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Intarakamhang U, Sriprasertpap K, Chiangkhong A, Srisawasdi N, Wongchan S, Boocha P. Effects of Digital Health Literacy Program on Sufficient Health Behavior Among Thai Working-Age People With Risk Factors for Noncommunicable Diseases. Health Lit Res Pract 2024; 8:e93-e101. [PMID: 38852071 PMCID: PMC11235984 DOI: 10.3928/24748307-20240520-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/11/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) account for more than 75% of deaths in Thailand, which is higher than the global average of 71%. OBJECTIVE The aim of this study was to investigate the effects of the Digital Health Literacy (DHL) and Sufficient Health Behavior (SHB) Program on Thai working-age adults age 20 to 65 years with risk factors for NCDs (i.e., overweight and lacking physical activity), and compare the health literacy (HL) and SHB of participants living in urban and semi-urban areas at posttest. METHODS Using the lottery method, this one-group pretest-posttest quasi-experimental design randomly selected 200 participants and assigned them to two equally sized groups. The data were gathered through surveys with an item discrimination power between .20 and .86 and a reliability of 0.94 and were statistically analyzed using t-test and F-test. KEY RESULTS The DHL and SHB Program comprises six sessions over a 12-week period, and activities designed to enhance knowledge of NCDs, HL, health communication, and health behavior modification. It was conducted by health care workers from urban and semi-urban public hospitals via Zoom using various digital toolkits such as YouTube, animations, infographics, role-play videos, clips, and e-books. At the posttest, the participants had higher HL (t = 2.67, p = .001) and SHB (t = 3.36, p = .001). There was a difference in SHB scores (F = 4.640, p = .032) between those living in urban and those in semi-urban areas, but no difference in HL scores (F = 1.436, p = .232). CONCLUSIONS The DHL and SHB Program improved HL and SHB in Thai working-age adults with risk factors for NCDs in both urban and semi-urban communities. [HLRP: Health Literacy Research and Practice. 2024;8(2):e93-e101.].
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Affiliation(s)
| | | | | | | | | | - Piya Boocha
- Address correspondence to Piya Boocha, PhD, Innovative Learning Center, Srinakharinwirot University, Bangkok 10110, Thailand;
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Selvan K, Leekha A, Abdelmeguid H, Malvankar-Mehta MS. Barriers adult refugees face to community health and patient engagement: a systematic review. Glob Public Health 2022; 17:3412-3425. [PMID: 36074889 DOI: 10.1080/17441692.2022.2121846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Meeting the health needs of refugee populations and increasing access to healthcare remains a challenge for healthcare systems globally. As such, community health and patient engagement are increasingly recommended strategies to address health-related issues among refugees. This systematic review aims to identify the reported barriers that adult refugees encounter with community health and patient engagement. Data sources included MEDLINE, Embase, APA PsycINFO, CINAHL, and Core Collection (Web of Science), yielding 1156 records. After removing duplicates and two levels of screening, 18 studies were selected for qualitative analysis. The barriers were conceptualised as cultural norms, pre-departure history, education, language proficiency, stigma, racism, social support, and multi-factorial barriers. These barriers can be addressed to improve rapport with refugees and the quality of community health and patient engagement initiatives.
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Affiliation(s)
- Kavin Selvan
- Genetics and Genome Biology (GGB) Program, The Hospital for Sick Children Research Institute, Toronto, Canada.,Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Canada.,Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,RefuHope, London, Canada
| | - Arshia Leekha
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Canada.,RefuHope, London, Canada
| | - Hana Abdelmeguid
- Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.,RefuHope, London, Canada
| | - Monali S Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
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Vidgen ME, Cutler K, Bean J, Bunker D, Fowles LF, Healy L, Hondow G, Istiko SN, McInerney-Leo AM, Pratt G, Robins D, Waddell N, Evans E. Community input in a genomic health implementation program: Perspectives of a community advisory group. Front Genet 2022; 13:892475. [PMID: 35938017 PMCID: PMC9355292 DOI: 10.3389/fgene.2022.892475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Consumer and community engagement (CCE) in the implementation of genomics into health services and associated research is needed to ensure that changes benefit the affected patients. Queensland Genomics was a program to implement genomics into a public health service. We describe its Community Advisory Group’s (CAG) structure and function and provide recommendations based on the CAG members’ perspectives. The CAG provided advice to the Queensland Genomics program and its projects in an advisory capacity. The CAG was also resourced to develop and lead community-focused activities. Key enablers for CAG included; diversity of CAG members’ skills and experience, adequate resourcing, and the CAG’s ability to self-determine their direction. The CAG experienced limitations due to a lack of mechanisms to implement CCE in the Program’s projects. Here, we provide insights and commentary on this CAG, which will be useful for other initiatives seeking to undertake CCE in genomic research and health care.
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Affiliation(s)
- Miranda E. Vidgen
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Katrina Cutler
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
| | - Jessica Bean
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - David Bunker
- Queensland Genomics, Herston, QLD, Australia
- Health Translation Queensland, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Lindsay F. Fowles
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Genetic Health Queensland, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Louise Healy
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Gary Hondow
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | | | - Aideen M. McInerney-Leo
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Dermatology Research Centre, University of Queensland Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Gregory Pratt
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Deborah Robins
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Correspondence: Miranda E. Vidgen, ; Nicola Waddell,
| | - Erin Evans
- Queensland Genomics Community Advisory Group, Brisbane, QLD, Australia
- Health Consumers Queensland, Brisbane, QLD, Australia
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4
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Lo Presti L, Testa M, Maggiore G, Marino V. Key drivers involved in the telemonitoring of covid-19 for self-health management: an exploratory factor analysis. BMC Health Serv Res 2022; 22:520. [PMID: 35440043 PMCID: PMC9016691 DOI: 10.1186/s12913-022-07828-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/15/2022] [Indexed: 12/20/2022] Open
Abstract
Background The recent COVID-19 pandemic and the shortage of general practitioners has determined a strong pressure on the Italian health system. This critical issue highlighted the fundamental support of e-health services not only to lighten the workload of doctors, but also to offer patients a health service tailored to real needs. Therefore, the digital engagement platforms represent a valid aid, as they reconcile the efficiency needs of the healthcare system with the benefits for the patients involved. In this perspective, little is known about the main factors associated with use of telemonitoring platforms and their effectiveness. This paper investigates the critical success factors of telemonitoring platforms during COVID-19 in order to understand the mechanisms underlying patient participation with the health engagement platforms. Methods An exploratory factor analysis was used to explain the main dimensions of patient participation in the COVID-19 telemonitoring. A sample of 119 patients with a suspected or confirmed infection was used in the investigation. Moreover, an analysis of variance was calculated to identify the differences between three types of patients (infected, uninfected, with suspected infection) and verify the effectiveness of the platform. Main Findings There are six main factors underlying the use of the COVID-19 telemonitoring platform. “Self-Health Engagement” emerges as a novel factor. Moreover, compared to other platforms, cognitive engagement is a crucial trigger for effective telemonitoring. Discussion By identifying the main triggers involved in the use of health engagement platforms, we can improve the satisfaction of telemonitoring services for appropriate health-crisis management. Furthermore, the COVID-19 telemonitoring platform appears to improve health management for both patients and health care providers as it provides the patient with the necessary tools for Self-Health Management (SHM), as well as helping to enrich the literature on health care. Conclusion A new construct emerges in the study of digital telemonitoring platforms: “health self-engagement”, that is, an engagement based on self-care that demonstrates the decisive role assumed by both digital technology and patient participation in self-management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07828-3.
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Affiliation(s)
- Letizia Lo Presti
- Department of Law and Economics, University of Rome "Unitelma Sapienza", Rome, Italy.
| | - Mario Testa
- Department of Management and Innovation Systems, University of Salerno, Fisciano, SA, Italy
| | - Giulio Maggiore
- Department of Law and Economics, University of Rome "Unitelma Sapienza", Rome, Italy
| | - Vittoria Marino
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
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5
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Hamilton CB, Dehnadi M, Snow ME, Clark N, Lui M, McLean J, Mamdani H, Kooijman AL, Bubber V, Hoefer T, Li LC. Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review. BMJ Open 2021; 11:e050208. [PMID: 34635521 PMCID: PMC8506891 DOI: 10.1136/bmjopen-2021-050208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems. METHODS We conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme. RESULTS Of 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness. CONCLUSIONS The 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.
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Affiliation(s)
- Clayon B Hamilton
- Evaluation and Research Services, Fraser Health Authority, Surrey, British Columbia, Canada
- Primary Care Division, Ministry of Health, Victoria, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maryam Dehnadi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - M Elizabeth Snow
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Michelle Lui
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Janet McLean
- Family Caregivers of British Columbia, Victoria, British Columbia, Canada
| | - Hussein Mamdani
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Allison L Kooijman
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
- School of Interdisciplinary Studies, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vikram Bubber
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Tammy Hoefer
- BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Chauhan A, Walpola RL, Manias E, Seale H, Walton M, Wilson C, Smith AB, Li J, Harrison R. How do health services engage culturally and linguistically diverse consumers? An analysis of consumer engagement frameworks in Australia. Health Expect 2021; 24:1747-1762. [PMID: 34264537 PMCID: PMC8483202 DOI: 10.1111/hex.13315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Engagement frameworks provide the conceptual structure for consumer engagement in healthcare decision making, but the level to which these frameworks support culturally and linguistically diverse (CALD) consumer engagement is not known. Objective This study aimed to investigate how consumer engagement is conceptualised and operationalized and to determine the implications of current consumer engagement frameworks for engagement with CALD consumers. Method Altheide's document analysis approach was used to guide a systematic search, selection and analytic process. Australian Government health department websites were searched for eligible publicly available engagement frameworks. A narrative synthesis was conducted. Results Eleven engagement frameworks published between 2007 and 2019 were identified and analysed. Only four frameworks discussed engagement with CALD consumers distinctly. Organisational prerequisites to enhance engagement opportunities and approaches to enable activities of engagement were highlighted to improve CALD consumers' active participation in decision making; however, these largely focused on language, with limited exploration of culturally sensitive services. Conclusion There is limited discussion of what culturally sensitive services look like and what resources are needed to enhance CALD consumer engagement in high‐level decision making. Health services and policy makers can enhance opportunities for engagement with CALD consumers by being flexible in their approach, implementing policies for reimbursement for participation and evaluating and adapting the activities of engagement in collaboration with CALD consumers. Patient/Public Contribution This study is part of a wider ‘CanEngage’ project, which includes a consumer investigator, and is supported by a consumer advisory group. The study was conceived with inputs from the consumer advisory group, which continued to meet regularly with the project team to discuss the methodology and emerging findings.
