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You J, Ganann R, Wilson M, Carusone SC, MacNeil M, Whitmore C, Dafel A, Dhamanaskar R, Ling E, Dingman L, Falbo AT, Kirk M, Luyckx J, Petrie P, Weldon D, Boothe K, Abelson J. Public Engagement in Health Policy-Making for Older Adults: A Systematic Search and Scoping Review. Health Expect 2024; 27:e70008. [PMID: 39188109 PMCID: PMC11347750 DOI: 10.1111/hex.70008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/29/2024] [Accepted: 08/12/2024] [Indexed: 08/28/2024] Open
Abstract
INTRODUCTION As the world's population ages, there has been increasing attention to developing health policies to support older adults. Engaging older adults in policy-making is one way to ensure that policy decisions align with their needs and priorities. However, ageist stereotypes often underestimate older adults' ability to participate in such initiatives. This scoping review aims to describe the characteristics and impacts of public engagement initiatives designed to help inform health policy-making for older adults. METHODS A systematic search of peer-reviewed and grey literature (English only) describing public engagement initiatives in health policy-making for older adults was conducted using six electronic databases, Google and the Participedia website. No geographical, methodological or time restrictions were applied to the search. Eligibility criteria were purposefully broad to capture a wide array of relevant engagement initiatives. The outcomes of interest included participants, engagement methods and reported impacts. RESULTS This review included 38 papers. The majority of public engagement initiatives were funded or initiated by governments or government agencies as a formal activity to address policy issues, compared to initiatives without a clear link to a specific policy-making process (e.g., research projects). While most initiatives engaged older adults as target participants, there was limited reporting on efforts to achieve participant diversity. Consultation-type engagement activities were most prevalent, compared to deliberative and collaborative approaches. Impacts of public engagement were frequently reported without formal evaluations. Notably, a few articles reported negative impacts of such initiatives. CONCLUSION This review describes how public engagement practices have been conducted to help inform health policy-making for older adults and the documented impacts. The findings can assist policymakers, government staff, researchers and seniors' advocates in supporting the design and execution of public engagement initiatives in this policy sector. PATIENT OR PUBLIC CONTRIBUTION Older adult partners from the McMaster University Collaborative for Health and Aging provided strategic advice throughout the key phases of this review, including developing a review protocol, data charting and synthesis and interpreting and presenting the review findings. This collaborative partnership was an essential aspect of this review, enhancing its relevance and meaningfulness for older adults.
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Affiliation(s)
- Jeonghwa You
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonCanada
| | | | - Michael Wilson
- Department of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonCanada
- McMaster Health ForumHamiltonCanada
| | - Soo Chan Carusone
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonCanada
- McMaster Collaborative for Health and AgingHamiltonCanada
| | | | | | - Andrea Dafel
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonCanada
| | - Roma Dhamanaskar
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonCanada
| | - Eugenia Ling
- School of NursingMcMaster UniversityHamiltonCanada
| | - Lance Dingman
- McMaster Collaborative for Health and AgingHamiltonCanada
| | - A. Tina Falbo
- McMaster Collaborative for Health and AgingHamiltonCanada
| | - Michael Kirk
- McMaster Collaborative for Health and AgingHamiltonCanada
| | - Joyce Luyckx
- McMaster Collaborative for Health and AgingHamiltonCanada
| | | | - Donna Weldon
- McMaster Collaborative for Health and AgingHamiltonCanada
| | - Katherine Boothe
- Department of Political ScienceMcMaster UniversityHamiltonCanada
- Centre for Health Economics and Policy Analysis (CHEPA)McMaster UniversityHamiltonCanada
| | - Julia Abelson
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonCanada
- Centre for Health Economics and Policy Analysis (CHEPA)McMaster UniversityHamiltonCanada
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Abousifein M, Falbo AT, Luyckx J, Abelson J, Ganann R, Vrkljan B, Carusone SC. Co-designing a participatory evaluation of older adult partner engagement in the mcmaster collaborative for health and aging. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:58. [PMID: 38863030 PMCID: PMC11165825 DOI: 10.1186/s40900-024-00595-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
Engagement of patients and the public in health research is crucial for ensuring research relevance and alignment with community needs. However, there is a lack of nuanced evaluations and examples that promote collaborative and reflective learning about partnerships with partners. The aim of this paper is to provide a case example of a participatory evaluation of the engagement of older adult partners in an aging-focused research centre. We outline our process of co-planning and implementing an evaluation of the McMaster Collaborative for Health and Aging's engagement strategy through the use of multiple methods, including a standardized tool and qualitative approaches. The team chose to explore and capture the engagement experiences and perspectives of the older adult partners within the Collaborative using a survey (the Public and Patient Engagement Evaluation Tool (PPEET)), an art-based method (photovoice), and a focus group. We present a brief summary of the findings but primarily focus this paper on the experiences of using each methodology and tool, with an emphasis on promoting dialogue on the benefits, limitations, and challenges. We reflect on the process of co-planning and the integration of both standardized tools and qualitative approaches to adopt a holistic approach to evaluating partnership within the Collaborative. Ultimately, this case example aims to provide practical guidance for other research groups navigating the complexities of partnership engagement and evaluation, thereby promoting meaningful partnerships in research.
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Affiliation(s)
- Marfy Abousifein
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada.
| | - A Tina Falbo
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
| | - Joyce Luyckx
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
| | - Julia Abelson
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Rebecca Ganann
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
- School of Nursing, McMaster University, Hamilton, Canada
| | - Brenda Vrkljan
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Soo Chan Carusone
- McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Canada
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Rioles N, March C, Muñoz CE, Ilkowitz J, Ohmer A, Wolf RM. Stakeholder Engagement in Type 1 Diabetes Research, Quality Improvement, and Clinical Care. Endocrinol Metab Clin North Am 2024; 53:165-182. [PMID: 38272594 DOI: 10.1016/j.ecl.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
The integration of stakeholder engagement (SE) in research, quality improvement (QI), and clinical care has gained significant traction. Type 1 diabetes is a chronic disease that requires complex daily management and care from a multidisciplinary team across the lifespan. Inclusion of key stakeholder voices, including patients, caregivers, health care providers and community advocates, in the research process and implementation of clinical care is critical to ensure representation of perspectives that match the values and goals of the patient population. This review describes the current framework for SE and its application to research, QI, and clinical care across the lifespan.
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Affiliation(s)
| | - Christine March
- Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Cynthia E Muñoz
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jeniece Ilkowitz
- Pediatric Diabetes Center, NYU Langone Health, New York, NY, USA
| | - Amy Ohmer
- International Children's Advisory Network, Atlanta, GA, USA
| | - Risa M Wolf
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Kolade OR, Porat-Dahlerbruch J, Makhmutov R, van Achterberg T, Ellen ME. Strategies for engaging older adults and informal caregivers in health policy development: A scoping review. Health Res Policy Syst 2024; 22:26. [PMID: 38374133 PMCID: PMC10875823 DOI: 10.1186/s12961-024-01107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Care for older adults is high on the global policy agenda. Active involvement of older adults and their informal caregivers in policy-making can lead to cost-effective health and long-term care interventions. Yet, approaches for their involvement in health policy development have yet to be extensively explored. This review maps the literature on strategies for older adults (65+ years) and informal caregivers' involvement in health policy development. METHOD As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute's methodology. Published and grey literature was searched, and eligible studies were screened. Data were extracted from included studies and analysed using the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare. RESULTS A total of 13 engagement strategies were identified from 11 publications meeting the inclusion criteria. They were categorized as "traditional", "deliberative" and "others", adopting the World Bank's categorization of engagement methods. Older adults and informal caregivers are often consulted to elicit opinions and identify priorities. However, their involvement in policy formulation, implementation and evaluation is unclear from the available literature. Findings indicate that older adults and their informal caregivers do not often have equal influence and shared leadership in policy-making. CONCLUSION Although approaches for involving older adults and their informal caregivers' involvement were synthesized from literature, we found next to no information about their involvement in policy formulation, implementation and evaluation. Findings will guide future research in addressing identified gaps and guide policy-makers in identifying and incorporating engagement strategies to support evidence-informed policy-making processes that can improve health outcomes for older adults/informal caregivers.
