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Karlsson AW, Kragh-Sørensen A, Børgesen K, Behrens KE, Andersen T, Kidholm ML, Rothmann MJ, Ketelaar M, Janssens A. Roles, outcomes, and enablers within research partnerships: A rapid review of the literature on patient and public involvement and engagement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:43. [PMID: 37322525 PMCID: PMC10268359 DOI: 10.1186/s40900-023-00448-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Recent studies mention a need to investigate partnership roles and dynamics within patient and public involvement and engagement (PPIE) in health research, and how impact and outcomes are achieved. Many labels exist to describe involvement processes, but it is unknown whether the label has implications on partnerships and outcomes. This rapid review investigates how roles between patients, relatives and researchers in a broad variety of PPIE activities in health research are described in peer reviewed papers and explores what enables these partnerships. METHODS Rapid review of articles published between 2012 and February 2022 describing, evaluating, or reflecting on experiences of PPIE in health research. All research disciplines and research areas were eligible. Four databases (Medline, Embase, PsychInfo and CINAHL) were searched between November 2021 and February 2022. We followed PRISMA guidelines and extracted descriptive factors: year, origin, research area and discipline, study focus, framework used and co-authorship. On a selection of articles, we performed a narrative analysis of partnership roles using Smits et al.'s. Involvement Matrix. Lastly, we performed a meta synthesis of reported enablers and outcomes of the partnerships. Patients and Relatives (PRs) have been involved in the whole rapid review process and are co-authors of this article. RESULTS Seventy articles from various research disciplines and areas were included. Forty articles were selected for a narrative analysis of the role description of PRs and researchers, and a meta synthesis of enablers and outcomes. Most articles described researchers as decision-makers throughout the research cycle. PRs most often were partners when they were included as co-authors; they were mostly partners in the design, analysis, write-up, and dissemination stages. Enablers of partnerships included: PR training, personality of PRs and communication skills, trust, remuneration and time. CONCLUSIONS Researchers' decision-making roles gives them control of where and when to include PRs in their projects. Co-authorship is a way of acknowledging patients' contributions which may lead to legitimation of their knowledge and the partnership. Authors describe common enablers, which can help future partnership formation.
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Affiliation(s)
- Anne Wettergren Karlsson
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Anne Kragh-Sørensen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Kirsten Børgesen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Karsten Erik Behrens
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Torben Andersen
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Maiken Langhoff Kidholm
- Department of Public Health, User Perspectives and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Mette Juel Rothmann
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Center for Innovative Medical Innovation, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Astrid Janssens
- Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark.
- University of Exeter Medical School, Exeter, UK.
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Zoellner JM, You W, Hill JL, Brock DJP, Yuhas M, Price B, Wilson J, Montague DR, Estabrooks PA. Comparing two different family-based childhood obesity treatment programmes in a medically underserved region: Effectiveness, engagement and implementation outcomes from a randomized controlled trial. Pediatr Obes 2022; 17:e12840. [PMID: 34396714 DOI: 10.1111/ijpo.12840] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Access to evidence- and family-based childhood obesity (FBCO) treatment interventions is a challenge, especially in underserved regions where childhood obesity disparities persist. OBJECTIVE Compare two 6-month FBCO treatment interventions, iChoose (high intensity, parent-child dyads) and Family Connections (low intensity, parents only), in one underserved US region. METHODS This unblinded, RCT reports on effectiveness and implementation outcomes. Eligibility included children ages 5-12 with BMI ≥85th percentile. Analyses included descriptive statistics and intention-to-treat Heckman treatment effect models. RESULTS Enrolled children (n = 139, mean age 10.1 ± 1.7 years, 30% with overweight, 70% with obesity, 45% black, 63% Medicaid) were randomly assigned to iChoose (n = 70) or Family Connections (n = 69). Retention rates were 63% for iChoose and 84% for Family Connection. Among children, 6-month BMI z-score changes were not statistically significant within iChoose [BMI z-score 0.03 (95% CI = -0.13, 0.19)] or Family Connections [BMI z-score 0.00 (95% CI = -0.16, 0.16)]. Likewise, parents' BMI changes were not statistically significant. No adverse events were reported. Both programmes were delivered with high fidelity (77%-100%). Engagement in core components was 25%-36% for iChoose and 52%-61% for Family Connections. Implementation costs per child with improved BMI z-score were $2841 for iChoose and $955 for Family Connections. CONCLUSIONS Neither intervention yielded significant improvements in child BMI z-score or parent BMI, yet both were delivered with high fidelity. Relative to iChoose, descriptive data indicated higher retention, better engagement, and lower costs for Family Connections-suggesting that a lower intensity and parent-focused programme may better fit the intended audience's context.