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Affiliation(s)
- Ashfaq Chauhan
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Ramesh L Walpola
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Holly Seale
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Merrilyn Walton
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Allan B Smith
- Centre for Oncology Education and Research Translation (CONSORT), Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, New South Wales, Australia
| | - Jiadai Li
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Reema Harrison
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
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7
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Cox R, Molineux M, Kendall M, Tanner B, Miller E. Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review. BMJ Qual Saf 2021; 31:134-146. [PMID: 34253682 PMCID: PMC8784995 DOI: 10.1136/bmjqs-2020-012729] [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: 11/15/2020] [Accepted: 06/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. OBJECTIVES The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities? METHODS A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis. RESULTS Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients' co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported. CONCLUSION The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.
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Affiliation(s)
- Ruth Cox
- Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia .,Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Melissa Kendall
- School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia.,Acquired Brain Injury Outreach Service and Transitional Rehabilitation Program, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Bernadette Tanner
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
| | - Elizabeth Miller
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
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8
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MacFarlane A, Ogoro M, de Freitas C, Niranjan V, Severoni S, Waagensen E. Migrants' involvement in health policy, service development and research in the WHO European Region: A narrative review of policy and practice. Trop Med Int Health 2021; 26:1164-1176. [PMID: 34169612 DOI: 10.1111/tmi.13643] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The involvement of individuals and communities in health decision-making is enshrined in WHO policies. However, migrant groups are under-represented in health decision-making processes. Our aim was to explore migrants' involvement in health policy, service development and research in the WHO European Region to identify levers for inclusive and meaningful practice. METHODS We conducted a narrative review of grey literature and peer-reviewed research on migrants' involvement in health decision-making across the 53 countries in WHO Europe. We searched for articles published in English between 2010 and the present in two electronic databases (PubMed, Scopus), IOM MIPEX Health Strand country reports, the EU SOPHIE project and using a Google advanced search. Findings were analysed descriptively and using Normalisation Process Theory to investigate levers and barriers to implementation of policy into practice. RESULTS Of 1,444 articles retrieved, 79 met the inclusion criteria. We identified 20 policies promoting migrants' involvement, but national-level policies were present in only two countries. We identified 59 examples of migrants' involvement in practice from half of the WHO Europe countries (n = 27). Our Normalisation Process Theory (NPT) analysis of 14 peer-reviewed empirical papers found that participatory research approaches are a lever to putting policy into practice in a meaningful way. CONCLUSIONS Migrants' involvement in health decision-making requires explicit national policies that are implemented evenly across policymaking, service provider and research activities in all countries in the WHO European Region. Participatory approaches to involvement activities are encouraged because they are a lever to perceived barriers to migrants' involvement.
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Affiliation(s)
- Anne MacFarlane
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Mamobo Ogoro
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
| | - Claudia de Freitas
- EPI Unit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Centre for Research and Studies in Sociology, University Institute of Lisbon, Lisbon, Portugal
| | - Vikram Niranjan
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Spencer J, Gilmore B, Lodenstein E, Portela A. A mapping and synthesis of tools for stakeholder and community engagement in quality improvement initiatives for reproductive, maternal, newborn, child and adolescent health. Health Expect 2021; 24:744-756. [PMID: 33794046 PMCID: PMC8235899 DOI: 10.1111/hex.13237] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/24/2021] [Accepted: 02/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Stakeholder and community engagement promotes collaboration and gives service users an opportunity to actively participate in the care they receive. Recognizing this potential, The Network for Improving Quality of Care for maternal, newborn and child health aimed to identify tools and operational guidance to integrate stakeholder and community engagement into quality improvement (QI) implementation. METHODS A mapping, consisting of a literature review and an open call through email and listservers, for implementation tools was conducted. Materials were included if they provided guidance on stakeholder and community engagement aligned to the Network's QI framework comprising seven phases. Screening of tools was done by two reviewers. RESULTS The literature search and the call for tools returned 197 documents with 70 tools included after screening. Most included tools (70%) were published after 2010. International organizations were the most frequently cited authors of tools. Only 15 tools covered all seven phases of the QI framework; few tools covered the more 'technical' phase of the QI framework: adapting standards and refining strategies. CONCLUSION The quantity of tools and their varied characteristics including types of stakeholder and community engagement processes across the QI framework confirms that engagement cannot be captured in a 'one-size-fits-all' formula. Many tools were designed with a generic focus to allow for adaption and use in different settings and sectors. Country programmes looking to strengthen engagement approaches can take advantage of available tools through an online portal on the WHO website and adapt them to meet their specific needs and context. PUBLIC INVOLVEMENT Programme implementers provided tools and resources during data collection.
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Affiliation(s)
- Jessie Spencer
- Division of Public HealthMichigan State UniversityCollege of Human MedicineFlintMIUSA
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary ResearchEducation and Innovation in Health SystemsSchool of Nursing, Midwifery and Health SystemsUniversity College DublinDublinIreland
| | | | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
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10
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Milley K, Chima S, McIntosh JG, Ackland E, Emery JD. Long-term consumer involvement in cancer research: Working towards partnership. Health Expect 2021; 24:1263-1269. [PMID: 33949071 PMCID: PMC8369080 DOI: 10.1111/hex.13258] [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: 12/16/2020] [Revised: 03/03/2021] [Accepted: 03/27/2021] [Indexed: 01/02/2023] Open
Abstract
Background Meaningful consumer involvement in health research is important. There are limited data on how to maintain long‐term consumer involvement. Objective To identify barriers and facilitators to meaningful long‐term consumer involvement in research. Design Six semi‐structured interviews were conducted with members of the Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group (CAG) and included the review of 40 supporting documents. Interviews and documents were analysed using inductive thematic analysis; the themes were mapped onto the domains of Cancer Australia's National Framework for Consumer Involvement in Cancer Control. Results Equality, respect and feeling valued were facilitators to long‐term involvement. These elements were part of an overarching theme of organizational commitment. Creating balance, managing competing deadlines and integrating a consumer role with a personal life were key barriers to involvement. These themes mapped strongly to the National Framework for Consumer Involvement in Cancer Control domains of committed organizations, capable consumers, inclusive groups and shared focus. Conclusion Research networks should reflect on several factors to maintain long‐term consumer involvement. Networks should aim to build a meaningful relationship, using clear communication and education, that reinforces the value and scope of a consumers contributions. We found that consumer education needs do not diminish over time and adequate skill development, support and feedback need to be on‐going. Creating regular opportunities for feedback and reflection are important to continue to meet best practice guidelines.
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Affiliation(s)
- Kristi Milley
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Sophie Chima
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Jennifer G McIntosh
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Elle Ackland
- Primary Care Collaborative Cancer Clinical Trials Group, Community Advisory Group, Melbourne, Vic., Australia
| | - Jon D Emery
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
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Abstract
Some agents representing the 'receiving end' of the medical-industrial complex could be called 'career consumers.' We identify these consucrats as a new class of intersectional representation of 'those affected' in healthcare delivery systems. We describe them in the context of (similar) abocrats and femocrats but show that consucrats face more complex and different level intersectional challenges. The designation, professionalization, and representation of consucrats are problematic, in particular for public policy change. We argue for an enhanced strategic and cautious role for the consumer health movement to support consucrats.
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Affiliation(s)
- Evelyne de Leeuw
- Centre for Health Equity, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
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12
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Dental Care in Times of the COVID-19 Pandemic: A Review. Med Sci (Basel) 2021; 9:medsci9010013. [PMID: 33669898 PMCID: PMC8006040 DOI: 10.3390/medsci9010013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023] Open
Abstract
Given the dynamic relationship between oral and general health, dental care must not be neglected even during a public health emergency. Nevertheless, the fear of contracting the infection appears to have caused instances of dental treatment avoidance. In these times of uncertainty, regulatory and public health organizations have made numerous and sometimes controversial recommendations to practitioners and to the public about how to secure their oral health care needs. Dentists, as advocates of oral health, should actively maintain their practices while considering local epidemiological reports and recommendations regarding prevention of SARS-CoV-2 infection. Providing appropriate safety measures, accurate triage and prioritization of patients, notice to susceptible communities, remote health care delivery when appropriate, and epidemiological reports of COVID-19 (whenever possible) are all critical considerations for dental practitioners.
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13
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Ehrlich C, Slattery M, Kendall E. Consumer engagement in health services in Queensland, Australia: A qualitative study about perspectives of engaged consumers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2290-2298. [PMID: 32511875 DOI: 10.1111/hsc.13050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/27/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
Successive health policies demonstrate unwavering commitment to partnering with consumers and communities. However, engaging consumers is complex and replete with priorities, perspectives and values that are firmly held, virtuous and different. In the context of political imperatives and different approaches to partnering with consumers in health services, we sought to explore consumers' experiences of engagement in public, private, primary care and non-government health services in Queensland, Australia. Participants identified themselves as consumers of health services and were currently, or had previously been, involved in planning, designing, delivering, monitoring and/or evaluating health services; were aged over 18 and consented to being involved. This qualitative study used semi-structured individual interviews to collect data which were analysed thematically. Four themes were identified, (a) authentic engagement and representation: asking, listening and acknowledging; (b) a continuum of consumer expertise; (c) contested engagement: transgressing health services thresholds of tolerance and (d) creating value for consumers and health services: reciprocity, trust, respect and remuneration. Findings demonstrated that 'rules of engagement' exist between consumers and staff employed in clinical, managerial, executive and administrative positions within health services in response to a legislated requirement that health services partner with consumers. The rules of consumer engagement centred on authenticity, transparency, expertise and individual capacity to transcend personal experience. If health services and the broader public are to fully benefit from safety and quality advances proposed by partnering with consumers, then it is essential that areas of contestation are identified and addressed.