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Affiliation(s)
- Opeyemi Rashidat Kolade
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
| | - Joshua Porat-Dahlerbruch
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | - Rustem Makhmutov
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Theo van Achterberg
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
| | - Moriah Esther Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Dews SA, Daley R, Bansal A, Preston J, Bohm N. The power of language: how to bridge the gap between healthcare research and patients - a scoping review. Curr Med Res Opin 2024; 40:279-291. [PMID: 38131338 DOI: 10.1080/03007995.2023.2295984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The value of patient involvement to the design, conduct, and outcomes of healthcare research is increasingly being recognized. Patient involvement also provides greater patient accessibility and contribution to research. However, the use of inaccessible and technical language when communicating with patients is a barrier to effective patient involvement. METHODS We analyzed peer-reviewed and gray literature on how language is used in communication between healthcare researchers and patients. We used this analysis to generate a set of recommendations for healthcare researchers about using more inclusive and accessible language when involving patients in research. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Review (PRISMA-ScR) checklist. RESULTS Four major themes about the use of language were developed from the literature analysis and were used to develop the set of recommendations. These recommendations include guidance on using standardized terminology and plain language when involving patients in healthcare research. They also discuss the implementation of co-development practices, patient support initiatives, and researcher training, as well as ways to improve emotional awareness and the need for greater equality, diversity, and inclusion. DISCUSSION AND CONCLUSION The use of inclusive, empathetic, and clear language can encourage patients to be involved in research and, once they are involved, make them feel like equal, empowered, and valued partners. Working toward developing processes and guidelines for the use of language that enables an equal partnership between researchers and patients is critical.
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Affiliation(s)
| | - Rachel Daley
- The Positivitree Charity, Wallasey, UK
- Parent and Carers Research Forum, National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Akhil Bansal
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Stanford Existential Risk Initiative, Stanford University, Stanford, CA, USA
| | - Jennifer Preston
- National Institute for Health and Care Research, Alder Hey Clinical Research Facility, Liverpool, UK
| | - Natalie Bohm
- Pfizer Ltd, Tadworth, UK
- Department of Continuing Education, University of Oxford, Oxford, UK
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Heyrman B, Meers S, Van De Velde A, Anguille S. Combined Results of Two Cross-Sectional Surveys on the Participation in Clinical Trials and the e-Consent Procedure in the Landscape of Haematology. Clin Pract 2023; 13:1520-1531. [PMID: 38131682 PMCID: PMC10742482 DOI: 10.3390/clinpract13060133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/07/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Despite the motivation of oncology patients to take part in clinical trials, only a minority of them are enrolled in clinical trials. Implementation of new practical procedures can become a barrier that withholds patients from participating in clinical trials. Treating physicians are crucial in augmenting trial accrual. The drivers that promote physicians to allocate patients for clinical trials need further assessment. We conducted two separate cross-sectional surveys, addressing patients with a haematological disease in one survey and haematologists in another survey. The patient survey was filled out by 420 patients. Significant relationships between the willingness to participate in a trial and trial knowledge (p < 0.001) and between doctor-patient relationship and participation willingness (p = 0.007) were noted. Patients above 60 years were less willing to use an electronic consent procedure vs. patients younger than 60 (p < 0.001). The physician questionnaire was completed by 42 participants of whom most (83%) were active in and (94%) motivated for clinical trials. Apart from the patient benefit and scientific interest, prestige was an equal motivator closely followed by financial remunerations. First goal was not to harm the patient. Our study confirms the high willingness of patients for trial participation and the need to rethink the structure of trial organisation. The e-consent procedure is not the method preferred by most patients above 60 years old.
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Affiliation(s)
- Bert Heyrman
- Ziekenhuis Netwerk Antwerpen, Department of Haematology, 2020 Antwerp, Belgium
| | - Stef Meers
- Algemeen Ziekenhuis KLINA, Department of Haematology, 2930 Brasschaat, Belgium
| | - Ann Van De Velde
- Department of Haematology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - Sébastien Anguille
- Department of Haematology, University Hospital Antwerp, 2650 Edegem, Belgium
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Allemann H, Andréasson F, Hanson E, Magnusson L, Jaarsma T, Thylén I, Strömberg A. The co-design of an online support programme with and for informal carers of people with heart failure: A methodological paper. J Clin Nurs 2023; 32:7589-7604. [PMID: 37605222 DOI: 10.1111/jocn.16856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Abstract
AIM To describe the co-designing process of an online support programme with and for informal carers of people with heart failure. DESIGN A co-design process built on core concepts and ideas embedded in co-design methodology. DATA SOURCES Our co-design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. OUTCOMES The co-design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. CONCLUSION Co-design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. RELEVANCE TO CLINICAL PRACTICE Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person-centred care and provides a valuable learning opportunity for those involved. Furthermore, a co-designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self-care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. REPORTING METHODS Consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION Both informal carers and content creators were involved in developing the support programme.
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Affiliation(s)
- Hanna Allemann
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Elizabeth Hanson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Regional Association of Kalmar County, Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Lennart Magnusson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Regional Association of Kalmar County, Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ingela Thylén
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
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Elliott J, Stolee P, Mairs K, Kothari A, Conklin J. A Community of Practice on Environmental Design for Long-Term Care Residents with Dementia. Can J Aging 2023; 42:404-415. [PMID: 36799024 DOI: 10.1017/s0714980823000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
The use of communities of practice (CoP) to support the application of knowledge in improved geriatric care practice is not widely understood. This case study's aim was to gain a deeper understanding of the knowledge-to-action (KTA) processes of a CoP focused on environmental design, to improve how persons with dementia find their way around in long-term care (LTC) homes. Qualitative data were collected (key informant interviews, observations, and document review), and analysed using emergent coding. CoP members contributed extensive knowledge to the KTA process characterized by the following themes: team dynamics, employing a structured process, technology use, varied forms of knowledge, and a clear initiative. The study's CoP effectively synthesized and translated knowledge into practical tools to inform changes in practice, programs, and policy on dementia care. More research is needed on how to involve patients and caregivers in the KTA processes, and to ensure that practical application of knowledge has financial and policy support.
