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Watson D, Mhlaba M, Molelekeng G, Chauke TA, Simao SC, Jenner S, Ware LJ, Barker M. How do we best engage young people in decision-making about their health? A scoping review of deliberative priority setting methods. Int J Equity Health 2023; 22:17. [PMID: 36698119 PMCID: PMC9876416 DOI: 10.1186/s12939-022-01794-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/18/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION International organisations have called to increase young people's involvement in healthcare and health policy development. We currently lack effective methods for facilitating meaningful engagement by young people in health-related decision-making. The purpose of this scoping review is to identify deliberative priority setting methods and explore the effectiveness of these in engaging young people in healthcare and health policy decision-making. METHODS Seven databases were searched systematically, using MeSH and free text terms, for articles published in English before July 2021 that described the use of deliberative priority setting methods for health decision-making with young people. All titles, abstracts and full-text papers were screened by a team of six independent reviewers between them. Data extraction followed the Centre for Reviews and Dissemination guidelines. The results are presented as a narrative synthesis, structured around four components for evaluating deliberative processes: 1) representation and inclusion of diverse participants, 2) the way the process is run including levels and timing of participant engagement, 3) the quality of the information provided to participants and 4) resulting outcomes and decisions. FINDINGS The search yielded 9 reviews and 21 studies. The more engaging deliberative priority setting tools involved young people-led committees, mixed methods for identifying and prioritising issues and digital data collection and communication tools. Long-term and frequent contact with young people to build trust underpinned the success of some of the tools, as did offering incentives for taking part and skills development using creative methods. The review also suggests that successful priority setting processes with young people involve consideration of power dynamics, since young people's decisions are likely to be made together with family members, health professionals and academics. DISCUSSION Young people's engagement in decision-making about their health is best achieved through investing time in building strong relationships and ensuring young people are appropriately rewarded for their time and contribution. If young people are to be instrumental in improving their health and architects of their own futures, decision-making processes need to respect young people's autonomy and agency. Our review suggests that methods of power-sharing with young people do exist but that they have yet to be adopted by organisations and global institutions setting global health policy.
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Affiliation(s)
- Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK. .,SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. .,Department of Global Health and Social Medicine, King's College London, London, UK.
| | - Mimi Mhlaba
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Gontse Molelekeng
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulani Andrew Chauke
- grid.412801.e0000 0004 0610 3238Department of Adult, College of Education, Community and Continuing Education, University of South Africa, Pretoria, South Africa
| | - Sara Correia Simao
- grid.5491.90000 0004 1936 9297Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah Jenner
- grid.5491.90000 0004 1936 9297Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Lisa J. Ware
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Barker
- grid.5491.90000 0004 1936 9297Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK ,grid.5491.90000 0004 1936 9297School of Health Sciences, Faculty of Life and Environmental Sciences, University of Southampton, Southampton, UK ,grid.11951.3d0000 0004 1937 1135School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.430506.40000 0004 0465 4079NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
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Chidwick H, Baumann A, Ogba P, Banfield L, DiLiberto DD. Exploring adolescent engagement in sexual and reproductive health research in Kenya, Rwanda, Tanzania, and Uganda: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000208. [PMID: 36962492 PMCID: PMC10022240 DOI: 10.1371/journal.pgph.0000208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/23/2022] [Indexed: 06/18/2023]
Abstract
Adolescent sexual and reproductive health (ASRH) in East Africa has prioritized research on the barriers to care, communication, and ASRH knowledge, attitudes, and practices. However, there is little research examining the extent to which meaningful adolescent engagement in research is achieved in practice and how this influences the evidence available to inform ASRH services. This review offers a critical step towards understanding current approaches to adolescent engagement in ASRH research and identifying opportunities to build a strengthened evidence base with adolescent voices at the centre. This scoping review is based on Arksey and O'Malley's (2005) framework, employing a keyword search of four databases via OVID: Medline, Global Health, Embase and PsycINFO. Two reviewers screened title, abstract and full text to select articles examining ASRH in Tanzania, Rwanda, Kenya, and Uganda, published between 2000 and 2020. After articles were selected, data was extracted, synthesized, and thematically organized to highlight emerging themes and potential opportunities for further research. The search yielded 1201 results, 34 of which were included in the final review. Results highlight the methods used to gather adolescent perspectives of ASRH (qualitative), the content of those perspectives (knowledge, sources of information, gaps in information and adolescent friendly services), and the overall narratives that frame discussions of ASRH (risky sexual behaviour, stigma, and gender norms). Findings indicate the extent of adolescent engagement in ASRH research is limited, resulting in a lack of comprehensive evidence, consistent challenges with stigma, little information on holistic concepts and a narrow framing of ASRH. In conclusion, there is opportunity for more meaningful engagement of adolescents in ASRH research. This engagement can be achieved by involving adolescents more comprehensively throughout the research cycle and by expanding the range of ASRH topics explored, as identified by adolescents.
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Affiliation(s)
- Hanna Chidwick
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Baumann
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Patricia Ogba
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Deborah D. DiLiberto
- Faculty of Health Sciences, Global Health Office, McMaster University, Hamilton, Ontario, Canada
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Behan JM, Arora RS, Carnevale FA, Bakhshi S, Bhattacharjee B, Tsimicalis A. An Ethnographic Study of the Moral Experiences of Children with Cancer in New Delhi, India. Glob Qual Nurs Res 2021; 8:2333393621995814. [PMID: 33748333 PMCID: PMC7905724 DOI: 10.1177/2333393621995814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/15/2022] Open
Abstract
There is a paucity of research examining children’s experiences with cancer in India. Childhood ethics is an emerging field, focusing on the moral dimension of children’s experiences, to promote children’s participation in their health care. A focused ethnography, using a moral experience framework, was conducted to better understand children’s participation in decisions, discussions, and actions in three oncology settings in New Delhi, India. We interviewed key informants, retrieved key documents, and conducted semi-structured interviews and participant observations with children. All 22 children demonstrated interest in varying aspects of their cancer care. Certain factors facilitated or impeded their participation. Some children became distressed when they lacked information about their treatment or were not given opportunities to enhance their understanding. The results advance our understanding of the moral experiences of children with cancer in India for healthcare professionals, policy makers, families, and interested others.
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Affiliation(s)
| | | | | | - Sameer Bakhshi
- All India Institute of Medical Sciences, New Delhi, India
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