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Affiliation(s)
- Carolyn Ehrlich
- The Hopkins Centre, MHIQ, Griffith University, Meadowbrook, Queensland, Australia
| | - Maddy Slattery
- The Hopkins Centre, MHIQ, Griffith University, Meadowbrook, Queensland, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, MHIQ, Griffith University, Meadowbrook, Queensland, Australia
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14
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Dutta T, Meyerson BE, Agley J, Barnes PA, Sherwood-Laughlin C, Nicholson-Crotty J. A qualitative analysis of vaccine decision makers' conceptualization and fostering of 'community engagement' in India. Int J Equity Health 2020; 19:185. [PMID: 33081792 PMCID: PMC7574459 DOI: 10.1186/s12939-020-01290-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, and in India, research has highlighted the importance of community engagement in achieving national vaccination goals and in promoting health equity. However, community engagement is not well-defined and remains an underutilized approach. There is also paucity of literature on community engagement's effectiveness in achieving vaccination outcomes. To address that gap, this study interviewed Indian vaccination decision makers to derive a shared understanding of the evolving conceptualization of community engagement, and how it has been fostered during India's Decade of Vaccines (2010-2020). METHODS Semi-structured interviews were conducted with 25 purposefully sampled national-level vaccine decision makers in India, including policymakers, immunization program heads, and vaccine technical committee leads. Participants were identified by their 'elite' status among decisionmakers in the Indian vaccination space. Schutz' Social Phenomenological Theory guided development of an a priori framework derived from the Social Ecological Model. The framework helped organize participants' conceptualizations of communities, community engagement, and related themes. Inter-rater reliability was computed for a subsample of coded interviews, and findings were validated in a one-day member check-in meeting with study participants and teams. RESULTS The interviews successfully elucidated participants' understanding of key terminology ("community") and approaches to community engagement propagated by the vaccine decision makers. Participants conceptualized 'communities' as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers. Engagement with those communities was understood to mean vaccine outreach, capacity-building of healthcare workers, and information dissemination. However, participants indicated that there were neither explicit policy guidelines defining community engagement nor pertinent evaluation metrics, despite awareness that community engagement is complex and under-researched. Examples of different approaches to community engagement ranged from vaccine imposition to empowered community vaccination decision-making. Finally, participants proposed an operational definition of community engagement and discussed concerns related to implementing it. CONCLUSIONS Although decision makers had different perceptions about what constitutes a community, and how community engagement should optimally function, the combined group articulated its importance to ensure vaccination equity and reiterated the need for concerted political will to build trust with communities. At the same time, work remains to be done both in terms of research on community engagement as well as development of appropriate implementation and outcome metrics.
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Affiliation(s)
- Tapati Dutta
- Room No. 469, Berndt Hall, Public Health Department, Health Sciences Division, Fort Lewis College, Durango, CO, 81301, USA.
| | - Beth E Meyerson
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| | - Jon Agley
- Department of Applied Health Science, Prevention Insights, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 101, Bloomington, IN, 47405, USA
| | - Priscilla A Barnes
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 203, Bloomington, IN, 47405, USA
| | - Catherine Sherwood-Laughlin
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 801 E 7th Street, Room 102, Bloomington, IN, 47405, USA
| | - Jill Nicholson-Crotty
- School of Public and Environmental Affairs, Indiana University, Room 351, 1315 E 10th Street, Bloomington, IN, 47405, USA
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15
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Gilmore B, Ndejjo R, Tchetchia A, de Claro V, Mago E, Diallo AA, Lopes C, Bhattacharyya S. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Glob Health 2020. [PMID: 33051285 DOI: 10.1136/bmjgh‐2020‐003188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and 'bottom-up' approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response. METHODOLOGY A rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language. RESULTS From 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. CONCLUSION COVID-19's global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.
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Affiliation(s)
- Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Adalbert Tchetchia
- Expanded Programme on Immunization, Ministry of Health, Yaoundé, Cameroon
| | | | - Elizabeth Mago
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Alpha A Diallo
- République de Guinée Ministère de Santé, Conakry, Guinea
| | - Claudia Lopes
- United Nations University International Institute for Global Health, Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Sanghita Bhattacharyya
- Public Health Foundation of India, Haryana, India.,Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
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16
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Muir R, Carlini JJ, Harbeck EL, Gillespie BM, Tuffaha HW, Walker RM, McInnes EC, Latimer SL, Lin FF, Pearcy JM, Chaboyer WP. Patient involvement in surgical wound care research: A scoping review. Int Wound J 2020; 17:1462-1482. [PMID: 32537915 PMCID: PMC7948725 DOI: 10.1111/iwj.13395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 11/27/2022] Open
Abstract
Active involvement of patients in planning, conducting, and disseminating research has been adopted by many organisations internationally, but the extent to which this occurs in surgical wound care is not evident. This scoping review aimed to identify how patients have been involved in surgical wound care research and the quality of its reporting. Full-text studies focused on preoperative and postoperative surgical wound care in the acute care setting, published in English between 2004 and 2019, were included in the review. Screening, data charting, and quality assessment were conducted by two reviewers independently, adjudicated by a third, and then reviewed by five others. Thematic analysis synthesised the findings. Of the eight included studies, seven explained the methods for patient involvement and five described aims related to patient involvement and commented on patient involvement in the discussion. None met all of the quality assessment criteria. Three themes emerged: involvement in modifying and refining research processes, connecting and balancing expert and patient views, and sharing personal insights. Recommendations to improve patient involvement in surgical wounds research include the following: using framework and tools to inform future research; training researcher and patients in their respective research roles; and ongoing monitoring of patient involvement.
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Affiliation(s)
- Rachel Muir
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Joan Julie Carlini
- Department of MarketingGriffith UniversityGold CoastQueenslandAustralia
- Consumer Advisory GroupGold Coast HealthGold CoastQueenslandAustralia
| | | | - Brigid Mary Gillespie
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Gold Coast Hospital and Health ServiceGold CoastQueenslandAustralia
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
| | - Haitham Wadah Tuffaha
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
- Centre for the Business and Economics of HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Rachel Michell Walker
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Centre for the Business and Economics of HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Elizabeth Catherine McInnes
- Division of SurgeryPrincess Alexandra Hospital, Metro South HealthBrisbaneQueenslandAustralia
- Nursing Research InstituteSt Vincent's Health Australia, St Vincent's Hospital Melbourne & Australian Catholic UniversitySydneyAustralia
- School of Nursing, Midwifery, and ParamedicineAustralian Catholic UniversitySydneyAustralia
| | - Sharon Leanne Latimer
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Gold Coast Hospital and Health ServiceGold CoastQueenslandAustralia
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
| | - Frances Fengzhi Lin
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
- School of Nursing, Midwifery, and ParamedicineUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | | | - Wendy Pearl Chaboyer
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
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17
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Gilmore B, Ndejjo R, Tchetchia A, de Claro V, Mago E, Diallo AA, Lopes C, Bhattacharyya S. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Glob Health 2020; 5:e003188. [PMID: 33051285 PMCID: PMC7554411 DOI: 10.1136/bmjgh-2020-003188] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and 'bottom-up' approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response. METHODOLOGY A rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language. RESULTS From 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. CONCLUSION COVID-19's global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.
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Affiliation(s)
- Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Adalbert Tchetchia
- Expanded Programme on Immunization, Ministry of Health, Yaoundé, Cameroon
| | | | - Elizabeth Mago
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Alpha A Diallo
- République de Guinée Ministère de Santé, Conakry, Guinea
| | - Claudia Lopes
- United Nations University International Institute for Global Health, Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Sanghita Bhattacharyya
- Public Health Foundation of India, Haryana, India
- Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
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18
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Timpel P, Lang C, Wens J, Contel JC, Schwarz PEH. The Manage Care Model - Developing an Evidence-Based and Expert-Driven Chronic Care Management Model for Patients with Diabetes. Int J Integr Care 2020; 20:2. [PMID: 32346360 PMCID: PMC7181948 DOI: 10.5334/ijic.4646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/25/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Most current care models are disease- or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus. METHOD An iterative approach was used combining systematic literature search with qualitative methods, including a standardised survey of experts in chronic care (n = 92), an expert workshop of professionals (n = 22) and a multilingual online survey (n = 659). Using three consensus meetings involving researchers, policy makers and experts in chronic care, a limited number of core components and care recommendations was set up to develop a new chronic care model. RESULTS The developed 'MANAGE CARE MODEL' includes aspects of the health and social care system, resources derived from the living environment, aspects of health promotion and prevention, as well as an expanded understanding of improved outcomes as an integral part of chronic care. CONCLUSION The MANAGE CARE MODEL provides guidance for the development and implementation of chronic care programs, regional networks and national strategies. Future research is needed to validate the model as an instrument of regional chronic care management.
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Affiliation(s)
- Patrick Timpel
- Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, DE
| | - Caroline Lang
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, DE
| | - Johan Wens
- Department of Primary and Interdisciplinary Care Antwerp, University of Antwerp, Antwerp, BE
| | - Juan Carlos Contel
- Chronic Care Program, Department of Health, Integrated Health and Social Care Plan, Generalitat de Catalunya, ES
| | - Peter E. H. Schwarz
- Prevention and Care of Diabetes, Department of Medicine III, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, DE
- Paul Langerhans Institut Dresden, German Center for Diabetes Research (DZD), Dresden, DE
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19
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Hogden A, Paynter C, Hutchinson K. How can we improve patient-centered care of motor neuron disease? Neurodegener Dis Manag 2020; 10:95-101. [DOI: 10.2217/nmt-2019-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This perspectives paper discusses patient-centered care for people living with motor neuron disease. We identify challenges and offer solutions from the patient-centered care literature for this population in frontline care, service delivery, research and health system organization. Examples from Australian and international motor neuron disease care are used to illustrate interrelated issues for practice and policy.