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Affiliation(s)
- Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Lawson Health Research Institute, London, Canada
- School of Health Studies, Western University, London, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Katie Mairs
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Anita Kothari
- School of Health Studies, Western University, London, Canada
| | - James Conklin
- Department of Applied Human Sciences, Concordia University, Montreal, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
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Elliott J, van Wyk P, Butler R, Giosa JL, Sims Gould J, Tong CE, Taabazuing MM, Johnson H, Coyne P, Mitchell F, Whate A, Callon A, Carson J, Stolee P. Developing an in-depth understanding of patient and caregiver engagement across care transitions from hospital: protocol for a qualitative study exploring experiences in Canada. BMJ Open 2023; 13:e077436. [PMID: 37479510 PMCID: PMC10364181 DOI: 10.1136/bmjopen-2023-077436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Patient and caregiver engagement is critical, and often compromised, at points of transition between care settings, which are more common, and more challenging, for patients with complex medical problems. The consequences of poor care transitions are well-documented, both for patients and caregivers, and for the healthcare system. With an ageing population, there is greater need to focus on care transition experiences of older adults, who are often more medically complex, and more likely to require care from multiple providers across settings. The overall goal of this study is to understand what factors facilitate or hinder patient and caregiver engagement through transitions in care, and how these current engagement practices align with a previously developed engagement framework (CHOICE Framework). This study also aims to co-develop resources needed to support engagement and identify how these resources and materials should be implemented in practice. METHODS AND ANALYSIS This study uses ethnographic approaches to explore the dynamics of patient and caregiver engagement, or lack thereof, during care transitions across three regions within Ontario. With the help of a front-line champion, patients (n=18-24), caregivers (n=18-24) and healthcare providers (n=36-54) are recruited from an acute care hospital unit (or similar) and followed through their care journey. Data are collected using in-depth semi-structured interviews. Workshops will be held to co-develop strategies and a plan for future implementation of resources and materials. Analysis of the data will use inductive and deductive coding techniques. ETHICS AND DISSEMINATION Ethics clearance was obtained through the Western University Research Ethics Board, University of Windsor Research Ethics Board and the University of Waterloo Office of Research Ethics. The findings from this study are intended to contribute valuable evidence to further bridge the knowledge to practice gap in patient and caregiver engagement through care transitions. Findings will be disseminated through publications, conference presentations and reports.
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Affiliation(s)
- Jacobi Elliott
- Lawson Health Research Institute, London, Ontario, Canada
- Specialized Geriatric Services, St. Joseph's Health Care London, London, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paula van Wyk
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Roy Butler
- Senior Leadership, St. Joseph's Health Care London, London, Ontario, Canada
| | - Justine L Giosa
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- SE Research Centre, Toronto, Ontario, Canada
| | | | - Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Mary Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
| | - Helen Johnson
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Paige Coyne
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
- Henry Ford Health System, Detroit, Michigan, USA
| | - Fallon Mitchell
- Kinesiology, University of Windsor, Windsor, Ontario, Canada
| | - Alexandra Whate
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne Callon
- Patient and Caregiver Partner, London, Ontario, Canada
| | - Judith Carson
- Patient and Caregiver Partner, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Burgher T, Shepherd V, Nollett C. Effective approaches to public involvement in care home research: a systematic review and narrative synthesis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:38. [PMID: 37268986 PMCID: PMC10234794 DOI: 10.1186/s40900-023-00453-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/26/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Public involvement (often referred to as patient and public involvement or PPI) integrates the voices of the public in health and care research. However, groups such as care home residents are often excluded from involvement opportunities due to the complexities of involving people with additional care and communication needs. Despite a range of approaches being used, there is little understanding about how best to incorporate their experiences, and those of other care home stakeholders, into the design and conduct of research. OBJECTIVE A systematic review was conducted to identify PPI methods that better meet the specific needs of care home stakeholders. This was undertaken by (1) outlining effective PPI approaches used in care home research and the key stakeholders involved; (2) describing the role of PPI in different care home contexts and (3) identifying stakeholders' experiences and attitudes towards PPI in care homes. METHODS Databases CINAHL, Embase, MEDLINE, PsycINFO and Scopus were searched for English language papers from inception to November 2021. A narrative synthesis approach was utilised to organise the extracted data into five themes. RESULTS The search initially yielded 2314 articles (following de-duplication), with 27 meeting the inclusion criteria. Articles reported a range of input from stakeholders (including residents, staff, relatives and community stakeholders), with the impact of PPI varying according to the type of care establishment and research context. The experiences and reflections of stakeholders' about their involvement in care home research varied, with some studies offering first-hand accounts compared with summaries from researchers. Some articles explicitly evaluated the effectiveness of the PPI approach using specific outcome measures whilst others indirectly described the impact of their approach. Five themes were identified as characterising an effective PPI approach: (1) valuing stakeholders' perspectives, (2) awareness of the multi-faceted research context, (3) ensuring inclusivity and transparency, (4) maintaining flexibility and adaptability and (5) utilising resources and wider support. CONCLUSION Effective PPI in care home research requires researchers to create person-centred opportunities to adequately involve groups with physical and cognitive impairments. The findings led to the creation of evidence-based practical recommendations to support future involvement opportunities and help researchers develop strategies for inclusive opportunities for involvement. SYSTEMATIC REVIEW REGISTRATION The review was prospectively registered on PROPSERO (CRD42021293353).
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Affiliation(s)
| | - Victoria Shepherd
- Centre for Trials Research, Cardiff University, 4Th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Claire Nollett
- Centre for Trials Research, Cardiff University, 4Th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
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Van Ooteghem K, Godkin FE, Thai V, Beyer KB, Cornish BF, Weber KS, Bernstein H, Kheiri SO, Swartz RH, Tan B, McIlroy WE, Roberts AC. User-centered design of feedback regarding health-related behaviors derived from wearables: An approach targeting older adults and persons living with neurodegenerative disease. Digit Health 2023; 9:20552076231179031. [PMID: 37312943 PMCID: PMC10259132 DOI: 10.1177/20552076231179031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Objective There has been tremendous growth in wearable technologies for health monitoring but limited efforts to optimize methods for sharing wearables-derived information with older adults and clinical cohorts. This study aimed to co-develop, design and evaluate a personalized approach for information-sharing regarding daily health-related behaviors captured with wearables. Methods A participatory research approach was adopted with: (a) iterative stakeholder, and evidence-led development of feedback reporting; and (b) evaluation in a sample of older adults (n = 15) and persons living with neurodegenerative disease (NDD) (n = 25). Stakeholders included persons with lived experience, healthcare providers, health charity representatives and individuals involved in aging/NDD research. Feedback report information was custom-derived from two limb-mounted inertial measurement units and a mobile electrocardiography device worn by participants for 7-10 days. Mixed methods were used to evaluate reporting 2 weeks following delivery. Data were summarized using descriptive statistics for the group and stratified by cohort and cognitive status. Results Participants (n = 40) were 60% female (median 72 (60-87) years). A total of 82.5% found the report easy to read or understand, 80% reported the right amount of information was shared, 90% found the information helpful, 92% shared the information with a family member or friend and 57.5% made a behavior change. Differences emerged in sub-group comparisons. A range of participant profiles existed in terms of interest, uptake and utility. Conclusions The reporting approach was generally well-received with perceived value that translated into enhanced self-awareness and self-management of daily health-related behaviors. Future work should examine potential for scale, and the capacity for wearables-derived feedback to influence longer-term behavior change.
