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Wright LC, Lopez Chemas N, Cooper C. Lived experience codesign of self-harm interventions: a scoping review. BMJ Open 2023; 13:e079090. [PMID: 38151276 PMCID: PMC10753750 DOI: 10.1136/bmjopen-2023-079090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES This study aims to map existing literature describing how people with lived experience of self-harm have engaged in codesigning self-harm interventions, understand barriers and facilitators to this engagement, and how the meaningfulness of codesign has been evaluated. DESIGN Scoping review by Joanna Briggs Institute methodology. A protocol was published online (http://dx.doi.org/10.17605/OSF.IO/P52UD). DATA SOURCES PubMed, Embase, PsycINFO, Web of Science, Cochrane Library, PROSPERO, ClinicalTrials.gov and relevant websites were searched on 24 December 2022 (repeated 4 November 2023). ELIGIBILITY CRITERIA We included studies where individuals with lived experience of self-harm (first-hand or caregiver) have codesigned self-harm interventions. DATA EXTRACTION AND SYNTHESIS Results were screened at title and abstract level, then full-text level by two researchers independently. Prespecified data were extracted, charted and sorted into themes. RESULTS We included 22 codesigned interventions across mobile health, educational settings, prisons and emergency departments. Involvement varied from designing content to multistage involvement in planning, delivery and dissemination. Included papers described the contribution of 159 female, 39 male and 21 transgender or gender diverse codesigners. Few studies included contributors from a minoritised ethnic or LGBTQIA+ group. Six studies evaluated how meaningfully people with lived experience were engaged in codesign: by documenting the impact of contributions on intervention design or through postdesign reflections. Barriers included difficulties recruiting inclusively, making time for meaningful engagement in stretched services and safeguarding concerns for codesigners. Explicit processes for ensuring safety and well-being, flexible schedules, and adequate funding facilitated codesign. CONCLUSIONS To realise the potential of codesign to improve self-harm interventions, people with lived experience must be representative of those who use services. This requires processes that reassure potential contributors and referrers that codesigners will be safeguarded, remunerated, and their contributions used and valued.
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Affiliation(s)
- Lucy C Wright
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Natalia Lopez Chemas
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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2
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Manning JC, Marufu TC, Carter T, Bolton S, Breedon P, Craven M, Frost K, Harbottle A, Hendron E, Patel J, Rad L, White P, Wood D, Albelbisi Z, Kaltsa A, Stevenson C, Landa P, Coad J. Developing a prototype digital risk mitigation pathway for children and young people admitted to acute paediatric NHS care in mental health crisis: Protocol of the Safety Assessment in Paediatric healthcare Environments (SAPhE) pathway study. Digit Health 2023; 9:20552076231205753. [PMID: 37846405 PMCID: PMC10576941 DOI: 10.1177/20552076231205753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
Background Globally, there are increasing numbers of Children and young people (CYPs) experiencing a mental health crisis requiring admission to acute paediatric inpatient care. These CYPs can often experience fluctuating emotional states accompanied by urges to self-harm or attempt to end their life, leading to reduced safety and poorer experiences. Currently, in the UK National Health Service (NHS) there are no standardised, evidence-based interventions in acute paediatric care to mitigate or minimise immediate risk of self-harm and suicide in CYP admitted with mental health crisis. Objective To outline the protocol for the SAPhE Pathway study which aims to: 1) identify and prioritise risk mitigation strategies to include in the digital prototype, 2) understand the feasibility of implementing a novel digital risk mitigation pathway in differing NHS contexts, and 3) co-create a prototype digital risk mitigation pathway. Methods This is a multi-centre study uses a mixed-methods design. A systematic review and exploratory methods (interviews, surveys, and focus groups) will be used to identify the content and feasibility of implementing a digital risk mitigation pathway. Participants will include healthcare professionals, digital experts and CYP with experience of mental health conditions. Data will be collected between January 2022 and March 2023 and analysed using content and thematic analysis, case study, cross-case analysis for qualitative data and descriptive statistics for quantitative data. Findings will inform the experience-based co-design workshops. Ethics and Dissemination The study received full ethical approval from NHS REC [Ref: 22/SC/0237 and 22/WM/0167]. Findings will be made available to all stakeholders using multiple approaches.