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Affiliation(s)
- Anne Hogden
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Camille Paynter
- Centre for Neuroscience of Speech, University of Melbourne, Melbourne, Victoria, Australia
| | - Karen Hutchinson
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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20
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Tello JE, Barbazza E, Waddell K. Review of 128 quality of care mechanisms: A framework and mapping for health system stewards. Health Policy 2020; 124:12-24. [PMID: 31791717 PMCID: PMC6946442 DOI: 10.1016/j.healthpol.2019.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/29/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022]
Abstract
Health system stewards have the critical task to identify quality of care deficiencies and resolve underlying system limitations. Despite a growing evidence-base on the effectiveness of certain mechanisms for improving quality of care, frameworks to facilitate the oversight function of stewards and the use of mechanisms to improve outcomes remain underdeveloped. This review set out to catalogue a wide range of quality of care mechanisms and evidence on their effectiveness, and to map these in a framework along two dimensions: (i) governance subfunctions; and (ii) targets of quality of care mechanisms. To identify quality of care mechanisms, a series of searches were run in Health Systems Evidence and PubMed. Additional grey literature was reviewed. A total of 128 quality of care mechanisms were identified. For each mechanism, searches were carried out for systematic reviews on their effectiveness. These findings were mapped in the framework defined. The mapping illustrates the range and evidence for mechanisms varies and is more developed for some target areas such as the health workforce. Across the governance sub-functions, more mechanisms and with evidence of effectiveness are found for setting priorities and standards and organizing and monitoring for action. This framework can support system stewards to map the quality of care mechanisms used in their systems and to uncover opportunities for optimization backed by systems thinking.
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Affiliation(s)
- Juan E Tello
- Integrated Prevention and Control of NCDs Programme, Division of NCDs and Promoting Health through the Life-Course, WHO Regional Office for Europe, Copenhagen, Denmark.
| | - Erica Barbazza
- Academic UMC, Department of Public Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; WHO European Centre for Primary Health Care, Almaty, Kazakhstan.
| | - Kerry Waddell
- McMaster Health Forum, McMaster University, Hamilton, Canada; WHO European Centre for Primary Health Care, Almaty, Kazakhstan.
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21
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Harris J, Haltbakk J, Dunning T, Austrheim G, Kirkevold M, Johnson M, Graue M. How patient and community involvement in diabetes research influences health outcomes: A realist review. Health Expect 2019; 22:907-920. [PMID: 31286639 PMCID: PMC6803418 DOI: 10.1111/hex.12935] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes. OBJECTIVE This realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self-management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type. DATA EXTRACTION AND SYNTHESIS Data were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis. MAIN RESULTS Projects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co-design and co-deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes. DISCUSSION AND CONCLUSIONS Achieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.
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Affiliation(s)
- Janet Harris
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | - Johannes Haltbakk
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Trisha Dunning
- Centre for Quality and Patient Safety ResearchDeakin University and Barwon Health PartnershipGeelongVictoriaAustralia
| | | | - Marit Kirkevold
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
- Department of Nursing Science, Institute of Health and SocietyUniversity of OsloOsloNorway
| | - Maxine Johnson
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | - Marit Graue
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
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22
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Randita A, Widyandana W, Claramita M. IPE-COM: a pilot study on interprofessional learning design for medical and midwifery students. J Multidiscip Healthc 2019; 12:767-775. [PMID: 31571894 PMCID: PMC6748318 DOI: 10.2147/jmdh.s202522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 08/22/2019] [Indexed: 11/23/2022] Open
Abstract
Background The skills of interprofessional teamwork, such as collaboration, team management, and interprofessional communication skills, should be embedded in the early stages of health profession education. In Indonesia, medical doctors and midwives have important roles and often work closely to partnership within the primary health care settings. Therefore, both medical students and midwifery students should have an interprofessional education training together during their professional education, using a community-based learning approach. Purpose This study aimed to investigate the effect of a community-based interprofessional educational learning on collaborative competencies (communication, collaboration, roles and responsibilities, collaborative patient-centered approach, the team functioning, and conflict management). Method Pre-experimental study with one group pre- and post-test design in 15 medical students and 19 midwifery students were involved in the community-based IPE (IPE-COM) course, later divided into nine groups. Data were collected by direct observations of supervisors using Interprofessional Collaborator Assessment Rubric (ICAR) instrument. Results The finding showed significant increase in IPE competencies before and after the 4-week course. IPE community-based learning had the strongest effect on the team’s functioning competence, while collaborative patient-centered approach competence had a moderate effect. Conclusion IPE community-based learning had positive impact with increasing collaborative competencies for both medical and midwifery students.
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Affiliation(s)
- Abt Randita
- Medical Education Unit, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - W Widyandana
- Department of Medical, Health Professions Education, and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - M Claramita
- Department of Medical, Health Professions Education, and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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23
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Burns KEA, Misak C, Herridge M, Meade MO, Oczkowski S. Patient and Family Engagement in the ICU. Untapped Opportunities and Underrecognized Challenges. Am J Respir Crit Care Med 2019; 198:310-319. [PMID: 29624408 DOI: 10.1164/rccm.201710-2032ci] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The call for meaningful patient and family engagement in health care and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, we review the rationale and the current state of patient and family engagement in patient care and research in the ICU. We identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. We also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, we provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
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Affiliation(s)
- Karen E A Burns
- 1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,2 Interdepartmental Division of Critical Care and.,3 Department of Clinical Epidemiology and Biostatistics and
| | - Cheryl Misak
- 4 Department of Philosophy, University of Toronto, Toronto, Ontario, Canada; and
| | - Margaret Herridge
- 1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,2 Interdepartmental Division of Critical Care and
| | - Maureen O Meade
- 3 Department of Clinical Epidemiology and Biostatistics and.,5 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Simon Oczkowski
- 3 Department of Clinical Epidemiology and Biostatistics and.,5 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Brett L, Nguyen AD, Siette J, Dove-Pizarro J, Hourihan F, Georgiou A. The co-design of timely and meaningful information needed to enhance social participation in community aged care services: Think tank proceedings. Australas J Ageing 2019; 39:e162-e167. [PMID: 31411384 DOI: 10.1111/ajag.12706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine what information from community aged care social participation and quality of life assessments needs to be captured, and meaningfully utilised as part of an integrated information and communication technology system. METHODS Two think tank sessions comprised of community aged care staff and researchers (n = 9) were conducted over 5 weeks. The sessions were guided by the Continuous Quality Improvement framework. Thematic analysis was used to categorise the think tank data. RESULTS To monitor progress over time, participants needed more contextual information captured in the assessment forms, such as client goals and outcomes of assessments. The aged care provider agreed to embed outcome measure score and action following assessment into its information and communication technology system. CONCLUSION Collaboration between aged care staff and researchers resulted in adjustments to the aged care provider's information and communication technology system to better target the monitoring and planning of its clients' psychosocial needs.
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Affiliation(s)
- Lindsey Brett
- Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia.,Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Amy D Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.,St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, New South Wales, Australia
| | - Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | | | - Fleur Hourihan
- Centre for Research and Social Policy, Uniting, New South Wales, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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The evidence for services to avoid or delay residential aged care admission: a systematic review. BMC Geriatr 2019; 19:217. [PMID: 31395018 PMCID: PMC6686247 DOI: 10.1186/s12877-019-1210-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/11/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Interventions that enable people to remain in their own home as they age are of interest to stakeholders, yet detailed information on effective interventions is scarce. Our objective was to systematically search and synthesise evidence for the effectiveness of community-based, aged care interventions in delaying or avoiding admission to residential aged care. METHOD Nine databases were searched from January 2000 to February 2018 for English publications. Reference lists of relevant publications were searched. The databases yielded 55,221 citations and 50 citations were gleaned from other sources. Where there was sufficient homogeneity of study design, population, intervention and measures, meta-analyses were performed. Studies were grouped by the type of intervention: complex multifactorial interventions, minimal/single focus interventions, restorative programs, or by the target population (e.g. participants with dementia). RESULTS Data from 31 randomised controlled trials (32 articles) that met our inclusion criteria were extracted and analysed. Compared to controls, complex multifactorial interventions in community aged care significantly improved older adults' ability to remain living at home (risk difference - 0.02; 95% CI -0.03, - 0.00; p = 0.04). Commonalities in the 13 studies with complex interventions were the use of comprehensive assessment, regular reviews, case management, care planning, referrals to additional services, individualised interventions, frequent client contact if required, and liaison with General Practitioners. Complex interventions did not have a significantly different effect on mortality. Single focus interventions did not show a significant effect in reducing residential aged care admissions (risk difference 0, 95% CI -0.01, 0.01; p = 0.71), nor for mortality or quality of life. Subgroup analysis of complex interventions for people with dementia showed significant risk reduction for residential aged care admissions (RD -0.05; 95% CI -0.09, -0.01; p = 0.02). Compared to controls, only interventions targeting participants with dementia had a significant effect on improving quality of life (SMD 3.38, 95% CI 3.02, 3.74; p < 0.000001). CONCLUSIONS Where the goal is to avoid residential aged care admission for people with or without dementia, there is evidence for multifactorial, individualised community programs. The evidence suggests these interventions do not result in greater mortality and hence are safe. Minimal, single focus interventions will not achieve the targeted outcomes. TRIAL REGISTRATION PROSPERO Registration CRD42016050086 .
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McClean J, Trigger K. Not just tea and biscuits; the Gold Coast Primary Health Network process of designing, implementing and operating a Community Advisory Council. Aust J Prim Health 2019; 23:504-508. [PMID: 28923164 DOI: 10.1071/py16157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/14/2017] [Indexed: 11/23/2022]
Abstract
Consumers are fast being acknowledged as a critical voice in the creation of sustainable health systems, and their ability and willingness to participate must be kept in mind by those eager to engage them. Federal health reform in Australia has mandated the formal involvement of communities in primary care through advisory committees in the newly established Primary Health Networks. Although there is clear progression towards increased consumer participation in Australia's health services, scope exists to improve the evidence base around identifying and implementing the most appropriate approach in different settings. Gold Coast Primary Health Network has drawn on the principles of deliberative participation to design, implement and operate their Community Advisory Council. Although functioning well, further work is required to evaluate the efficiency of this approach.
