Patient partners confirmed the importance of all the researcher identified challenges when presented with them, they also provided additional comments on the researchers' initiatives. This led to the formation of recommendations for involving patient partners. CONCLUSIONS A collaborative learning process was shown to be a suitable method for patient partner involvement. Consistency was seen between the challenges and initiatives identified by researchers and patient partners. Based on these observations, three recommendations were developed: (1) create specific programmes that aim to involve all kind of patients (including but limited to vulnerable patients) as patient partners, (2) produce ethical guidelines for the involvement of patient partners, and (3) develop a national strategy for patient partner involvement. To build on these recommendations, a joint workshop with both researchers and patient partners is needed.
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Affiliation(s)
- Pernille Christiansen Skovlund
- Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Jeanette Finderup
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sanne Aabo
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
| | - Flemming Jensen
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
| | - Henning Søndergaard
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
| | - Lotte Ørneborg Rodkjær
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Happell B, Gordon S, Sharrock J, Warner T, Donovan AO. The Wisdom of Hindsight: Allies Reflections on Their Role in Supporting the Implementation of Expert by Experience Positions in Academia. Issues Ment Health Nurs 2024; 45:76-84. [PMID: 37616594 DOI: 10.1080/01612840.2023.2241075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Experts by experience involvement in mental health education has consistently demonstrated positive attitudinal outcomes including a greater appreciation for recovery-focused practice. Mental health academic allies have played a crucial role in supporting implementation of expert by experience academic positions. To date the inclusion of their views in research is limited. The aim of this study was to explore and present allies' reflections on their involvement in supporting expert by experience academic roles in relation to "hindsight" and "foresight." A qualitative descriptive design was used, involving in-depth semi-structured interviews with allies who had supported the implementation of academic roles for experts by experience. Participants described the wisdom of hindsight. Based on their own experiences they emphasised the importance of, laying the groundwork, facilitating a supportive environment, contributing to meaningful, credible, and sustainable roles, and vision for the future as key to successful implementation. They also described a vision for the expansion of expert by experience roles in mental health education in the future. Allies' reflections suggest the importance of preparation to facilitate a smooth as possible implementation process and enhance the likelihood of successful outcomes. The transition to recovery-focused mental health services requires the attitudes of health professionals to change. The potential of experts by experience to influence attitudinal change can be enhanced by understanding the experiences and reflections of academic allies.
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Affiliation(s)
- Brenda Happell
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
- Nursing Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Sarah Gordon
- Department of Psychological Medicine School of Medicine, and Health Sciences, University of Otago, Wellington, Wellington South, New Zealand
| | - Julie Sharrock
- Nursing Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Terri Warner
- ANU Medical School Florey Building, Australian National University, Acton, Australia
- ACT Mental Health Consumer Network, Canberra, Australia
| | - Aine O Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Huish C, Greenhalgh C, Garrow A, Verma A. Intercultural gaps in knowledge, skills and attitudes of public health professionals: a systematic review. J Public Health (Oxf) 2023; 45:i35-i44. [PMID: 38127566 DOI: 10.1093/pubmed/fdac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 10/23/2022] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Previous cultural competence reviews focused on medical professions. Identifying intercultural competence gaps for public health professionals is long overdue. Gaps will inform training to work effectively within increasingly diverse cultural contexts. METHODS A systematic review was conducted identifying intercultural competence gaps using hand/electronic searches: MEDLINE, EMBASE, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL and CDSR, 2004-March 2020. Data were extracted on intercultural knowledge, skills and attitude gaps. Themes were coded into an emerging framework, mapped against three competences. Studies were assessed using validated tools. RESULTS 506 studies retrieved and 15 met inclusion criteria. Key findings include: intercultural knowledge requires local demographics framing within global context to better understand culturally informed community health needs; intercultural skills lack training opportunities applying cultural theory into practice using flexible, diverse methods encouraging culturally appropriate responses in diverse settings; intercultural attitude gaps require a non-judgemental focus on root causes and population patterns, preventing stereotypes further increasing health disparities. CONCLUSION Gaps found indicate understanding local public health within its global context is urgently required to deliver more effective services. Flexible, diverse training opportunities applying cultural theory into practice are essential to engage successfully with diverse communities. A non-judgemental focus on population patterns and root causes enables selecting culturally aligned health strategies to mitigate stereotyping communities and increasing health disparities.