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Affiliation(s)
- Joseph C. Manning
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- School of Healthcare, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Takawira C. Marufu
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Tim Carter
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Sarah Bolton
- The Centre for Healthcare Equipment & Technology Adoption (CHEATA), Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Philip Breedon
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Michael Craven
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kate Frost
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Anthony Harbottle
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Elizabeth Hendron
- Library Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Julian Patel
- East Midlands Academic Health Science Network (EMAHSN), University of Nottingham, Nottingham, UK
| | - Laura Rad
- Clinical Research Division, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Peter White
- Digital and Innovation, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Damian Wood
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Zaki Albelbisi
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Aikaterina Kaltsa
- Nottingham Childrens Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Jane Coad
- Centre for Children and Young People's Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK
- East Midlands Academic Health Science Network (EMAHSN), University of Nottingham, Nottingham, UK
- Centre for Care excellence, University Hospital Coventry and Warwickshire, NHS Trust, Nottingham, UK
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3
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Viksveen P, Bjønness SE, Cardenas NE, Game JR, Berg SH, Salamonsen A, Storm M, Aase K. User involvement in adolescents' mental healthcare: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:1765-1788. [PMID: 34089383 PMCID: PMC9666298 DOI: 10.1007/s00787-021-01818-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022]
Abstract
More than one out of ten adolescents suffer from mental illness at any given time. Still, there is limited knowledge about their involvement in mental healthcare. Adolescents have the right to be involved in decisions affecting their healthcare, but limited research focuses on their engagement and decision-making. Therefore, this systematic review aims to explore the existing experiences with, the effectiveness of, and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organizational level. A systematic literature review on user involvement in adolescents' mental healthcare was carried out. A protocol pre-determined the eligibility criteria and search strategies, and established guidelines were used for data extraction, critical appraisal, and reporting of results. Quantitative studies were analysed individually due to heterogeneity of the studies, while qualitative studies were analysed using thematic synthesis. A total of 31 studies were included in the review. The experiences with user involvement were reported in 24 studies with three themes at the individual level: unilateral clinician control versus collaborative relationship, capacity and support for active involvement, the right to be involved; and two themes at the organizational level: involvement outcomes relevant to adolescents' needs, conditions for optimal involvement. The effectiveness of user involvement was reported in seven studies documenting fragmented evidence related to different support structures to facilitate adolescents' involvement. The safety associated with user involvement was not reported in any studies, yet a few examples related to potential risks associated with involvement of adolescents in decision-making and as consultants were mentioned.
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Affiliation(s)
- Petter Viksveen
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
| | - Stig Erlend Bjønness
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Nicole Elizabeth Cardenas
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Health Sciences, University of Aberdeen, Aberdeen, Scotland
| | - Julia Rose Game
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Siv Hilde Berg
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Anita Salamonsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North (RKBU North), Faculty of Health Sciences, UiT The Arctic University of Norway, Langnes, P.O. Box 6050, Tromsø, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Karina Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
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4
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Meldahl LG, Krijger L, Andvik MM, Cardenas NE, Cuddeford O, Duerto S, Game JR, Ibenfeldt M, Mustafa M, Tong M, Viksveen P. Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives. Health Expect 2022; 25:2924-2936. [PMID: 36074720 DOI: 10.1111/hex.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. METHODS A two-stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in-depth perspectives of 10 adolescent coresearchers were gathered through self-reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. RESULTS Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. DISCUSSION This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self-learning system to continuously adapt to user feedback. CONCLUSION This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost-effectiveness and safety. PATIENT OR PUBLIC CONTRIBUTION This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript.