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Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Wen You
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Jennie L Hill
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Donna-Jean P Brock
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Maryam Yuhas
- Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, University of Virginia (UVA), Christiansburg, Virginia, USA
| | - Bryan Price
- Community Outreach and Education, UVA Cancer Center, Danville, Virginia, USA
| | - Jonathon Wilson
- Parks and Recreation, City of Danville, Danville, Virginia, USA
| | | | - Paul A Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Brock DJP, Estabrooks PA, Yuhas M, Wilson JA, Montague D, Price BE, Elliott K, Hill JL, Zoellner JM. Assets and Challenges to Recruiting and Engaging Families in a Childhood Obesity Treatment Research Trial: Insights From Academic Partners, Community Partners, and Study Participants. Front Public Health 2021; 9:631749. [PMID: 33692983 PMCID: PMC7937718 DOI: 10.3389/fpubh.2021.631749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/25/2021] [Indexed: 12/18/2022] Open
Abstract
Background: There is need for the childhood obesity treatment literature to identify effective recruitment and engagement strategies for rural communities that are more likely to lack supportive infrastructure for healthy lifestyles and clinical research relative to their urban counterparts. This community case study examines recruitment and engagement strategies from a comparative effectiveness research (CER) trial of two family-based childhood obesity (FBCO) treatment interventions conducted in a medically underserved, rural region. Guided by a Community Based Participatory Research (CBPR) and systems-based approach, the primary aim was to analyze interviews from academic partners, community partners, and parent study participants for recruitment and engagement assets, challenges, and lessons learned. Methods: Over the 3-year lifespan of the study, researchers conducted 288 interviews with Community Advisory Board members (n = 14), Parent Advisory Team members (n = 7), and study participants (n = 100). Using an inductive-deductive approach, interviews were broadly coded for recruitment and engagement assets, challenges, and recommendations; analyzed for descriptive sub-coding; and organized into stakeholder/organization and participant level themes. Codes were analyzed aggregately across time and examined for differences among stakeholders and parent study participants. Results: Adherence to CBPR principles and development of strong community partnerships facilitated recruitment and engagement; however, variability in recruitment and engagement success impacted partner confidence, threatened outcome validity, and required additional resources. Specifically, assets and challenges emerged around eight key needs. Three were at the stakeholder/organization level: (1) readiness of stakeholders to conduct CBPR research, (2) development of sustainable referral protocols, and (3) development of participant engagement systems. The remaining five were at the participant level: (1) comfort and trust with research, (2) awareness and understanding of the study, (3) intervention accessibility, (4) intervention acceptability, and (5) target population readiness. Future recommendations included conducting readiness assessments and awareness campaigns, piloting and evaluating recruitment and engagement strategies, identifying participant barriers to engagement and finding a priori solutions, and fostering stakeholder leadership to develop sustainable protocols. Conclusion: Collective findings from multiple perspectives demonstrate the need for multi-leveled approaches focusing on infrastructure supports and strategies to improve stakeholder and participant awareness of, and capacity for, recruiting and engaging medically underserved, rural families in a FBCO CER trial.
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Affiliation(s)
- Donna-Jean P. Brock
- Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Paul A. Estabrooks
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Maryam Yuhas
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, United States
| | | | | | - Bryan E. Price
- Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Kenya Elliott
- Piedmont Access to Health Services, Danville, VA, United States
| | - Jennie L. Hill
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jamie M. Zoellner
- Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States
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Zoellner JM, You W, Hill JL, Brock DJP, Yuhas M, Alexander RC, Price B, Estabrooks PA. A comparative effectiveness trial of two family-based childhood obesity treatment programs in a medically underserved region: Rationale, design & methods. Contemp Clin Trials 2019; 84:105801. [PMID: 31260792 DOI: 10.1016/j.cct.2019.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/13/2019] [Accepted: 06/27/2019] [Indexed: 12/18/2022]
Abstract
While there is a large body of literature documenting the efficacy of family-based childhood obesity (FBCO) treatment interventions, there is little evidence that these interventions have been systematically translated into regular practice - particularly in health disparate regions. To address this research-practice gap, this project was guided by a community advisory board (CAB) and the RE-AIM planning and evaluation framework within a systems-based and community-based participatory research approach. Families with overweight or obese children between 5 and 12 years old, in the medically-underserved Dan River Region, were randomly assigned to one of two FBCO treatment programs (iChoose vs. Family Connections) delivered by local Parks & Recreation staff. Both programs have previously demonstrated clinically meaningful child BMI z-score reductions, but vary in intensity, structure, and implementation demands. Two clinical CAB partners embedded recruitment methods into their regional healthcare organization, using procedures representative to what could be used if either program was taken to scale. The primary effectiveness outcome is child BMI z-scores at 6-months, with additional assessments at 3-months and at 12-months. Secondary goals are to determine: (1) reach into the intended audience; (2) effectiveness on secondary child and parent outcomes; (3) intervention adoption by organizations and staff; (4) fidelity, cost, and capacity for intervention implementation; and (5) maintenance of individual-level changes and organizational-level sustainability. This research addresses literature gaps related to the features within clinical and community settings that could improve both child weight status and the translation of FBCO interventions into typical practice in medically-underserved communities. IDENTIFIERS: Clincialtrials.gov: NCT03245775.
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Affiliation(s)
- Jamie M Zoellner
- University of Virginia (UVA), Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA.
| | - Wen You
- Virginia Tech, Department of Agricultural and Applied Economics, 304 Hutcheson Hall, 24060, USA
| | - Jennie L Hill
- Department of Epidemiology, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198-6075, USA
| | - Donna-Jean P Brock
- University of Virginia (UVA), Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Maryam Yuhas
- University of Virginia (UVA), Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Ramine C Alexander
- Department of Family and Consumer Sciences, North Carolina A&T State University, Benbow 202-A, Greensboro, NC 27411, USA
| | - Bryan Price
- UVA Cancer Center, Community Outreach and Education, Main Street, Unit 102, Danville, VA 24541, USA
| | - Paul A Estabrooks
- Department of Health Promotion, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198-6075, USA
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