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Affiliation(s)
- Jessica McClean
- Primary Care Gold Coast (trading as Gold Coast Primary Health Network), Level 1, 14 Edgewater Court, Robina, Qld 4226, Australia
| | - Kellie Trigger
- Primary Care Gold Coast (trading as Gold Coast Primary Health Network), Level 1, 14 Edgewater Court, Robina, Qld 4226, Australia
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Blignault I, Aspinall D, Reay L, Hyman K. Realisation of a joint consumer engagement strategy in the Nepean Blue Mountains region. Aust J Prim Health 2019; 23:531-535. [PMID: 28196579 DOI: 10.1071/py16103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/30/2016] [Indexed: 11/23/2022]
Abstract
Ensuring consumer engagement at different levels of the health system - direct care, organisational design and governance and policy - has become a strategic priority. This case study explored, through interviews with six purposively selected 'insiders' and document review, how one Medicare Local (now a Primary Health Network, PHN) and Local Health District worked together with consumers, to establish a common consumer engagement structure and mechanisms to support locally responsive, integrated and consumer-centred services. The two healthcare organisations worked as partners across the health system, sharing ownership and responsibility. Critical success factors included a consumer champion working with other highly motivated consumers concerned with improving the health system, a budget, and ongoing commitment from the Medicare Local or PHN and the Local Health District at executive and board level. Shared boundaries were an enormous advantage. Activities were jointly planned and executed, with consumer participation paramount. Training and mentoring enhanced consumer capacity and confidence. Bringing everyone on board and building on existing structures required time, effort and resources. The initiative produced immediate and lasting benefits, with consumer engagement now embedded in organisational governance and practice.
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Affiliation(s)
- Ilse Blignault
- Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Diana Aspinall
- Wentworth Healthcare Limited, PO Box 903, Penrith, NSW 2751, Australia
| | - Lizz Reay
- Wentworth Healthcare Limited, PO Box 903, Penrith, NSW 2751, Australia
| | - Kay Hyman
- Nepean Blue Mountains Local Health District, PO Box 63, Penrith, NSW 2751, Australia
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Peake RM, Jackson D, Lea J, Usher K. Investigating the processes used to develop and evaluate the effectiveness of health education resources for adult Indigenous people: A literature review. Contemp Nurse 2019; 55:421-449. [DOI: 10.1080/10376178.2019.1633939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rachel M. Peake
- Stroke Care Coordinator, Peel & Mehi Sector, Tamworth, NSW 2348 Australia
- Hunter New England Local Health District, Tamworth, NSW 2348 Australia
| | - Debra Jackson
- Faculty of Health, University of Technology, Sydney (UTS), Australia
| | - Jackie Lea
- School of Nursing & Midwifery, Faculty of Health, Engineering & Sciences, University of Southern Queensland, Toowoomba, QLD, Australia 4350
| | - Kim Usher
- School of Health Faculty of Medicine & Health, University of New England, Armidale, NSW 2351 Australia
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Thumboo J, Yoon S, Wee S, Yeam CT, Low ECT, Lee CE. Developing population health research priorities in Asian city state: Results from a multi-step participatory community engagement. PLoS One 2019; 14:e0216303. [PMID: 31042782 PMCID: PMC6493761 DOI: 10.1371/journal.pone.0216303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/17/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To identify a broad range of research priorities to inform the studies seeking to improve population health outcomes based on the engagement of diverse stakeholders. METHODS A multi-step, participatory and mixed-methods approach was adopted to solicit and structure the investigative themes from diverse stakeholders. The priority setting exercise involved four key phases: (1) feedback from community leadership; (2) interim ranking survey and focus group discussions during the population health symposium; (3) individual in-depth interviews with stakeholders in the community; and (4) synthesis of the research priorities from the multistep process. RESULTS Diverse stakeholders in Singapore, comprising community partnership leaders, health care and social service providers, users of population health services, patients and caregivers, participated in the research priority setting exercise. Initial 14 priorities were identified from six community leadership feedback, 42 survey responses, two focus groups (n = 16) and 95 in-depth interviews. The final integrated research agenda identified six priorities: empower residents and patients to take charge of their health; improve care transition and management through relationship building and communication; enhance health-social care interface; improve respite care services for long-term caregivers; develop primary care as a driving force for care integration; and capacity building for service providers. Selected research questions in each priority area were also generated to develop novel models of care, foster collaboration, implement optimal services and enhance understanding of the end users' care needs. CONCLUSIONS This study illuminates that greater community engagement in research priority setting for population health can facilitate the formulation of evidence-based research agendas that matter to the care providers and service users in the community. The outcomes derived from this exercise will help focus researchers' efforts through which meaningful gains can be made for population health.
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Affiliation(s)
- Julian Thumboo
- Regional Health System, Singapore Health Services, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sungwon Yoon
- Regional Health System, Singapore Health Services, Singapore, Singapore
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sharon Wee
- Regional Health System, Singapore Health Services, Singapore, Singapore
| | | | - Edwin C. T. Low
- Regional Health System, Singapore Health Services, Singapore, Singapore
| | - Chien Earn Lee
- Regional Health System, Singapore Health Services, Singapore, Singapore
- Changi General Hospital, Singapore, Singapore
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Enhancing Equitable Access to Assistive Technologies in Canada: Insights from Citizens and Stakeholders. Can J Aging 2019; 39:69-88. [DOI: 10.1017/s0714980819000187] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
RÉSUMÉLes besoins en technologies d’assistance augmentent au Canada, mais l’accès à ces technologies est inégal et fragmentaire, ce qui ferait en sorte que des besoins demeureraient non comblés. Cette étude visait à identifier les valeurs et préférences des citoyens concernant les moyens à utiliser pour favoriser un accès équitable aux technologies d’assistance. Elle visait également à impliquer les décideurs politiques, les parties prenantes et les chercheurs dans des discussions afin d’élaborer des actions dans ce domaine. Au printemps 2017, nous avons organisé trois panels de citoyens et un dialogue avec les parties prenantes. Les principales conclusions des panels ont été incluses dans une synthèse qui a été partagée avec les participants du dialogue. Trente-sept citoyens ont participé aux panels et ont souligné l’importance de l’accès à de l’information fiable, d’un accès équitable aux technologies d’assistance (et ce, quelle que soit la capacité de payer), et de la collaboration. Les vingt-deux participants au dialogue ont fait valoir la nécessité d’un cadre d’orientation pour appuyer l’évolution des pratiques dans l’ensemble au pays. Le cadre d’orientation proposé combinerait des politiques et programmes simplifiés incluant la collecte et l’évaluation de données robustes pour appuyer l’innovation et l’imputabilité à travers le pays.
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Synnot AJ, Cherry CL, Summers MP, Stuckey R, Milne CA, Lowe DB, Hill SJ. Consumer engagement critical to success in an Australian research project: reflections from those involved. Aust J Prim Health 2019; 24:197-203. [PMID: 29875031 DOI: 10.1071/py17107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/08/2018] [Indexed: 11/23/2022]
Abstract
This paper describes the people, activities and methods of consumer engagement in a complex research project, and reflects on the influence this had on the research and people involved, and enablers and challenges of engagement. The 2.5-year Integrating and Deriving Evidence Experiences and Preferences (IN-DEEP) study was conducted to develop online consumer summaries of multiple sclerosis (MS) treatment evidence in partnership with a three-member consumer advisory group. Engagement methods included 6-monthly face-to-face meetings and email contact. Advisory group members were active in planning, conduct and dissemination and translational phases of the research. Engaging consumers in this way improved the quality of the research process and outputs by: being more responsive to, and reflective of, the experiences of Australians with MS; expanding the research reach and depth; and improving the researchers' capacity to manage study challenges. Advisory group members found contributing their expertise to MS research satisfying and empowering, whereas researchers gained confidence in the research direction. Managing the unpredictability of MS was a substantive challenge; the key enabler was the 'brokering role' of the researcher based at an MS organisation. Meaningfully engaging consumers with a range of skills, experiences and networks can make important and unforeseen contributions to research success.
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Affiliation(s)
- Anneliese J Synnot
- Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3068, Australia
| | - Catherine L Cherry
- Centre for Biomedical Research, Burnet Institute 85 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Michael P Summers
- Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3068, Australia
| | - Rwth Stuckey
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, Vic. 3086, Australia
| | - Catherine A Milne
- Sydney Health Ethics, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Dianne B Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3068, Australia
| | - Sophie J Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3068, Australia
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Valkenburg C, Van der Weijden FA, Slot DE. Plaque control and reduction of gingivitis: The evidence for dentifrices. Periodontol 2000 2019; 79:221-232. [PMID: 30892760 PMCID: PMC7328759 DOI: 10.1111/prd.12257] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta-review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque.
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Affiliation(s)
- Cees Valkenburg
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Fridus A. Van der Weijden
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Dagmar E. Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Currie G, Szabo J. "It is like a jungle gym, and everything is under construction": The parent's perspective of caring for a child with a rare disease. Child Care Health Dev 2019; 45:96-103. [PMID: 30370696 DOI: 10.1111/cch.12628] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/21/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
DESCRIPTIVE TITLE Parents of children with rare diseases face pervasive challenges in meeting medical and social care needs. Existing research on the parents' experience of caring for a child with a rare disease is limited. This paper offers suggestions for better supporting families living with rare disease as well as possible avenues of future research. BACKGROUND Parents of children with rare diseases face pervasive challenges in meeting medical and social care needs. Existing research on the parent's experience of caring for a child with a rare disease is limited. METHODS An interpretive phenomenological approach was applied in this inquiry. Fifteen parents of children with rare diseases participated in semistructured interviews. RESULTS Interpretive thematic analysis revealed that due to the rarity of the disease and an overall lack of knowledge of the disease, there is an increase in the burden on the family in relation to "rarity" in addition to "disability." Four insights were also revealed: (a) Parents often know more about the disease then Health Care providers, and this leads to entanglements in communication and collaboration as experts and parents; (b) there is lack of coordination of care between providers and services caring for children with rare diseases; (c) there is a gap in accessibility to government supports; and (d) due to fragmented care, parents must fill the aforementioned gaps by juggling multiple roles including that of advocate, case manager, and medical navigator. CONCLUSION This paper offers suggestions for better supporting families living with rare disease as well as possible avenues of future research.