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Affiliation(s)
- Karen Van Ooteghem
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - F Elizabeth Godkin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Vanessa Thai
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Kit B Beyer
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Benjamin F Cornish
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Kyle S Weber
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Hannah Bernstein
- Department of Nanotechnology Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Soha O Kheiri
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - William E McIlroy
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Department of Computer Science, Western University, London, ON, Canada
- Canadian Centre for Activity and Aging, Western University, London, ON, Canada
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12
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Carr DC, Tian S, He Z, Chakraborty S, Dieciuc M, Gray N, Agharazidermani M, Lustria MLA, Dilanchian A, Zhang S, Charness N, Terracciano A, Boot WR. Motivation to Engage in Aging Research: Are There Typologies and Predictors? THE GERONTOLOGIST 2022; 62:1466-1476. [PMID: 35267020 PMCID: PMC9710243 DOI: 10.1093/geront/gnac035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Study recruitment and retention of older adults in research studies is a major challenge. Enhancing understanding of individual differences in motivations to participate, and predictors of motivators, can serve the dual aims of facilitating the recruitment and retention of older adults, benefiting study validity, economy, and power. RESEARCH DESIGN AND METHODS Older adults (N = 472) past and potential participants were surveyed about motivations to participate in research, demographic, and individual difference measures (e.g., health status, cognitive difficulties). Latent class and clustering analyses explored motivation typologies, followed by regression models predicting individual motivators and typologies. RESULTS Older adults endorsed a diversity of research motivations, some of which could be predicted by individual difference measures (e.g., older participants were more motivated by the desire to learn new technology, participants without a college education were more motivated by financial compensation, and participants with greater self-reported cognitive problems were more likely to participate to gain cognitive benefit). Clustering analysis revealed 4 motivation typologies: brain health advocates, research helpers, fun seekers, and multiple motivation enthusiasts. Cognitive difficulties, age, employment status, and previous participation predicted membership in these categories. DISCUSSION AND IMPLICATIONS Results provide an understanding of different participant motivations beyond differences between younger and older adults and begin to identify different classes of older adults motivated to participate in research studies. Results can provide guidance for targeted recruitment and retention strategies based on individual differences in stated or predicted motivations.
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Affiliation(s)
- Dawn C Carr
- Department of Sociology, Florida State University, Tallahassee, Florida, USA.,Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, Florida, USA
| | - Shubo Tian
- Department of Statistics, Florida State University, Tallahassee, Florida, USA
| | - Zhe He
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA.,School of Information, Florida State University, Tallahassee, Florida, USA
| | - Shayok Chakraborty
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA.,Department of Computer Science, Florida State University, Tallahassee, Florida, USA
| | - Michael Dieciuc
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Nicholas Gray
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA.,Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Mia Liza A Lustria
- School of Information, Florida State University, Tallahassee, Florida, USA.,Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, Florida, USA
| | - Andrew Dilanchian
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Shenghao Zhang
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Neil Charness
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA.,Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Antonio Terracciano
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
| | - Walter R Boot
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA.,Department of Psychology, Florida State University, Tallahassee, Florida, USA
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13
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Tong CE, Lopez KJ, Chowdhury D, Arya N, Elliott J, Sims-Gould J, Grindrod K, Stolee P. Understanding racialised older adults' experiences of the Canadian healthcare system, and codesigning solutions: protocol for a qualitative study in nine languages. BMJ Open 2022; 12:e068013. [PMID: 36216419 PMCID: PMC9557314 DOI: 10.1136/bmjopen-2022-068013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Racialised immigrant older adults (RIOAs) in Canada have poorer self-rated health and are more likely to report chronic conditions, while they concurrently experience well-documented challenges in navigating and accessing the healthcare system. There is strong evidence that patient and caregiver engagement in their healthcare leads to improved management of chronic disease and better health outcomes. International research suggests that engagement has the potential to reduce health disparities and improve quality of care. We aim to (1) describe what role(s) RIOAs are/are not taking in their own healthcare, from the perspectives of participant groups (RIOAs, caregivers and healthcare providers (HCPs)); and (2) develop a codesign process with these participants, creating linguistically aligned and culturally aligned tools, resources or solutions to support patient engagement with RIOAs. METHODS AND ANALYSIS Using a cross-cultural participatory action research approach, our work will consist of three phases: phase 1, strengthen existing partnerships with RIOAs and appropriate agencies and cultural associations; phase 2, on receipt of informed consent, in-depth interviews with RIOAs and caregivers (n=~45) and HCPs (n=~10), professionally interpreted as needed. Phase 3, work with participants, in multiple interpreted sessions, to codesign culturally sensitive and linguistically sensitive/aligned patient engagement tools. We will conduct this research in the Waterloo-Wellington region of Ontario, in Arabic, Bangla, Cantonese, Hindi, Mandarin, Punjabi, Tamil and Urdu, plus English. Data will be transcribed, cleaned and entered into NVivo V.12, the software that will support team-based analysis. Analysis will include coding, theming and interpreting the data, and, preparing narrative descriptions that summarise each language group and each participant group (older adults, caregivers and HCPs), and illustrate themes. ETHICS AND DISSEMINATION Ethics clearance was obtained through the University of Waterloo Office of Research Ethics (ORE #43297). Findings will be disseminated through peer-reviewed publications, presentations and translated summary reports for our partners and participants.
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Affiliation(s)
- Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kimberly J Lopez
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Diya Chowdhury
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Joanie Sims-Gould
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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14
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Kolade O, Porat-Dahlerbruch J, van Achterberg T, Ellen M. Strategies for engaging senior citizens and their informal caregivers in health policy development: a scoping review protocol. BMJ Open 2022; 12:e064505. [PMID: 36198463 PMCID: PMC9535191 DOI: 10.1136/bmjopen-2022-064505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Care for senior citizens is a global policy issue. There has been limited focus on senior citizen and informal caregiver engagement in policy development. Encouraging senior citizen participation through active engagement in the policymaking process enhances the provision of better services and the creation of responsive policies and is critical to better healthcare. Accordingly, this review aims to map the available evidence to provide an overview of strategies for engaging senior citizens and informal caregivers in health policy development. METHODS AND ANALYSIS A scoping review will be conducted. This study will use the updated methodological guidance for conducting a scoping review developed by the Joanna Briggs Institute. This review aims to answer the question: 'What is known in the literature about strategies for engaging senior citizens and informal caregivers in health policy development?' Titles and abstracts will be screened to determine eligibility for full-text review based on already established eligibility criteria. Data will be extracted from relevant articles. A summary of extracted data will be presented. The results will be interpreted within the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare. ETHICS AND DISSEMINATION Ethical review is not required as scoping reviews are a form of secondary data analysis that synthesises data from publicly available sources. Findings from this proposed review will be disseminated in conferences and to the global scientific community through published academic papers in reputable health policy-related journals.