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Affiliation(s)
- Clare Huish
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Christine Greenhalgh
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Adam Garrow
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
| | - Arpana Verma
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK
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McParland C, Johnston B, Alassoud B, Drummond M, Farnood A, Purba CIH, Seckin M, Thanthong S. Involving patients and the public in nursing PhD projects: practical guidance, potential benefits and points to consider. Nurse Res 2023; 31:21-29. [PMID: 37731298 DOI: 10.7748/nr.2023.e1891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Funders, academic publishers and governance bodies increasingly require research to involve patients and the public. This also enables nurse researchers to increase the visibility of scholarly nursing roles, which are poorly understood by the public. There are different approaches to involvement, and a wealth of guidance about how it can and should be implemented. Less is known about how it should be done in the context of a nursing PhD. AIM To discuss the experiences of the authors' nursing research group in involving patients and the public in PhD research, reflect on the benefits to be gained from doing so, and highlight considerations for those planning to involve patients and the public in their doctoral research projects. Discussion It is essential to decide in advance of a study who you will involve, how to reach them and why you are involving patients and the public. Some potential benefits of involvement are: more accessible documentation, refined methods and better research outputs created in collaboration with patients and the public. CONCLUSION Patients and the public should be involved in nursing PhD projects. Not only does this improve the quality of the research and raise the profile of nursing research, but it provides the opportunity for students to learn skills that they can develop further throughout their academic careers. IMPLICATIONS FOR PRACTICE Obtaining high-quality patient and public involvement is an important skill for nurse researchers. The first steps in acquiring this skill should be taken during research training.
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Affiliation(s)
- Chris McParland
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
| | - Bridget Johnston
- director of research, School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland, and chief nurse research, NHS Greater Glasgow and Clyde, Scotland
| | - Bahaa Alassoud
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
| | - Maria Drummond
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
| | - Annabel Farnood
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
| | | | - Muzeyyen Seckin
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
| | - Saengrawee Thanthong
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland
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Papageorgiou V, Dewa LH, Bruton J, Murray KK, Hewlett N, Thamm W, Hamza H, Frumiento P, Steward R, Bradshaw M, Brooks-Hall E, Petretti S, Ewans S, Williams M, Chapko D. 'Building bridges': reflections and recommendations for co-producing health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:113. [PMID: 38057931 DOI: 10.1186/s40900-023-00528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Co-produced research is when all stakeholders, including experts by experience and researchers, work together to conceptualise, design, deliver and disseminate research to enhance understanding and knowledge. This type of participatory inquiry is being increasingly used across health research; however, it continues to be a complex area to navigate given existing institutional structures. MAIN BODY We collaborated across three independent co-produced research studies to share insights, reflections, and knowledge of our work in the fields of HIV, mental health, and disability research. We co-designed and delivered a three-hour online workshop at a conference to share these reflections using the metaphor of 'building bridges' to describe our co-production journey. We generated key principles of co-production from our different experiences working in each individual research project as well as together across the three projects. Our principles are to: (1) be kind, have fun and learn from each other; (2) share power (as much as you can with people); (3) connect with people you know and don't know; (4) remain connected; and (5) use clear and simple language. CONCLUSION We recommend that co-produced research needs additional funding, resource, and flexibility to remain impactful and ethical. Co-produced research teams need to be mindful of traditional power structures and ensure that the process is transparent, fair, and ethical. Addressing equality, diversity, and inclusion of traditionally underrepresented groups in research is essential as are the skills, expertise, and experiences of all members of the co-production team.
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Affiliation(s)
- Vasiliki Papageorgiou
- NIHR Imperial Biomedical Research Centre Patient Experience Research Centre, Imperial College London, London, UK.
| | - Lindsay H Dewa
- NIHR Imperial Biomedical Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Jane Bruton
- NIHR Imperial Biomedical Research Centre Patient Experience Research Centre, Imperial College London, London, UK
| | | | - Nick Hewlett
- NIHR Applied Research Collaboration Northwest London, Imperial College London, London, UK
| | | | | | | | | | | | - Ellie Brooks-Hall
- NIHR Imperial Biomedical Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK
| | | | | | | | - Dorota Chapko
- NIHR Applied Research Collaboration Northwest London, Imperial College London, London, UK
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Murry LT, Desselle SP. Beyond satisfaction in person-centered pharmacy services. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100355. [PMID: 38023636 PMCID: PMC10660128 DOI: 10.1016/j.rcsop.2023.100355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Patient self-reported satisfaction is commonly used as an assessment of service experience and quality for community pharmacy services. This commentary discusses alternative foundational approaches to evaluating service experience and quality in patient-centered care. It describes historical and recent literature pertaining to the development and use of satisfaction measures for service design and patient experience assessment. It then highlights potential limitations of patient satisfaction as an assessment tool for patient-centeredness and patient experience identified in the pharmacy literature, which include criticisms that use of patient satisfaction may compromise accuracy in measuring quality due to factors such as patients having poor knowledge of and low expectations for quality and having a predisposition toward rating satisfaction highly when experiencing no-cost and/or unfamiliar services. Moreover, satisfaction measurements may change based on service exposure, with patient preferences for service offerings changing with increased service exposure and variation in patient-specific and environmental factors. After discussing limitations and criticism of patient self-reported satisfaction, we introduce alternative assessments methods which may facilitate more accurate assessments of patient experience and patient-centered pharmacy services such as patient-reported outcomes measures (PROMs), patient-reported experience measures (PREMs), and human-centered design techniques such as journey mapping, prototyping, and user testing to design and assess patient-centered pharmacy services. These alternative assessments are rooted in, or related to preferred implementation science approaches to establishing, evaluating, and sustaining pharmacy services.