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Affiliation(s)
- Laia G Meldahl
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Lou Krijger
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,ESCP Europe (Business Management), Ecole Supérieure de Commerce de Paris, Paris, France
| | - Maren M Andvik
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Medical, Veterinary and Life Sciences (Zoology), University of Glasgow, Glasgow, Scotland
| | - Nicole E Cardenas
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Psychology (Psychology), University of Aberdeen, Aberdeen, Scotland
| | - Oliver Cuddeford
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Art Design and Architecture (Architecture), University of Huddersfield, Huddersfield, UK
| | - Samuel Duerto
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Philosophy, Theology and Religious Studies (Philosophy, Politics and Societies), Radboud University, Nijmegen, The Netherlands
| | - Julia R Game
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Maya Ibenfeldt
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Biology, Medicine and Health (Pharmacology), University of Manchester, Manchester, UK
| | - Murad Mustafa
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Health Sciences (Nursing), University of Stavanger, Stavanger, Norway
| | - Mathias Tong
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Chemical Engineering and Analytical Science (Chemical Engineering), University of Manchester, Manchester, UK
| | - Petter Viksveen
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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5
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Robinson A, Sile L, Govind T, Guraya HK, O'Brien N, Harris V, Pilkington G, Todd A, Husband A. 'He or she maybe doesn't know there is such a thing as a review': A qualitative investigation exploring barriers and facilitators to accessing medication reviews from the perspective of people from ethnic minority communities. Health Expect 2022; 25:1432-1443. [PMID: 35384182 PMCID: PMC9327850 DOI: 10.1111/hex.13482] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Regular reviews of medications, including prescription reviews and adherence reviews, are vital to support pharmacological effectiveness and optimize health outcomes for patients. Despite being more likely to report a long‐term illness that requires medication when compared to their white counterparts, individuals from ethnic minority communities are less likely to engage with regular medication reviews, with inequalities negatively affecting their access. It is important to understand what barriers may exist that impact the access of those from ethnic minority communities and to identify measures that may act to facilitate improved service accessibility for these groups. Methods Semi‐structured interviews were conducted between June and August 2021 using the following formats as permitted by governmental COVID‐19 restrictions: in person, over the telephone or via video call. Perspectives on service accessibility and any associated barriers and facilitators were discussed. Interviews were audio‐recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the Health Research Authority (ref: 21/HRA/1426). Results In total 20 participants from ethnic minority communities were interviewed; these participants included 16 UK citizens, 2 refugees and 2 asylum seekers, and represented a total of 5 different ethnic groups. Three themes were developed from the data regarding the perceived barriers and facilitators affecting access to medication reviews and identified approaches to improve the accessibility of such services for ethnic minority patients. These centred on (1) building knowledge and understanding about medication reviews; (2) delivering medication review services; and (3) appreciating the lived experience of patients. Conclusion The results of this study have important implications for addressing inequalities that affect ethnic minority communities. Involving patients and practitioners to work collaboratively in coproduction approaches could enable better design, implementation and delivery of accessible medication review services that are culturally competent. Patient or Public Contribution The National Institute for Health Research Applied Research Collaboration and Patient and Public Involvement and Engagement group at Newcastle University supported the study design and conceptualization. Seven patient champions inputted to ensure that the research was conducted, and the findings were reported, with cultural sensitivity.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Sile
- School of Pharmacy, Faculty of Medical Sciences, Liverpool John Moores University, Liverpool, UK
| | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | | | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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6
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Young T, Pang J, Ferguson M. Hearing From You: Design Thinking in Audiological Research. Am J Audiol 2022; 31:1003-1012. [PMID: 35344385 DOI: 10.1044/2022_aja-21-00222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this article is to describe the emerging use of design thinking methodologies in hearing health care research using a participatory action approach with a consumer and community involvement panel, audiologists, and adults with hearing loss. METHOD Two connected hearing health care projects that adopted design thinking principles are presented here as case studies. Case 1 investigated the applicability and acceptability of smart voice assistant technology as post-hearing aid fitting support. Case 2 investigated the feasibility of providing support for new adult patients with hearing loss before they attend their hearing assessment appointment. DISCUSSION The design thinking process provided a flexible structure in which researchers were able to empathize with stakeholders, define their unmet needs, and ideate potential connected hearing health care solutions to develop and evaluate prototypes in clinical and home settings. CONCLUSION Utilizing a needs-based, collaborative design thinking approach to conduct development in hearing health care research is a viable and novel option to produce innovative, relevant, and translational hearing health solutions that address stakeholder needs.