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Affiliation(s)
- Opeyemi Kolade
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Joshua Porat-Dahlerbruch
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Moriah Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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15
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Adams C, Albert P, Benson T, Cordingley A, Daniels B, Fynn N, Gurgone M, Jeffery C, White A, Strobel N. The realities and expectations of community involvement in COVID-19 research: a Consumer Reference Group perspective. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:54. [PMID: 36171600 PMCID: PMC9516529 DOI: 10.1186/s40900-022-00389-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Older adults have been disproportionately impacted by the COVID-19 pandemic. COVID-19 restrictions such as stay at home orders and physical distancing measures have been implemented to reduce older adults' risk of infection, however, such measures can have negative effects on older adults' mental health and social wellbeing. In 2020, the research team received funding as part of an Australian COVID-19 research grants program to investigate how services can better meet the mental health and social support needs of older adults during COVID-19. A Consumer Reference Group (CRG) was established to provide a community perspective on all research activities. MAIN BODY The CRG comprised of eight older adults aged 65 years and older living in Western Australia. Two members of the CRG were involved in the initial grant proposal, and one member worked for a not-for-profit organisation that provides support and advocacy for older adults. The CRGs role was to provide consumer and community perspectives on the research design, advise on study materials, facilitate links between consumers, the community, and researchers, and advocate on behalf of consumers and the community. The CRG was encouraged to reflect on the research project, their contributions, and the outcomes obtained. In this commentary, we document the CRGs contributions to the project, and record their reflections, including what went well, what were some challenges, the realities of conducting research during COVID-19, and lessons learnt. CONCLUSION The CRG were active participants in the research process. They shared their perspectives and made important contributions to the project. Through collaboration with the CRG, we were able to reach four key messages, underpinned by consumers lived experiences, that were used to co-develop knowledge translation products. These were disseminated to service providers and older adults.
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Affiliation(s)
- Claire Adams
- Kurongkurl Katitjin, Edith Cowan University, 2 Bradford Street, Mount Lawley, Perth, 6050, Australia
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | - Paul Albert
- Consumer Reference Group Member, Perth, Australia
| | - Tim Benson
- Consumer Reference Group Member, Perth, Australia
| | | | | | - Noreen Fynn
- Consumer Reference Group Member, Perth, Australia
| | - Mary Gurgone
- Consumer Reference Group Member, Perth, Australia
| | - Chris Jeffery
- Consumer Reference Group Member, Perth, Australia
- Council on the Ageing, Perth, Australia
| | - Ann White
- Consumer Reference Group Member, Perth, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, 2 Bradford Street, Mount Lawley, Perth, 6050, Australia.
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16
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Tittlemier BJ, Cooper J, Steliga D, Woodgate RL, Sibley KM. A scoping review to identify and describe the characteristics of theories, models and frameworks of health research partnerships. Health Res Policy Syst 2022; 20:69. [PMID: 35717196 PMCID: PMC9206347 DOI: 10.1186/s12961-022-00877-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging users of health research, namely knowledge users, as partners in the research process may to lead to evidence that is more relevant to the users. This may optimize the uptake of evidence in healthcare practice, resulting in improved health outcomes or more efficient healthcare systems. However, barriers to involving knowledge users in the research process exist. Theories, models and frameworks may help guide the process of involving knowledge users and address barriers to engaging with knowledge users in research; however, there is little evidence identifying or describing the theories, models and frameworks of health research partnerships. OBJECTIVES Identify and describe theories, models and frameworks of health research partnerships. Report on concepts of knowledge user engagement represented in identified theories, models and frameworks. METHODS We conducted a scoping review. Database (MEDLINE, Embase, CINAHL, PCORI) and ancestry and snowball searches were utilized. Included articles were written in English, published between January 2005 and June 2021, specific to health, a research partnership, and referred to a theory, model or framework. No critical appraisal was conducted. We developed a coding framework to extract details related to the publication (e.g. country, year) and theory, model or framework (e.g. intended users, theoretical underpinning, methodology, methods of development, purpose, concepts of knowledge user engagement). One reviewer conducted data extraction. Descriptive statistics and narrative synthesis were utilized to report the results. RESULTS We identified 21 874 articles in screening. Thirty-nine models or frameworks were included in data analysis, but no theory. Two models or frameworks (5%) were underpinned by theory. Literature review was the method (n = 11, 28%) most frequently used to develop a model or framework. Guiding or managing a partnership was the most frequently reported purpose of the model/framework (n = 14, 36%). The most represented concept of knowledge user engagement was principles/values (n = 36, 92%). CONCLUSIONS The models and frameworks identified could be utilized by researchers and knowledge users to inform aspects of a health research partnership, such as guidance or implementation of a partnership. Future research evaluating the quality and applicability of the models and frameworks is necessary to help partners decide which model or framework to implement.
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Affiliation(s)
- B. J. Tittlemier
- Applied Health Sciences Program, University of Manitoba, 202 Active Living Centre, Winnipeg, MB R3T 2N2 Canada
| | - J. Cooper
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R106- 771 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
| | - D. Steliga
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, S113- 750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
| | - R. L. Woodgate
- Tier 1 Canadian Institutes of Health Research Canada Research Chair, Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2N2 Canada
| | - K. M. Sibley
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
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17
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Oberschmidt K, Grünloh C, Nijboer F, van Velsen L. Best Practices and Lessons Learned for Action Research in eHealth Design and Implementation: Literature Review. J Med Internet Res 2022; 24:e31795. [PMID: 35089158 PMCID: PMC8838546 DOI: 10.2196/31795] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/09/2021] [Accepted: 12/06/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Action research (AR) is an established research framework to introduce change in a community following a cyclical approach and involving stakeholders as coresearchers in the process. In recent years, it has also been used for eHealth development. However, little is known about the best practices and lessons learned from using AR for eHealth development. OBJECTIVE This literature review aims to provide more knowledge on the best practices and lessons learned from eHealth AR studies. Additionally, an overview of the context in which AR eHealth studies take place is given. METHODS A semisystematic review of 44 papers reporting on 40 different AR projects was conducted to identify the best practices and lessons learned in the research studies while accounting for the particular contextual setting and used AR approach. RESULTS Recommendations include paying attention to the training of stakeholders' academic skills, as well as the various roles and tasks of action researchers. The studies also highlight the need for constant reflection and accessible dissemination suiting the target group. CONCLUSIONS This literature review identified room for improvements regarding communicating and specifying the particular AR definition and applied approach.
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Affiliation(s)
- Kira Oberschmidt
- eHealth Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Christiane Grünloh
- eHealth Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Femke Nijboer
- Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Lex van Velsen
- eHealth Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
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18
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McNeil H, McMurray J, Byrne K, Grindrod K, Stolee P. Engagement of older adults in regional health innovation: The ECOTECH concept mapping project. SAGE Open Med 2022; 10:20503121211073333. [PMID: 35083046 PMCID: PMC8785349 DOI: 10.1177/20503121211073333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: Regional health innovation ecosystems can activate collaboration and support planning, self-management and development and commercialization of innovations. We sought to understand how older adults and their caregivers can be meaningfully engaged in regional health innovation ecosystems focused on health and aging–related technology innovation. Methods: A six-phase concept mapping technique gathered data over six time points across Canada. Brainstorming conducted online and in person identified engagement ideas. Statements were sorted by similarity and rated by participants on importance and feasibility. Qualitative approaches and multidimensional scaling, hierarchical cluster analysis, descriptive statistics and t tests were used for analysis. Results: Sixty-two unique ideas were assembled into a seven-cluster framework of priorities for engagement in regional health innovation ecosystems including public forums, co-production and partnerships, engagement, linkage and exchange, developing cultural capacity, advocacy and investment in the ecosystem. Conclusions: This study identified a framework of priorities for directions and strategies for older adult and caregiver engagement in regional health innovation ecosystems. Next steps include collaborations to develop regional health innovation ecosystems that actively engage older adults and their caregivers in health and aging–related technology innovation.