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Affiliation(s)
- Logan T. Murry
- The University of Iowa College of Pharmacy, 180 S Grande Ave, Iowa City, IA 52242, USA
- The Accreditation Council for Pharmacy Education, 190 S LaSalle St Suite 3000, Chicago, IL 60603, USA
| | - Shane P. Desselle
- Touro University College of Pharmacy, 11310 Club Dr Vallejo, CA 94592, USA
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Ray Chaudhuri K, Podlewska A, Hui Lau Y, Gonde C, McIntosh A, Qamar M, O'Donoghue S, Larcombe K, Adeeko M, Gupta A, Bajwah S, Lafond S, Awogbemila O, van Coller R, Murtagh A, Ocloo J. Addressing the gap for racially diverse research involvement: The King's Model for minority ethnic research participant recruitment. PUBLIC HEALTH IN PRACTICE 2023; 6:100426. [PMID: 37744301 PMCID: PMC10511795 DOI: 10.1016/j.puhip.2023.100426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/30/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives Ethnic minorities (EM) are still underrepresented in research recruitment. Despite wide literature outlining the barriers, enablers and recommendations for driving inclusion and diversity in research, there is still little evidence for successful diversity in research participation, which has a direct impact on the quality of care provided to ethnically diverse individuals. A new, comprehensive approach to recruitment strategies is therefore necessary. Study design service improvement initiative. Methods In the light of the Covid-19 pandemic and the key public health need to address the disparity in care provided to non-white populations, we used a novel, comprehensive approach (The King's Model) comprising of local and community actions to promote inclusive research recruitment. We then compared rates of diverse recruitment in studies where the novel approach, was applied to studies which had been closed to recruitment at the time of analysis and where ethnicity data was available. Results Our results demonstrate that following the introduction of the King's Model for diverse recruitment, commercial interventional study diverse recruitment increased from 6.4% to 16.1%, and for non-commercial studies, from 30.2% to 41.0% and 59.2% in the selected studies. Conclusions King's Model is potentially a useful tool in enhancing non-Caucasian recruitment to clinical research. Enriched by additional recommendations based on our experiences during the Covid-19 research recruitment drive, we propose the King's Model is used to support ethnically diverse research recruitment. Further evidence is needed to replicate our findings, although this preliminary evidence provides granular details necessary to address the key unmet need of validating clinical research outcomes in non-white populations.