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Affiliation(s)
- Taegan Young
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Jermy Pang
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Melanie Ferguson
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- enAble Institute and School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Ear Science Institute Australia, Perth, Western Australia
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7
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Lloyd N, Kenny A, Hyett N. Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review. BMC Health Serv Res 2021; 21:364. [PMID: 33879149 PMCID: PMC8056601 DOI: 10.1186/s12913-021-06319-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 03/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Internationally, it is expected that health services will involve the public in health service design. Evaluation of public involvement has typically focused on the process and experiences for participants. Less is known about outcomes for health services. The aim of this systematic review was to a) identify and synthesise what is known about health service outcomes of public involvement and b) document how outcomes were evaluated. METHODS Searches were undertaken in MEDLINE, EMBASE, The Cochrane Library, PsycINFO, Web of Science, and CINAHL for studies that reported health service outcomes from public involvement in health service design. The review was limited to high-income countries and studies in English. Study quality was assessed using the Mixed Methods Appraisal Tool and critical appraisal guidelines for assessing the quality and impact of user involvement in health research. Content analysis was used to determine the outcomes of public involvement in health service design and how outcomes were evaluated. RESULTS A total of 93 articles were included. The majority were published in the last 5 years, were qualitative, and were located in the United Kingdom. A range of health service outcomes (discrete products, improvements to health services and system/policy level changes) were reported at various levels (service level, across services, and across organisations). However, evaluations of outcomes were reported in less than half of studies. In studies where outcomes were evaluated, a range of methods were used; most frequent were mixed methods. The quality of study design and reporting was inconsistent. CONCLUSION When reporting public involvement in health service design authors outline a range of outcomes for health services, but it is challenging to determine the extent of outcomes due to inadequate descriptions of study design and poor reporting. There is an urgent need for evaluations, including longitudinal study designs and cost-benefit analyses, to fully understand outcomes from public involvement in health service design.
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Affiliation(s)
- Nicola Lloyd
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Nerida Hyett
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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8
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Wharrad H, Sarre S, Schneider J, Maben J, Aldus C, Argyle E, Arthur A. In-PREP: a new learning design framework and methodology applied to a relational care training intervention for healthcare assistants. BMC Health Serv Res 2020; 20:1010. [PMID: 33148232 PMCID: PMC7643258 DOI: 10.1186/s12913-020-05836-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 10/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Older People's Shoes' is a training intervention designed for healthcare assistants (HCAs) to improve the relational care of older people in hospital. The intervention formed part of a broader evaluation, in this paper we describe its development from a learning design and methodological perspective. METHODS Learning theory and an instructional design model were key components of the In-PREP (Input, Process, Review and Evaluation, Product) development methodology used in the design of the 'Older People's Shoes' training intervention to improve the delivery of relational care by front-line hospital staff. An expert panel, current evidence, and pedagogical theory were used to co-design a training programme tailored to a challenging work environment and taking account of trainees' diverse educational experience. Peer review and process evaluation were built into the development model. RESULTS In-PREP provided a methodological scaffold for producing evidence-based, peer-reviewed, co-designed training. The product, 'Older People's Shoes', involved a one-day Train the Trainers event, followed by delivery of a two-day, face-to-face training programme by the trainers, with accompanying handbooks underpinned by a range of digital resources. Evaluation found the approach met learner needs, was applicable in practice and won approval from trainers. DISCUSSION In-PREP enables high quality learning content, alignment with learner needs and a product that is relevant, practical and straightforward to implement.
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Affiliation(s)
- Heather Wharrad
- School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK.
| | - Sophie Sarre
- School of Nursing, Midwifery and Palliative Care, King's College, London, UK
| | - Justine Schneider
- School of Law and Social Sciences, University of Nottingham, Nottingham, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Clare Aldus
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Elaine Argyle
- School of Education, University of Nottingham, Nottingham, UK
| | - Anthony Arthur
- School of Health Sciences, University of East Anglia, Norwich, UK
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Stevens CJ, Horrigan J, Heale R, Koren I. Northeastern Ontario nurses' perceptions of e-learning: An interpretive description. NURSE EDUCATION TODAY 2020; 92:104509. [PMID: 32599472 DOI: 10.1016/j.nedt.2020.104509] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/04/2020] [Accepted: 06/16/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND E-learning is a common method of continuing education for nurses that supports professional competencies and learning needs. However, variations in setting, information technology, and quality of the e-learning may impact these experiences. OBJECTIVE To explore registered nurses' perceptions of e-learning in a hospital setting. DESIGN A qualitative study using an Interpretive Description methodology. SETTING A small urban Northeastern Ontario hospital. PARTICIPANTS Ten registered nursing staff from acute medical and surgical inpatient departments. METHOD Face-to-face semi-structured interviews were conducted to explore nurses' e-learning perceptions. Interview transcripts were analyzed for themes. RESULTS Three key themes were found that described the participants' perceptions of e-learning and how it related to their continuing education: Unsatisfactory, Meaningful, and Enhancing learning experiences. CONCLUSION E-learning can be a useful method of continuing education for registered nurses; however, there are challenges in the delivery of e-learning and an ongoing need for quality development.