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Affiliation(s)
- Heather McNeil
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Lazaridis School of Business and Economics/Health Studies, Wilfrid Laurier University, Brantford, ON, Canada
| | - Josephine McMurray
- Lazaridis School of Business and Economics/Health Studies, Wilfrid Laurier University, Brantford, ON, Canada
| | - Kerry Byrne
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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19
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Saint-Onge K, Bernard P, Kingsbury C, Houle J. Older Public Housing Tenants' Capabilities for Physical Activity Described Using Walk-Along Interviews in Montreal, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11647. [PMID: 34770160 PMCID: PMC8583507 DOI: 10.3390/ijerph182111647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022]
Abstract
Older public housing tenants experience various factors associated with physical inactivity and are locally dependent on their environment to support their physical activity. A better understanding of the person-environment fit for physical activity could highlight avenues to improve access to physical activity for this subgroup of the population. The aim of this study was to evaluate older public housing tenants' capabilities for physical activity in their residential environment using a socioecological approach. We conducted individual semi-structured walk-along interviews with 26 tenants (female = 18, male = 8, mean age = 71.96 years old). Living in housing developments exclusively for adults aged 60 years or over in three neighborhoods in the city of Montreal, Canada. A hybrid thematic analysis produced five capabilities for physical activity: Political, financial, social, physical, and psychological. Themes spanned across ecological levels including individual, public housing, community, and government. Tenant committees appear important to physical activity promotion. Participants called for psychosocial interventions to boost their capability for physical activity as well as greater implication from the housing authority and from government. Results further support a call for intersectoral action to improve access to physical activity for less affluent subgroups of the population such as older public housing tenants.
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Affiliation(s)
- Kadia Saint-Onge
- Department of Psychology, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
| | - Paquito Bernard
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC H2L 2C4, Canada
| | - Célia Kingsbury
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC H2L 2C4, Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada;
- Research Center, Montreal University Institute of Mental Health, Montréal, QC H1N 3M5, Canada; (P.B.); (C.K.)
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20
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Elliott J, Whate A, McNeil H, Kernoghan A, Stolee P. A SHARP Response: Developing COVID-19 Research Aims in Partnership with the Seniors Helping as Research Partners (SHARP) Group. Can J Aging 2021; 40:1-8. [PMID: 34704552 DOI: 10.1017/s0714980821000453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.
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Affiliation(s)
- Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Alexandra Whate
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Alison Kernoghan
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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21
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Zibrowski E, Carr T, McDonald S, Thiessen H, van Dusen R, Goodridge D, Haver C, Marciniuk D, Stobart C, Verrall T, Groot G. A rapid realist review of patient engagement in patient-oriented research and health care system impacts: part one. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:72. [PMID: 34629118 PMCID: PMC8504114 DOI: 10.1186/s40900-021-00299-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/15/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Patient-oriented research affords individuals with opportunities to genuinely contribute to health care research as members of research teams. While checklists and frameworks can support academic researchers' awareness of patient engagement methods, less guidance appears available to support their understanding of how to develop and maintain collaborative relationships with their patient partners. This knowledge is essential as patient partners report that the social atmospheres of research teams significantly impacts the quality of their experiences. This study sought to develop theory regarding how academic researchers support and sustain patient engagement in patient-oriented research. METHODS A six-step, rapid realist review was conducted: (1) research question development, (2) preliminary theory development, (3) search strategy development; (4) study selection and appraisal, (4) data extraction, analysis and synthesis (5) identification of relevant formal theories, and (6) theory refinement with stakeholders. Findings were additionally distilled by collective competence theory. RESULTS A program theory was developed from 62 international studies which illuminated mechanisms supporting academic researchers to engage patient partners, contexts supporting these mechanisms, and resources that enabled mechanism activation. Interaction between seven contexts (patient-oriented research belief, prior interaction with a healthcare system, prior interaction with a particular academic researcher, educational background of patient partner, prior experience with patient-oriented research, study type, and time lived in a rural-urban setting) and seven mechanisms (deciding to become involved in patient-oriented research, recognizing valuable experiential knowledge, cultural competence, reducing power differentials, respectful team environment, supporting patient partners to feel valued, and readiness to research) resulted in an intermediate outcome (sense of trust). Trust then acted as an eighth mechanism which triggered the final-level outcome (empowered patient-centred lens). CONCLUSIONS Our theory posits that if patient partners trust they are a member of a supportive team working alongside academic researchers who authentically want to incorporate their input, then they are empowered to draw upon their experiential knowledge of health care systems and contribute as researchers in patient-oriented research. Our theory extends conceptual thinking regarding the importance of trust on patient-oriented research teams, how patient partners' trust is shaped by team interactions, and the role that academic researchers have within those interactions.
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Affiliation(s)
- Elaine Zibrowski
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | | | | | | | - Donna Goodridge
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Charlene Haver
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Darcy Marciniuk
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Christine Stobart
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tanya Verrall
- Saskatchewan Health Quality Council, Atrium Building, Innovation Place, 241 - 111 Research Drive, Saskatoon, SK, S7N 3R2, Canada
| | - Gary Groot
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
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Cranley L, Sivakumaran G, Helfenbaum S, Galessiere D, Meyer R, Duggleby W, McGillis Hall L, McGilton KS. Development of communication tool for resident- and family-led care discussions in long-term care through patient and family engagement. Int J Older People Nurs 2021; 17:e12429. [PMID: 34618396 PMCID: PMC9285466 DOI: 10.1111/opn.12429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Effective communication between residents (older adults), families, and the healthcare team supports person-centred care. However, communication breakdowns can occur that can impact care and outcomes. The aim of this paper is to describe a feedback approach to developing a communication tool for residents and families to guide information sharing during care discussions with the healthcare team in long-term care. METHODS Development of the communication tool included consultation with key stakeholders for their feedback and input. Following initial development of the tool template by our research team, we invited feedback from our study collaborators. Next, individual interviews and a focus group were conducted with family members, followed by individual interviews with selected residents from two long-term care homes in Ontario, Canada. Participants were asked to provide input and feedback on the tool's content and usability and to share ideas for improving the tool. Content analysis was used to analyse the interview data. RESULTS Feedback from residents and family included suggestions to enhance the tool's content and use of plain language, and suggestions for potential application of the tool. CONCLUSION Feedback highlighted the value of engaging residents and family members in the development of a communication tool. The communication tool offers a structured format to support participation of residents and families in information sharing for care discussions with the healthcare team.
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Affiliation(s)
- Lisa Cranley
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gajan Sivakumaran
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Shoshana Helfenbaum
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Daniel Galessiere
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Raquel Meyer
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Baycrest, Toronto, ON, Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Linda McGillis Hall
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Katherine S McGilton
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Re-engaging in Aging and Mobility Research in the COVID-19 Era: Early Lessons from Pivoting a Large-Scale, Interdisciplinary Study amidst a Pandemic. Can J Aging 2021. [DOI: 10.1017/s0714980821000374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AbstractIn the wake of the COVID-19 pandemic, those planning and conducting research involving older adults have faced many challenges, in part because of the public health measures in place. This article details the early steps and corresponding strategies implemented by our multidisciplinary team to pivot our large-scale aging and mobility study. Based on the premise that all current and emerging research in aging has been impacted by the pandemic, we propose a continuum approach whereby the research question, analysis, and interpretation are situated in accordance with the stage of the pandemic. Using examples from our own study, we outline potential ways to partner with older adults and other stakeholders as well as to encourage collaboration beyond disciplinary silos even under the current circumstances. Finally, we suggest the formation of a Canadian-led consortium that leverages cross-disciplinary expertise to address the complexities of our aging population in the COVID-19 era and beyond.