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Affiliation(s)
- K. Ray Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Podlewska
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Yue Hui Lau
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - C. Gonde
- Institute of Liver Studies, King's College Hospital, NHS Trust Foundation, London, United Kingdom
| | - A. McIntosh
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - M.A. Qamar
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - S. O'Donoghue
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's Health Partners, London, SE1 9RT, United Kingdom
| | - K. Larcombe
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - M. Adeeko
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - A. Gupta
- Paediatric Respiratory Medicine, King's College Hospital, London, United Kingdom
| | - S. Bajwah
- Cicely Saunders Institute, King's College London, London, United Kingdom
| | - S. Lafond
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - O. Awogbemila
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - R. van Coller
- Department of Neurology, Faculty of Health Sciences, University of Pretoria, South Africa
| | - A.M. Murtagh
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - J.E. Ocloo
- National Institute for Health and Care Research (NIHR), Applied Research Collaboration South London (NIHR ARC South London), King's College Hospital NHS Foundation Trust, London, United Kingdom
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Vanderhout S, Richards DP, Butcher N, Courtney K, Nicholls SG, Fergusson DA, Potter BK, Bhalla M, Nevins P, Fox G, Ly V, Taljaard M, Macarthur C. Prevalence of patient partner authorship and acknowledgment in child health research publications: an umbrella review. J Clin Epidemiol 2023; 164:35-44. [PMID: 37871836 DOI: 10.1016/j.jclinepi.2023.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Children and families are increasingly involved as equal partners in child health research, however, considerations around authorship have received little attention and there is limited guidance on the topic. Our objective was to determine the frequency and nature of patient partner authorship and/or acknowledgment among articles focused on patient engagement in child health research. STUDY DESIGN AND SETTING In this umbrella review, we searched MEDLINE, Embase, APA PsycINFO, Cochrane Database of Systematic Reviews, CINAHL, and Web of Science for systematic/scoping reviews on patient engagement in child health research. Individual articles included in eligible reviews comprised the sample of articles for analysis and were examined to identify patient partner authorship. Descriptive statistics were used to quantify patient partner authorship and/or acknowledgment and to summarize article characteristics. RESULTS Twelve systematic/scoping reviews met eligibility criteria, from which 230 individual articles were examined. In 16/230 (7%) articles, there was at least one patient partner author, and in 6/230 (3%) articles, patient partners were included as group authors. Within article Acknowledgments sections, patient partners were acknowledged by name in 41/230 (18%) articles, and anonymously or as a group in 98/230 (43%) articles. Patient partner authorship and/or acknowledgment was more frequent among articles published more recently (after 2015) and among articles where patient engagement was explicitly reported in the article. CONCLUSION Patient partners were more likely to be acknowledged than listed as an author on articles on patient engagement in child health research. Understanding patient partner preferences about authorship and acknowledgment, examination of the unique aspects of child and youth authorship and developing supports to empower patient partner authorship are needed.
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Affiliation(s)
- Shelley Vanderhout
- Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, Ontario L5B 1B8, Canada.
| | - Dawn P Richards
- Patient Partner, Toronto, Ontario, Canada; Five02 Labs Inc., Toronto, Ontario, Canada
| | - Nancy Butcher
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, Ontario M5G 0A4, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College St, 8th floor, Toronto, Ontario M5T 1R8, Canada
| | - Kim Courtney
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, Ontario, Canada
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Manav Bhalla
- University College Dublin School of Medicine, Health Sciences Centre, Belfield, Dublin, Ireland
| | - Pascale Nevins
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Grace Fox
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada
| | - Valentina Ly
- University of Ottawa Library Services, 65 University Private, Ottawa, Ontario K1N 6N5, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario K1G 5Z3, Canada
| | - Colin Macarthur
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, Ontario M5G 0A4, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario M5S 1A1, Canada
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Ankomah SE, Fusheini A, Derrett S. Implementing patient-public engagement for improved health: Lessons from three Ghanaian community-based programmes. Health Expect 2023; 26:2684-2694. [PMID: 37694501 PMCID: PMC10632621 DOI: 10.1111/hex.13866] [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: 03/22/2023] [Revised: 06/28/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Community-based health interventions have been implemented as a key strategy for achieving improved health outcomes in Ghana. Effectiveness, however, largely depends on the successful implementation of patient-public engagement (PPE). Although several PPE studies have been conducted in Ghana, little research has been done to understand the specific role of PPE in the context of implementing community-based health programmes. This paper, therefore, examines the extent of PPE implementation in three selected community-based health programmes (Community-based Health Planning and Service [CHPS], Community-based Maternal and Child Health and Buruli Ulcer) to understand their specific effects on health outcomes. METHODS Three focus groups, involving 26 participants, were held in three districts of the Ashanti region of Ghana. Participants were mainly health service users involving community health committee members/volunteers, residents and health professionals. They were invited to participate based on their roles in the design and implementation of the programmes. Participants focused on each of Rifkin's spider-gram components. Data were transcribed and analysed descriptively using NVIVO 12 Plus. RESULTS PPE implementation was found to be extensive across the three programmes in specific areas such as organisation and resource mobilisation. PPE was more restricted in relation to community needs assessment, leadership and management, particularly for the CHPS and Buruli Ulcer programmes. CONCLUSION Findings suggest that benefits from community-based health interventions are likely to be greater if PPE can be widely implemented across all dimensions of the spider-gram framework.
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Affiliation(s)
- Samuel E. Ankomah
- Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
- Ngāi Tahu Māori Health Research Unit, Division of Health SciencesUniversity of OtagoDunedinNew Zealand
| | - Adam Fusheini
- Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
| | - Sarah Derrett
- Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
- Ngāi Tahu Māori Health Research Unit, Division of Health SciencesUniversity of OtagoDunedinNew Zealand
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