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Affiliation(s)
- Genevieve Currie
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Canada
| | - Joanna Szabo
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Canada
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Patient and public involvement in hospital policy-making: Identifying key elements for effective participation. Health Policy 2018; 122:380-388. [DOI: 10.1016/j.healthpol.2018.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/21/2017] [Accepted: 02/14/2018] [Indexed: 11/19/2022]
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Cooke M, Ullman AJ, Ray-Barruel G, Wallis M, Corley A, Rickard CM. Not "just" an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries. PLoS One 2018; 13:e0193436. [PMID: 29489908 PMCID: PMC5831386 DOI: 10.1371/journal.pone.0193436] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/09/2018] [Indexed: 11/21/2022] Open
Abstract
Peripheral intravascular cannula/catheter (PIVC) insertion is a common invasive procedure, but PIVC failure before the end of therapy is unacceptably high. As PIVC failure disrupts treatment and reinsertion can be distressing for the patient, prevention of PIVC failure is an important patient outcome. Consumer participation in PIVC care to prevent failure is an untapped resource. This study aimed to understand consumers’ PIVC experience; establish aspects of PIVC insertion and care relevant to them; and to compare experiences of adult consumers to adult carers of a child. An international, web-based, cross-sectional survey was distributed via social media inviting adult consumers and adult carers of a child under 18 years who had experienced having a PIVC in the last five years (one survey each for adults and adult carers) to complete a 10-item survey. As such, sampling bias is a limitation and results should be carefully considered in light of this. There were 712 respondents from 25 countries, mainly female (87.1%) and adults (80%). A little over 50% of adults described insertion as moderately painful or worse, with level of insertion difficulty (0–10 scale) identified as moderate (median 4, IQR 1, 7). Adult carers reported significantly more pain during insertion and insertion difficulty (both p < 0.001). Rates of first insertion attempt failure were higher in children compared with adults (89/139 [64%] vs 221/554 [40%]; p < 0.001), and 23% of children required ≥ 4 attempts, compared with 9% of adults (p < 0.0001). Three themes from open-ended question emerged: Significance of safe and consistent PIVC care; Importance of staff training and competence; and Value of communication. The PIVC experience can be painful, stressful and frustrating for consumers. Priorities for clinicians and policy makers should include use of pain relief as standard practice to reduce the pain associated with PIVC insertion and developing strategies to increase first PIVC insertion attempt success particularly for children and older consumers.
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Affiliation(s)
- Marie Cooke
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
- * E-mail:
| | - Amanda J. Ullman
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Gillian Ray-Barruel
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Marianne Wallis
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia
| | - Amanda Corley
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Claire M. Rickard
- Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
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Price A, Albarqouni L, Kirkpatrick J, Clarke M, Liew SM, Roberts N, Burls A. Patient and public involvement in the design of clinical trials: An overview of systematic reviews. J Eval Clin Pract 2018; 24:240-253. [PMID: 29076631 DOI: 10.1111/jep.12805] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/03/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Funders encourage lay-volunteer inclusion in research. There are controversy and resistance, given concerns of role confusion, exploratory methods, and limited evidence about what value lay-volunteers bring to research. This overview explores these areas. METHODS Eleven databases were searched without date or language restrictions for systematic reviews of public and patient involvement (PPI) in clinical trials design. This systematic overview of PPI included 27 reviews from which areas of good and bad practice were identified. Strengths, weaknesses, opportunities, and threats of PPI were explored through use of meta-narrative analysis. RESULTS Inclusion criteria were met by 27 reviews ranging in quality from high (n = 7), medium (n = 14) to low (n = 6) reviews. Reviews were assessed using CERQUAL NICE, CASP for qualitative research and CASP for systematic reviews. Four reviews report risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow-up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning, and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation, and dissemination. Challenges identified include lack of clarity within common language, roles, and research boundaries, while logistical needs include extra time, training, and funding. Researchers report struggling to report involvement and avoid tokenism. CONCLUSIONS Involving patients and the public in clinical trials design can be beneficial but requires resources, preparation, training, flexibility, and time. Issues to address include reporting deficits for risk of bias, study quality, and conflicts of interests. We need to address these tensions and improve dissemination strategies to increase PPI and health literacy.
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Affiliation(s)
- Amy Price
- University of Oxford, UK.,Empower-2-Go, UK and USA
| | - Loai Albarqouni
- Bond University, Faculty of Health Sciences and Medicine, Gold Coast Australia, Australia
| | | | - Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, UK
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de Brún T, O’Reilly - de Brún M, Van Weel-Baumgarten E, Burns N, Dowrick C, Lionis C, O’Donnell C, Mair FS, Papadakaki M, Saridaki A, Spiegel W, Van Weel C, Van den Muijsenbergh M, MacFarlane A. Using Participatory Learning & Action (PLA) research techniques for inter-stakeholder dialogue in primary healthcare: an analysis of stakeholders' experiences. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:28. [PMID: 29225922 PMCID: PMC5718138 DOI: 10.1186/s40900-017-0077-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/06/2017] [Indexed: 05/12/2023]
Abstract
PLAIN ENGLISH SUMMARY It is important for health care workers to know the needs and expectations of their patients. Therefore, service users have to be involved in research. To achieve a meaningful dialogue between service users, healthcare workers and researchers, participatory methods are needed. This paper describes how the application of a specific participatory methodology, Participatory Learning and Action (PLA) can lead to such a meaningful dialogue. In PLA all stakeholders are regarded as equal partners and collaborators in research.During 2011-2015, a European project called RESTORE used PLA in Austria, Greece, Ireland, The Netherlands and the UK to investigate how communication between primary health care workers and their migrant patients could be improved.Seventy eight migrants, interpreters, doctors, nurses and other key stakeholders (see Table 2) participated in 62 PLA sessions. These dialogues (involving discussions, activities, PLA techniques and evaluations) were generally 2-3 h long and were recorded and analysed by the researchers.Participants reported many positive experiences about their dialogues with other stakeholders. There was a positive, trusting atmosphere in which all stakeholders could express their views despite differences in social power. This made for better understanding within and across stakeholder groups. For instance a doctor changed her view on the use of interpreters after a migrant explained why this was important. Negative experiences were rare: some doctors and healthcare workers thought the PLA sessions took a lot of time; and despite the good dialogue, there was disappointment that very few migrants used the new interpreting service. ABSTRACT Background In order to be effective, primary healthcare must understand the health needs, values and expectations of the population it serves. Recent research has shown that the involvement of service users and other stakeholders and gathering information on their perspectives can contribute positively to many aspects of primary healthcare. Participatory methodologies have the potential to support engagement and dialogue between stakeholders from academic, migrant community and health service settings. This paper focuses on a specific participatory research methodology, Participatory Learning and Action (PLA) in which all stakeholders are regarded as equal partners and collaborators in research.Our research question for this paper was: "Does the application of PLA lead to meaningful engagement of all stakeholders, and if so, what elements contribute to a positive and productive inter-stakeholder dialogue?". Methods We explored the use of PLA in RESTORE, a European FP7-funded project, during 2011-2015 in 5 countries: Austria, Greece, Ireland, the Netherlands and the UK. The objective of RESTORE was to investigate and support the implementation of guidelines and training initiatives (G/TIs) to enhance communication in cross-cultural primary care consultations with migrants.Seventy eight stakeholders (migrants, interpreters, doctors, nurses and others - see Table 2) participated in a total of 62 PLA sessions (discussions, activities, evaluations) of approximately 2-3 h' duration across the five sites. During the fieldwork, qualitative data were generated about stakeholders' experiences of engagement in this dialogue, by means of various methods including participatory evaluations, researchers' fieldwork reports and researcher interviews. These were analysed following the principles of thematic analysis. Results Stakeholders involved in PLA inter-stakeholder dialogues reported a wide range of positive experiences of engagement, and very few negative experiences. A positive atmosphere during early research sessions helped to create a sense of safety and trust. This enabled stakeholders from very different backgrounds, with different social status and power, to offer their perspectives in a way that led to enhanced learning in the group - they learned with and from each other. This fostered shifts in understanding - for example, a doctor changed her view on interpreted consultations because of the input of the migrant service-users. Conclusion PLA successfully promoted stakeholder involvement in meaningful and productive inter-stakeholder dialogues. This makes it an attractive approach to enhance the further development of health research partnerships to advance primary healthcare.
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Affiliation(s)
- T. de Brún
- Centre for Participatory Strategies (CPS), Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - M. O’Reilly - de Brún
- Centre for Participatory Strategies (CPS), Galway, Ireland
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - E. Van Weel-Baumgarten
- Department of Primary and Community Care, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - N. Burns
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YW UK
| | - C. Dowrick
- Department of Psychological Sciences, B121 Waterhouse Buildings University of Liverpool, Liverpool, UK
| | - C. Lionis
- University of Crete, Faculty of Medicine, Clinic of Social and Family Medicine, Heraklion, Greece
| | - C. O’Donnell
- General Practice & Primary Care, Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - F. S. Mair
- General Practice & Primary Care, Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - M. Papadakaki
- Technological Educational Institute of Crete, School of Health and Social Welfare, Department of Social Work, Heraklion, Greece
| | - A. Saridaki
- University of Crete, Faculty of Medicine, Clinic of Social and Family Medicine, Heraklion, Greece
| | - W. Spiegel
- Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, A-1090, Vienna, Austria
| | - C. Van Weel
- Department of Primary and Community Care, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - M. Van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Pharos, centre of expertise on health disparities, Utrecht, The Netherlands
| | - A. MacFarlane
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Braithwaite J, Testa L, Lamprell G, Herkes J, Ludlow K, McPherson E, Campbell M, Holt J. Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review. BMJ Open 2017; 7:e018568. [PMID: 29133332 PMCID: PMC5695467 DOI: 10.1136/bmjopen-2017-018568] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system. METHODS AND ANALYSIS The protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies. ETHICS AND DISSEMINATION As no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems.