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A national intervention to support frail older adults in primary care: a protocol for an adapted implementation framework. BMC Geriatr 2021; 21:453. [PMID: 34348660 PMCID: PMC8336337 DOI: 10.1186/s12877-021-02395-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older Canadians are high users of health care services, however the health care system is not well-designed to meet the complex needs of many older adults. Older persons often look to their primary care practitioners to assess their needs and coordinate their care. The intervention seeks to improve primary care for older persons living with frailty and will be implemented in six primary care clinics in three Canadian provinces. Presently, more than 1.6 million older Canadians are living with frailty, and this is projected to increase to 2.5 million within a decade (Canadian Frailty Network, Frailty Matters, 2020). The model will include frailty screening, an online portal to expedite referrals and improve coordination with community services, and several tools and techniques to support patient and family engagement and shared decision-making. Our project is guided by the Consolidated Framework for Implementation Research (CFIR) (Damschroder LJ, et al. Implement Scil, 4, 50, 2009). As others have done, we adapted the CFIR for our work. Our adapted framework combines elements of the socio-ecological model, key concepts from the CFIR, and elements from other implementation science frameworks. Nested within a broader mixed-method implementation study, the focus of this paper is to outline our guiding conceptual framework and qualitative methods protocol. METHODS We will use the adapted CFIR framework to inform the data we collect and our analytic approach. Our work is divided into three phases: (1) baseline assessment of 'usual care'; (2) tailoring and implementing a new primary care model; and (3) evaluation. In each of these phases we will engage in qualitative data collection, including clinical observations, focus groups, in-depth interviews and extensive field notes. At each site we will collect data with health care providers, key informants (e.g., executive directors), and rostered patients ≥ 70 years. We will engage in team-based analysis across multiple sites, three provinces and two languages through regular telephone conferences, a comprehensive analysis codebook, leadership from our Qualitative Working Group and a collective appreciation that "science is a team sport" (Clinical Orthopaedics and Related Research 471, 701-702, 2013). DISCUSSION Outcomes of this research may be used by other research teams who chose to adapt the CFIR framework to reflect the unique contexts of their work, and clinicians seeking to implement our model, or other models of care for frail older patients in primary care. TRIAL REGISTRATION U.S. National Library of Medicine, NCT03442426 . Registered 22 February 2018- Retrospectively registered.
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25
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Siqeca F, Obas K, Yip O, Stenz S, Vounatsou P, Briel M, Schwenkglenks M, Quinto C, Blozik E, Zeller A, Zullig LL, De Geest S, Deschodt M. The INSPIRE Population Survey: development, dissemination and respondent characteristics. BMC Med Res Methodol 2021; 21:131. [PMID: 34162324 PMCID: PMC8223353 DOI: 10.1186/s12874-021-01329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/20/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Most older adults prefer to continue living at home despite increasing care needs and demand for services. To aid in maintaining independence, integrated care models for community-dwelling older people are promoted as the most cost-effective approach. The implementation of such care models is challenging and often the end-users are not involved or their needs are not considered. We conducted a population survey in order to understand the needs and preferences of home-dwelling older adults living in Canton Basel-Landschaft, Switzerland. The aims of this paper are to chronicle the development of the INSPIRE Population Survey, outline its variables and measurements, describe the marketing strategy utilized for survey dissemination and report on the response rate and respondent characteristics. METHODS The INSPIRE Population Survey, conducted between March and August 2019, is a cross-sectional survey of older adults aged 75 and older living at home in Canton Basel-Landschaft. The questionnaire was developed by expert input and stakeholder involvement. Its readability and acceptability were pilot-tested with older people. To ensure the likelihood of a high and representative response rate, a meticulous step-by-step marketing strategy was developed prior to the dissemination of the questionnaire. RESULTS The overall response rate was 30.7% (n = 8,846), with variations between 20.6 and 34.5% across the different care regions in the canton. A generally higher response rate was found in the care regions with a higher density and which bordered the urban city of Basel. We received support from local stakeholders, policy makers and media through using a broad combination of marketing channels and targeting our community partners who have a strong relationship with our target audience. CONCLUSIONS Although recruiting older adults in research is challenging, our study shows that a high response rate can be achieved by developing the survey through expert input and by involving all important stakeholders, including older adults, throughout the entire process.
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Affiliation(s)
- Flaka Siqeca
- Department Public Health, Institute of Nursing Science, University of Basel, 4051, Basel, Switzerland
| | - Katrina Obas
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland
| | - Olivia Yip
- Department Public Health, Institute of Nursing Science, University of Basel, 4051, Basel, Switzerland
| | - Samuel Stenz
- Department Public Health, Institute of Nursing Science, University of Basel, 4051, Basel, Switzerland
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland
| | - Matthias Briel
- Department of Clinical Research, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, 4051, Basel, Switzerland
| | - Matthias Schwenkglenks
- Department Public Health, Institute of Pharmaceutical Medicine (ECPM), University of Basel, 4051, Basel, Switzerland
| | - Carlos Quinto
- Aerztegesellschaft Baselland, 4132, Muttenz, Switzerland
| | - Eva Blozik
- Helsana-Gruppe, 8001, Zürich, Switzerland
| | - Andreas Zeller
- Department Clinical Research, Center for Primary Health Care, University of Basel, 4051, Basel, Switzerland
| | - Leah L Zullig
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, 27701, USA
| | - Sabina De Geest
- Department Public Health, Institute of Nursing Science, University of Basel, 4051, Basel, Switzerland.
| | - Mieke Deschodt
- Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, 3000, Leuven, Belgium
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26
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Salerno J, Coleman KJ, Jones F, Peters ES. The ethical challenges and opportunities of implementing engagement strategies in health research. Ann Epidemiol 2021; 59:37-43. [PMID: 33894383 DOI: 10.1016/j.annepidem.2021.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/10/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The American College of Epidemiology (ACE) held its 2019 Annual Meeting in Pasadena, California, September 7-10 with a theme of "Real-World Epidemiologic Evidence in Policy and Practice". The ACE Ethics Committee hosted a symposium session at the annual meeting on the ethical challenges of stakeholder engagement in the health research setting. The purpose of this paper is to further examine the design and conduct of stakeholder engagement and reflect on the ethical challenges with the goal of offering best practices and identifying areas where future guidance, critical reflection and teaching may be needed. METHODS Three speakers with diverse affiliations were selected to present on the opportunities and ethical challenges of stakeholder engagement in epidemiology and community health. Dr. K Coleman presented an "Overview of Stakeholder-Engaged Research Strategies" and "Engaging Stakeholders in Retrospective Observational Studies"; Dr. J Salerno presented on "An Ethical Perspective to Optimize Engagement Strategies"; and Ms. F Jones presented on the "Structure of Community-Partnered Participatory Research". RESULTS Three main insights were identified: (1) the need for a unifying framework of ethical principles for the implementation of stakeholder engagement, (2) an expanded set of research activities for stakeholders aligned with their engagement in epidemiology studies, and (3) strengths of a community-based partnership model of stakeholder engagement in community health, known as community-partnered participatory research (CPPR). CONCLUSIONS There is a need to broaden the dialogue and understanding of stakeholder engagement for researchers who are increasingly faced with the ethical challenges of implementing approaches and strategies to engage patients, communities, policy makers and the public as stakeholders. To address current challenges, we offered a unifying framework to guide best practices of stakeholder engagement by integrating the core ethical principles of research conduct involving human subjects with the guiding principles of patient engagement. We shared 2 model overviews of implementing stakeholder engagement: (1) a 4-staged model when implementing stakeholder engagement using an epidemiological study design, (2) a stakeholder engagement model rooted in authentic academic-community partnerships, known as community-partnered participatory research (CPPR) to address depression disparities. By critically reflecting on stakeholder engagement across disciplines and appraising the opportunities and ethical challenges of implementing stakeholder engagement in health research, we have provided insights on how to operationalize, conduct and implement stakeholder engagement and have contributed to moving this important field forward.