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Affiliation(s)
| | - Judith Horrigan
- Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.
| | - Roberta Heale
- Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.
| | - Irene Koren
- Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada.
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10
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Brook J, Leanne Aitken, MacLaren DJA, Salmon D. Co-production of an intervention to increase retention of early career nurses: Acceptability and feasibility. Nurse Educ Pract 2020; 47:102861. [PMID: 32858300 PMCID: PMC7428677 DOI: 10.1016/j.nepr.2020.102861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 07/25/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023]
Abstract
Co-production is a process employed to solve complex issues, recognising the expertise of all stakeholders. This paper reports on co-production undertaken by nursing students, early career nurses and researchers as part of a larger study to design an intervention to increase retention of early career nurses. Mixed methods were used to evaluate the acceptability and feasibility of the co-production process in a UK university. Data were collected prospectively, concurrently and retrospectively via interview and questionnaire, between April 2018 and January 2019. Twelve co-production group members completed the questionnaire and six group members and facilitators were interviewed. Students and early career nurses reported personal benefit from participating; they developed and practised transferrable communication and problem-solving skills, believed they were able to make a difference, enjoyed contributing, found benefit from using the group as a reflective space and considered that co-production produced a credible intervention. Findings indicated co-production equipped participants to function more effectively in their nursing roles; incorporating co-production into the development of future interventions may prove beneficial. The relative novelty of this approach, and the potential application of the findings to a diverse range of geographical and organisational settings, add to the utility of the findings. Co-production is acceptable and effective for designing nurse retention interventions 84. Co-production helped develop skills that were transferrable to the clinical area. Facilitators found co-production subject to competing demands and expectations. Co-production should be considered to promote a credible retention interventions.
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Affiliation(s)
- Judy Brook
- City, University of London, Northampton Square London, EC1V 0HB, UK.
| | - Leanne Aitken
- City, University of London, Northampton Square London, EC1V 0HB, UK.
| | | | - Debra Salmon
- City, University of London, Northampton Square London, EC1V 0HB, UK.
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Development and mixed-methods evaluation of an online animation for young people about genome sequencing. Eur J Hum Genet 2020; 28:896-906. [PMID: 31896776 PMCID: PMC7316978 DOI: 10.1038/s41431-019-0564-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 11/08/2022] Open
Abstract
Children and young people with rare and inherited diseases will be significant beneficiaries of genome sequencing. However, most educational resources are developed for adults. To address this gap in informational resources, we have co-designed, developed and evaluated an educational resource about genome sequencing for young people. The first animation explains what a genome is, genomic variation and genome sequencing ("My Genome Sequence": http://bit.ly/mygenomesequence), the second focuses on the limitations and uncertainties of genome sequencing ("My Genome Sequence part 2": http://bit.ly/mygenomesequence2). In total, 554 school pupils (11-15 years) took part in the quantitative evaluation. Mean objective knowledge increased from before to after watching one or both animations (4.24 vs 7.60 respectively; t = 32.16, p < 0.001). Self-rated awareness and understanding of the words 'genome' and 'genome sequencing' increased significantly after watching the animation. Most pupils felt they understood the benefits of sequencing after watching one (75.4%) or both animations (76.6%). Only 17.3% felt they understood the limitations and uncertainties after watching the first, however this was higher among those watching both (58.5%, p < 0.001). Twelve young people, 14 parents and 3 health professionals consenting in the 100,000 Genomes Project reported that the animation was clear and engaging, eased concerns about the process and empowered young people to take an active role in decision-making. To increase accessibility, subtitles in other languages could be added, and the script could be made available in a leaflet format for those that do not have internet access. Future research could focus on formally evaluating the animations in a clinical setting.