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Affiliation(s)
- Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Luke Testa
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Gina Lamprell
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jessica Herkes
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Kristiana Ludlow
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Elise McPherson
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Margie Campbell
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Joanna Holt
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Jones D, McAllister L, Dyson R, Lyle D. Service-learning partnerships: Features that promote transformational and sustainable rural and remote health partnerships and services. Aust J Rural Health 2017; 26:80-85. [PMID: 29105870 DOI: 10.1111/ajr.12381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe features that promote transformational and sustainable community engaged health partnerships and services in rural and remote Australian locations. DESIGN A pragmatic qualitative study using focus groups and individual semi-structured interviews. Data were analysed using four stages of data comparison. SETTING Far west New South Wales, Australia. The health partnership, initiated by primary school principals in 2008, aimed to address allied health service inequities experienced by regional children. A service-learning program was developed, aligning allied health student placements to student-led services. The program has been operational since 2009. PARTICIPANTS Community participants included school principals (n = 7) and senior managers (n = 2) from local facilitating agencies. Campus participants included allied health students (n = 10) and academics (n = 2), one rurally located with student supervision responsibility and one metropolitan located with a strategic partnership role. MEASURES All data were collected by an independent researcher. Four stages of data comparison were undertaken. A thematic analysis was conducted and six key features identified through Stage Four comparison, a comparison across the findings from discrete community and campus groups, reflecting transformational community engagement were identified. RESULTS These six features are: (i) identifying and responding to community need, (ii) providing services of value, (iii) community leadership and innovation, (iv) reputation and trust, (v) consistency, and (vi) knowledge sharing and program adaptation. CONCLUSION We propose that these features contributed to the transformational engagement of community and university participants. These features can inform health sector approaches to community engagement, enhancing rural and remote service accessibility, acceptability, and sustainability outcomes.
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Affiliation(s)
- Debra Jones
- Broken Hill University Department of Rural Health, The University of Sydney, Broken Hill, New South Wales, Australia
| | - Lindy McAllister
- Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
| | - Robert Dyson
- Networked Specialist Centre Facilitator, Public Schools NSW, NSW Department of Education, Broken Hill, New South Wales, Australia
| | - David Lyle
- Broken Hill University Department of Rural Health, The University of Sydney, Broken Hill, New South Wales, Australia
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Giesler JM, Keller B, Repke T, Leonhart R, Weis J, Muckelbauer R, Rieckmann N, Müller-Nordhorn J, Lucius-Hoene G, Holmberg C. Effect of a Website That Presents Patients' Experiences on Self-Efficacy and Patient Competence of Colorectal Cancer Patients: Web-Based Randomized Controlled Trial. J Med Internet Res 2017; 19:e334. [PMID: 29030329 PMCID: PMC5660297 DOI: 10.2196/jmir.7639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/29/2017] [Accepted: 07/14/2017] [Indexed: 12/19/2022] Open
Abstract
Background Patients often seek other patients’ experiences with the disease. The Internet provides a wide range of opportunities to share and learn about other people’s health and illness experiences via blogs or patient-initiated online discussion groups. There also exists a range of medical information devices that include experiential patient information. However, there are serious concerns about the use of such experiential information because narratives of others may be powerful and pervasive tools that may hinder informed decision making. The international research network DIPEx (Database of Individual Patients’ Experiences) aims to provide scientifically based online information on people’s experiences with health and illness to fulfill patients’ needs for experiential information, while ensuring that the presented information includes a wide variety of possible experiences. Objective The aim is to evaluate the colorectal cancer module of the German DIPEx website krankheitserfahrungen.de with regard to self-efficacy for coping with cancer and patient competence. Methods In 2015, a Web-based randomized controlled trial was conducted using a two-group between-subjects design and repeated measures. The study sample consisted of individuals who had been diagnosed with colorectal cancer within the past 3 years or who had metastasis or recurrent disease. Outcome measures included self-efficacy for coping with cancer and patient competence. Participants were randomly assigned to either an intervention group that had immediate access to the colorectal cancer module for 2 weeks or to a waiting list control group. Outcome criteria were measured at baseline before randomization and at 2 weeks and 6 weeks Results The study randomized 212 persons. On average, participants were 54 (SD 11.1) years old, 58.8% (124/211) were female, and 73.6% (156/212) had read or heard stories of other patients online before entering the study, thus excluding any influence of the colorectal cancer module on krankheitserfahrungen.de. No intervention effects were found at 2 and 6 weeks after baseline. Conclusions The results of this study do not support the hypothesis that the website studied may increase self-efficacy for coping with cancer or patient competencies such as self-regulation or managing emotional distress. Possible explanations may involve characteristics of the website itself, its use by participants, or methodological reasons. Future studies aimed at evaluating potential effects of websites providing patient experiences on the basis of methodological principles such as those of DIPEx might profit from extending the range of outcome measures, from including additional measures of website usage behavior and users’ motivation, and from expanding concepts, such as patient competency to include items that more directly reflect patients’ perceived effects of using such a website. Trial Registration Clinicaltrials.gov NCT02157454; https://clinicaltrials.gov/ct2/show/NCT02157454 (Archived by WebCite at http://www.webcitation.org/6syrvwXxi)
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Affiliation(s)
- Jürgen M Giesler
- Section of Health Services Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bettina Keller
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tim Repke
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Hasso-Plattner-Institute, Potsdam, Germany
| | - Rainer Leonhart
- Department of Psychology, University of Freiburg, Freiburg, Germany
| | - Joachim Weis
- Clinic for Oncological Rehabilitation, UKF Reha, Department of Psycho-Oncology, University Clinic Center, Freiburg, Germany
| | - Rebecca Muckelbauer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nina Rieckmann
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jacqueline Müller-Nordhorn
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Christine Holmberg
- Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Norris JM, White DE, Nowell L, Mrklas K, Stelfox HT. How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study. Implement Sci 2017; 12:98. [PMID: 28764728 PMCID: PMC5540524 DOI: 10.1186/s13012-017-0625-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. METHODS Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" RESULTS Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. CONCLUSIONS This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various stakeholders.
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Affiliation(s)
- Jill M Norris
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Deborah E White
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Kelly Mrklas
- Research Priorities, Planning and Implementation, Alberta Health Services, 11th Floor, South Tower, Foothills Medical Centre, 1403-29 St. NW, Calgary, AB, T2N 2T9, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Henry T Stelfox
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Wortley S, Street J, Lipworth W, Howard K. What factors determine the choice of public engagement undertaken by health technology assessment decision-making organizations? J Health Organ Manag 2017; 30:872-90. [PMID: 27681022 DOI: 10.1108/jhom-08-2015-0119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose Public engagement in health technology assessment (HTA) is increasingly considered crucial for good decision making. Determining the "right" type of engagement activity is key in achieving the appropriate consideration of public values. Little is known about the factors that determine how HTA organizations (HTAOs) decide on their method of public engagement, and there are a number of possible factors that might shape these decisions. The purpose of this paper is to understand the potential drivers of public engagement from an organizational perspective. Design/methodology/approach The published HTA literature is reviewed alongside existing frameworks of public engagement in order to elucidate key factors influencing the choice of public engagement process undertaken by HTAOs. A conceptual framework is then developed to illustrate the factors identified from the literature that appear to influence public engagement choice. Findings Determining the type of public engagement undertaken in HTA is based on multiple factors, some of which are not always explicitly acknowledged. These factors included the: perceived complexity of the policy-making issue, perceived impact of the decision, transparency and opportunities for public involvement in governance, as well as time and resource constraints. The influences of these factors vary depending on the context, indicating that a one size fits all approach to public engagement may not be effective. Originality/value Awareness of the various factors that might influence the type of public engagement undertaken would enable decision makers to reflect on their choices and be more accountable and transparent about their choice of engagement process in eliciting public values and preferences in a HTAO.
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Affiliation(s)
- Sally Wortley
- School of Public Health, The University of Sydney , Sydney, Australia
| | - Jackie Street
- School of Population Health, The University of Adelaide , Adelaide, Australia
| | - Wendy Lipworth
- Centre for Values, Ethics & Law in Medicine (VELIM), School of Public Health, The University of Sydney , Sydney, Australia
| | - Kirsten Howard
- School of Public Health, The University of Sydney , Sydney, Australia
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The Untapped Potential of Patient and Family Engagement in the Organization of Critical Care. Crit Care Med 2017; 45:899-906. [PMID: 28234753 DOI: 10.1097/ccm.0000000000002282] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is growing interest in patient and family participation in critical care-not just as part of the bedside, but as part of educational and management organization and infrastructure. This offers tremendous opportunities for change but carries risk to patients, families, and the institution. The objective is to provide a concise definitive review of patient and family organizational participation in critical care as a high-risk population and other vulnerable groups. A pragmatic, codesigned model for critical care is offered as a suggested approach for clinicians, researchers, and policy-makers. DATA SOURCES To inform this review, a systematic search of Ovid Medline, PubMed, and Embase was undertaken in April 2016 using the MeSH terms: patient participation and critical care. A second search was undertaken in PubMed using the terms: patient participation and organizational models to search for other examples of engagement in vulnerable populations. We explicitly did not seek to include discussions of bedside patient-family engagement or shared decision-making. STUDY SELECTION Two reviewers screened citations independently. Included studies either actively partnered with patients and families or described a model of engagement in critical care and other vulnerable populations. DATA EXTRACTION Data or description of how patient and family engagement occurred and/or description of model were extracted into a standardized form. DATA SYNTHESIS There was limited evidence of patient and family engagement in critical care although key recommendations can be drawn from included studies. Patient and family engagement is occurring in other vulnerable populations although there are few described models and none which address issues of risk. CONCLUSIONS A model of patient and family engagement in critical care does not exist, and we propose a pragmatic, codesigned model that takes into account issues of psychologic safety in this population. Significant opportunity exists to document processes of engagement that reflect a changing paradigm of healthcare delivery.
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Norris JM, Hecker KG, Rabatach L, Noseworthy TW, White DE. Development and psychometric testing of the clinical networks engagement tool. PLoS One 2017; 12:e0174056. [PMID: 28350834 PMCID: PMC5369681 DOI: 10.1371/journal.pone.0174056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 03/02/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Clinical networks are being used widely to facilitate large system transformation in healthcare, by engagement of stakeholders throughout the health system. However, there are no available instruments that measure engagement in these networks. METHODS The study purpose was to develop and assess the measurement properties of a multiprofessional tool to measure engagement in clinical network initiatives. Based on components of the International Association of Public Participation Spectrum and expert panel review, we developed 40 items for testing. The draft instrument was distributed to 1,668 network stakeholders across different governance levels (leaders, members, support, frontline stakeholders) in 9 strategic clinical networks in Alberta (January to July 2014). With data from 424 completed surveys (25.4% response rate), descriptive statistics, exploratory and confirmatory factor analysis, Pearson correlations, linear regression, multivariate analysis, and Cronbach alpha were conducted to assess reliability and validity of the scores. RESULTS Sixteen items were retained in the instrument. Exploratory factor analysis indicated a four-factor solution and accounted for 85.7% of the total variance in engagement with clinical network initiatives: global engagement, inform (provided with information), involve (worked together to address concerns), and empower (given final decision-making authority). All subscales demonstrated acceptable reliability (Cronbach alpha 0.87 to 0.99). Both the confirmatory factor analysis and regression analysis confirmed that inform, involve, and empower were all significant predictors of global engagement, with involve as the strongest predictor. Leaders had higher mean scores than frontline stakeholders, while members and support staff did not differ in mean scores. CONCLUSIONS This study provided foundational evidence for the use of this tool for assessing engagement in clinical networks. Further work is necessary to evaluate engagement in broader network functions and activities; to assess barriers and facilitators of engagement; and, to elucidate how the maturity of networks and other factors influence engagement.
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Affiliation(s)
- Jill M. Norris
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Kent G. Hecker
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leora Rabatach
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tom W. Noseworthy
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deborah E. White
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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O’Donnell P, Tierney E, O’Carroll A, Nurse D, MacFarlane A. Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. Int J Equity Health 2016; 15:197. [PMID: 27912783 PMCID: PMC5135741 DOI: 10.1186/s12939-016-0487-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/25/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care. METHODS This Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision. RESULTS Four overarching themes were identified: the home environment, the effects of the 'two-tier' healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services. CONCLUSIONS Members of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.
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Affiliation(s)
- Patrick O’Donnell
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Edel Tierney
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Austin O’Carroll
- North Dublin City General Practice Training Scheme, Catherine McAuley Centre, Nelson Street, Dublin 7, Ireland
| | - Diane Nurse
- National Social Inclusion Office, Primary Care Division, Health Service Executive, Mill Lane, Palmerstown, Dublin 20, Ireland
| | - Anne MacFarlane
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Russell DJ, Sprung J, McCauley D, Kraus de Camargo O, Buchanan F, Gulko R, Martens R, Gorter JW. Knowledge Exchange and Discovery in the Age of Social Media: The Journey From Inception to Establishment of a Parent-Led Web-Based Research Advisory Community for Childhood Disability. J Med Internet Res 2016; 18:e293. [PMID: 27836818 PMCID: PMC5124112 DOI: 10.2196/jmir.5994] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/29/2016] [Accepted: 10/22/2016] [Indexed: 01/29/2023] Open
Abstract
Background Efforts to involve parents and families in all aspects of research, from initiating the question through to dissemination and knowledge exchange, are increasing. While social media as a method for health communication has shown numerous benefits, including increasing accessibility, interactions with others, and access to health care information, little work has been published on the use of social media to enhance research partnerships. Objective Our objective was to describe the development and evaluation of a Web-based research advisory community, hosted on Facebook and connecting a diverse group of parents of special needs children with researchers at CanChild Centre for Childhood Disability Research. The goal of this community is to work together and exchange knowledge in order to improve research and the lives of children and their families. Methods The Web-based Parents Participating in Research (PPR) advisory community was a secret Facebook group launched in June 2014 and run by 2 parent moderators who worked in consultation with CanChild. We evaluated its success using Facebook statistics of engagement and activity (eg, number of posts, number of comments) between June 2014 and April 2015, and a Web-based survey of members. Results The PPR community had 96 participants (2 parent moderators, 13 researchers, and 81 family members) as of April 1, 2015. Over 9 months, 432 original posts were made: 155 (35.9%) by moderators, 197 (45.6%) by parents, and 80 (18.5%) by researchers. Posts had a median of 3 likes (range 0-24) and 4 comments (range 0-113). Members, rather than moderators, generated 64% (277/432) of posts. The survey had a 51% response rate (49/96 members), with 40 (82%) being parent members and 9 (18%) being researchers. The initial purpose of the group was to be an advisory to CanChild, and 76% (28/37) of parents and all the researchers (9/9) identified having an impact on childhood disability research as their reason for participating. A total of 58% (23/40) of parents and 56% (5/9) of researchers indicated they felt safe to share sensitive or personal information. While researchers shared evidence-based resources and consulted with families to get guidance on specific issues, there was an unexpected benefit of gaining an understanding of what issues were important to families in their daily lives. Parents felt a sense of belonging to this community where they could share their stories but also wanted more researcher participation and clarity on the purpose of the group. Conclusions The PPR community grew from inception to an established community with active engagement and knowledge exchange. Both parents and researchers described valuable experiences. Researchers should consider social media as a means of engaging families in all phases of research to ensure that research and its outcomes are meaningful to those who need it most.
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Affiliation(s)
- Dianne J Russell
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Jennifer Sprung
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Dayle McCauley
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Olaf Kraus de Camargo
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Francine Buchanan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Roman Gulko
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Rachel Martens
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Jan Willem Gorter
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Wynn TA, Wyatt SB, Hardy CM, Walker SS, Thomas TF, Williams AG, Partridge EE. Using Community Feedback to Improve Community Interventions: Results From the Deep South Network for Cancer Control Project. FAMILY & COMMUNITY HEALTH 2016; 39:234-41. [PMID: 27536928 PMCID: PMC4991235 DOI: 10.1097/fch.0000000000000101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The Deep South Network for Cancer Control (DSNCC), initiated in 2000, is a dual-state, community-based participatory research infrastructure composed of academic and community partners committed to reducing cancer disparities among underserved African Americans in 12 designated counties of the Alabama Black Belt and the Mississippi Delta, 2 historically underserved areas of the country. Local residents trained as Community Health Advisors as Research Partners implemented a 3-tier community action plan (CAP) focused on promoting cancer screening, physical activity, and nutrition. Breast, cervical and colorectal cancer screening, healthy eating habits, and physical activity levels increased among many, but not all, African American women in the 12-county DSNCC coverage area. Seeking to improve our reach to include participants who reported they had never heard of the DSNCC or participated in the CAP, we conducted in-depth conversations with community residents about reasons for selective nonparticipation and ways to improve participation in the DSNCC community health interventions. Three patterns and their associated themes described ways to improve the penetration of CAP strategies and tailor them to effectively reach underserved African Americans in the intervention counties. We conclude with lessons learned for future interventions.
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Affiliation(s)
- Theresa A Wynn
- Division of Preventive Medicine (Dr Wynn and Ms Williams), Comprehensive Cancer Center (Mss Hardy and Walker and Dr Partridge), and Medicine-Immunology/Rheumatology (Ms Thomas), University of Alabama at Birmingham, Birmingham, Alabama; and School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi (Dr Wyatt)
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Hinchcliff R, Greenfield D, Hogden A, Sarrami-Foroushani P, Travaglia J, Braithwaite J. Levers for change: an investigation of how accreditation programmes can promote consumer engagement in healthcare. Int J Qual Health Care 2016; 28:561-565. [DOI: 10.1093/intqhc/mzw074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 06/05/2016] [Accepted: 06/20/2016] [Indexed: 01/09/2023] Open
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O’Reilly-de Brún M, de Brún T, Okonkwo E, Bonsenge-Bokanga JS, De Almeida Silva MM, Ogbebor F, Mierzejewska A, Nnadi L, van Weel-Baumgarten E, van Weel C, van den Muijsenbergh M, MacFarlane A. Using Participatory Learning & Action research to access and engage with 'hard to reach' migrants in primary healthcare research. BMC Health Serv Res 2016; 16:25. [PMID: 26792057 PMCID: PMC4721015 DOI: 10.1186/s12913-015-1247-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 12/19/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Communication problems occur in general practice consultations when migrants and general practitioners do not share a common language and culture. Migrants' perspectives have rarely been included in the development of guidelines designed to ameliorate this. Considered 'hard-to-reach' on the basis of inaccessibility, language discordance and cultural difference, migrants have been consistently excluded from participation in primary healthcare research. The purpose of this qualitative study was to address this gap. METHODS The study was conducted in the Republic of Ireland, 2009 - 2011. We developed a multi-lingual community-university research team that included seven established migrants from local communities. They completed training in Participatory Learning & Action (PLA) - a qualitative research methodology. Then, as trained service-user peer researchers (SUPERs) they used their access routes, language skills, cultural knowledge and innovative PLA techniques to recruit and engage in research with fifty-one hard-to-reach migrant service-users (MSUs). RESULTS & DISCUSSION In terms of access, university researchers successfully accessed SUPERs, who, in turn, successfully accessed, recruited and retained MSUs in the study. In terms of meaningful engagement, SUPERs facilitated a complex PLA research process in a language-concordant manner, enabling inclusion and active participation by MSUs. This ensured that MSUs' perspectives were included in the development of a guideline for improving communication between healthcare providers and MSUs in Ireland. SUPERs evaluated their experiences of capacity-building, training, research fieldwork and dissemination as positively meaningful for them. MSUs evaluated their experiences of engagement in PLA fieldwork and research as positively meaningful for them. CONCLUSIONS Given the need to build primary healthcare 'from the ground up', the perspectives of diverse groups, especially the hard-to-reach, must become a normative part of primary healthcare research. PLA is a powerful, practical 'fit-for-purpose' methodology for achieving this: enabling hard-to-reach groups to engage meaningfully and contribute with ease to academic research. PLA has significant potential to become a 'standard' or generic approach in building community-based primary health care. Community-university partnerships have a significant role to play in this, with capacity to radically influence the shape of healthcare research, expanding the research agenda to incorporate the views and needs of hard-to-reach and vulnerable populations.
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Affiliation(s)
- Mary O’Reilly-de Brún
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Tomas de Brún
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Ekaterina Okonkwo
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | | | | | - Florence Ogbebor
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Aga Mierzejewska
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | - Lovina Nnadi
- Discipline of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
| | | | - Chris van Weel
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
- Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
- Pharos, Centre of Expertise on Health Disparities, Utrecht, The Netherlands
| | - Anne MacFarlane
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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