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Huang KY, Lee D, Nakigudde J, Cheng S, Gouley KK, Mann D, Schoenthaler A, Chokshi S, Kisakye EN, Tusiime C, Mendelsohn A. Use of Technology to Promote Child Behavioral Health in the Context of Pediatric Care: A Scoping Review and Applications to Low- and Middle-Income Countries. Front Psychiatry 2019; 10:806. [PMID: 31798470 PMCID: PMC6865208 DOI: 10.3389/fpsyt.2019.00806] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The burden of mental, neurological, and substance (MNS) disorders is greater in low- and middle-income countries (LMICs). The rapid growth of digital health (i.e., eHealth) approaches offer new solutions for transforming pediatric mental health services and have the potential to address multiple resource and system barriers. However, little work has been done in applying eHealth to promote young children's mental health in LMICs. It is also not clear how eHealth has been and might be applied to translating existing evidence-based practices/strategies (EBPs) to enable broader access to child mental health interventions and services. Methods: A scoping review was conducted to summarize current eHealth applications and evidence in child mental health. The review focuses on 1) providing an overview of existing eHealth applications, research methods, and effectiveness evidence in child mental health promotion (focused on children of 0-12 years of age) across diverse service contexts; and 2) drawing lessons learned from the existing research about eHealth design strategies and usability data in order to inform future eHealth design in LMICs. Results: Thirty-two (32) articles fitting our inclusion criteria were reviewed. The child mental health eHealth studies were grouped into three areas: i) eHealth interventions targeting families that promote child and family wellbeing; ii) eHealth for improving school mental health services (e.g., promote school staff's knowledge and management skills); and iii) eHealth for improving behavioral health care in the pediatric care system (e.g., promote use of integrated patient-portal and electronic decision support systems). Most eHealth studies have reported positive impacts. Although most pediatric eHealth studies were conducted in high-income countries, many eHealth design strategies can be adapted and modified to fit LMIC contexts. Most user-engagement strategies identified from high-income countries are also relevant for populations in LMICs. Conclusions: This review synthesizes patterns of eHealth use across a spectrum of individual/family and system level of eHealth interventions that can be applied to promote child mental health and strengthen mental health service systems. This review also summarizes critical lessons to guide future eHealth design and delivery models in LMICs. However, more research in testing combinations of eHealth strategies in LMICs is needed.
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Affiliation(s)
- Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Douglas Lee
- College of Osteopathic Medicine, New York Institute of Technology, New York, NY, United States
| | - Janet Nakigudde
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Sabrina Cheng
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Kathleen Kiely Gouley
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Devin Mann
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Antoinette Schoenthaler
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Sara Chokshi
- Department of Population Health, New York University School of Medicine, New York, NY, United States
| | | | | | - Alan Mendelsohn
- Department of Population Health, New York University School of Medicine, New York, NY, United States
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Ferguson M, Leighton P, Brandreth M, Wharrad H. Development of a multimedia educational programme for first-time hearing aid users: a participatory design. Int J Audiol 2018; 57:600-609. [PMID: 29718733 DOI: 10.1080/14992027.2018.1457803] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. DESIGN RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. STUDY SAMPLE An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. RESULTS Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. CONCLUSIONS This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.
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Affiliation(s)
- Melanie Ferguson
- a National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Otology and Hearing Group, Division of Clinical Neuroscience , School of Medicine, University of Nottingham , Nottingham , UK.,b Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Paul Leighton
- c School of Medicine , University of Nottingham , Nottingham , UK
| | - Marian Brandreth
- a National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Otology and Hearing Group, Division of Clinical Neuroscience , School of Medicine, University of Nottingham , Nottingham , UK.,b Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Heather Wharrad
- d Faculty of Medicine and Health Sciences , University of Nottingham , Nottingham , UK
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Carter T, Latif A, Callaghan P, Manning JC. An exploration of predictors of children's nurses’ attitudes, knowledge, confidence and clinical behavioural intentions towards children and young people who self‐harm. J Clin Nurs 2018; 27:2836-2846. [DOI: 10.1111/jocn.14361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Tim Carter
- Faculty of Medicine and Health Sciences School of Health Sciences University of Nottingham Nottingham UK
| | - Asam Latif
- Faculty of Medicine and Health Sciences School of Health Sciences University of Nottingham Nottingham UK
| | | | - Joseph C. Manning
- Faculty of Medicine and Health Sciences School of Health Sciences University of Nottingham Nottingham UK
- Family Health Division Nottingham University Hospitals Nottingham UK
- Children and Families Research Centre for Technology Enabled Health Research Coventry University Coventry UK
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Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities. PHARMACY 2018; 6:pharmacy6010013. [PMID: 29382062 PMCID: PMC5874552 DOI: 10.3390/pharmacy6010013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. AIM This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. METHOD Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals (n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). RESULTS Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. DISCUSSION This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.
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