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Affiliation(s)
- Jennifer Salerno
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; McMaster Institute for Research on Aging
- Collaborative for Health and Aging, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Karen J Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Felica Jones
- Healthy African American Families II, Los Angeles, CA
| | - Edward S Peters
- Epidemiology Program, School of Public Health, Louisiana State University, New Orleans, LA
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27
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Markle-Reid M, Ganann R, Ploeg J, Heald-Taylor G, Kennedy L, McAiney C, Valaitis R. Engagement of older adults with multimorbidity as patient research partners: Lessons from a patient-oriented research program. JOURNAL OF COMORBIDITY 2021; 11:2633556521999508. [PMID: 33796472 PMCID: PMC7975523 DOI: 10.1177/2633556521999508] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 12/26/2022]
Abstract
Background Patient "engagement" in health research broadly refers to including people with lived experience in the research process. Although previous reviews have systematically summarized approaches to engaging older adults and their caregivers in health research, there is currently little guidance on how to meaningfully engage older adults with multimorbidity as research partners. Objectives This paper describes the lessons learned from a patient-oriented research program, the Aging, Community and Health Research Unit (ACHRU), on how to engage older adults with multimorbidity as research partners. Over the past 7-years, over 40 older adults from across Canada have been involved in 17 ACHRU projects as patient research partners. Methods We developed this list of lessons learned through iterative consensus building with ACHRU researchers and patient partners. We then met to collectively identify and summarize the reported successes, challenges and lessons learned from the experience of engaging older adults with multimorbidity as research partners. Results ACHRU researchers reported engaging older adult partners across many phases of the research process. Five challenges and lessons learned were identified: 1) actively finding patient partners who reflect the diversity of older adults with multimorbidity, 2) developing strong working relationships with patient partners, 3) providing education and support for both patient partners and researchers, 4) using flexible approaches for engaging patients, and 5) securing adequate resources to enable meaningful engagement. Conclusion The lessons learned through this work may provide guidance to researchers on how to facilitate meaningful engagement of this vulnerable and understudied subgroup in the patient engagement literature.
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Affiliation(s)
- Maureen Markle-Reid
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.,Department of Health, Aging and Society, McMaster University, Hamilton, Ontario, Canada
| | - Gail Heald-Taylor
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laurie Kennedy
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - C McAiney
- Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.,Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada.,Murray Alzheimer Research & Education Program (MAREP), University of Waterloo, Waterloo, Ontario, Canada
| | - Ruta Valaitis
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Aging, Community and Health Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
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Gerber K, Maharaj E, Brijnath B, Antoniades J. End-of-life care for older first-generation migrants: a scoping review. BMJ Support Palliat Care 2020:bmjspcare-2020-002617. [PMID: 33298550 DOI: 10.1136/bmjspcare-2020-002617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The unprecedented scale of contemporary migration across countries over the last decade means that ageing and dying occur in a more globalised, multicultural context. It is therefore essential to explore the end-of-life experiences of older people from migrant backgrounds. METHODS A scoping review of peer-reviewed articles published in English from 2008 to 2018. Included studies addressed end-of-life preferences, attitudes, values and beliefs of first-generation international migrants who were at least 50 years of age. RESULTS Fifteen studies met the inclusion criteria for this review, which addressed six key themes: (1) the reluctance among older migrants and their families to talk about death and dying; (2) difficult communication in patient-clinician relationships; (3) the contrast between collectivistic and individualistic norms and its associated end-of-life preferences; (4) limited health literacy in older adults from migrant backgrounds; (5) experiences with systemic barriers like time pressure, inflexibility of service provision and lack of cultural sensitivity and (6) the need for care providers to appreciate migrants' 'double home experience' and what this means for end-of-life decision-making regarding place of care and place of death. DISCUSSION To respond effectively to an increasingly culturally diverse population, healthcare staff, researchers and policymakers need to invest in the provision of culturally sensitive end-of-life care. Areas for improvement include: (a) increased awareness of cultural needs and the role of family members; (b) cultural training for healthcare staff; (c) access to interpreters and translated information and (d) involvement of older migrants in end-of-life discussions, research and policymaking.
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Affiliation(s)
- Katrin Gerber
- Melbourne Ageing Research Collaboration, National Ageing Research Institute Inc, Parkville, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Emma Maharaj
- Division of Social Gerontology, National Ageing Research Institute Inc, Parkville, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Bianca Brijnath
- Division of Social Gerontology, National Ageing Research Institute Inc, Parkville, Victoria, Australia
- Department of General Practice, Monash University, Clayton, Victoria, Australia
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
| | - Josefine Antoniades
- Division of Social Gerontology, National Ageing Research Institute Inc, Parkville, Victoria, Australia
- Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Bentley, Western Australia, Australia
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29
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Berge I, Barenfeld E, Dahlin-Ivanoff S, Haak M, Lood Q. Challenging oneself on the threshold to the world of research - frail older people's experiences of involvement in research. BMC Geriatr 2020; 20:410. [PMID: 33069211 PMCID: PMC7568390 DOI: 10.1186/s12877-020-01817-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background User involvement of people outside academia in research is argued to increase relevance of research for society and to empower the involved lay persons. Frail older people can be a hard to reach group for research and thus an underrepresented group in research. There is a lack of knowledge how collaboration with frail older people should be best performed. Therefore, the aim of this study was to explore frail older people’s experiences of involvement in research. Methods In this study we have invited people, 75 years of age or older screened as physically frail and who have previously participated in a study as data sources, to share their experiences by intensive interviewing. Data was collected and analysed in parallel inspired by a constructivist grounded theory approach. Results The results demonstrate how frail older people have different incentives, how their context of ageing and the unusual position of being involved in research altogether influenced how, where and in what way they wished to be involved in research. This is described in three categories: Contributing to making a difference for oneself and others, Living a frail existence and Being on somebody else’s turf. The categories compose the core category, Challenging oneself on the threshold to the world of research, which symbolises the perceived distance between the frail older people themselves and the research world, but also the challenges the frail older people could go through when choosing to be involved in research. Conclusions Frail older people have a varied capacity to participate in research, but in what way and how is difficult to know before they have been involved in the process of research. Our results advocate that it is problematic to exclude frail older people a priori and that there is a potential for new perspectives and knowledge to be shaped in the encounter and in the relationship between the researcher and the frail older person. For research to be able to cater for frail older people’s needs of health services, their voices need to be heard and taken into consideration.
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Affiliation(s)
- Isak Berge
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
| | - Emmelie Barenfeld
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Synneve Dahlin-Ivanoff
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.,School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
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30
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Abrams R, Park S, Wong G, Rastogi J, Boylan AM, Tierney S, Petrova M, Dawson S, Roberts N. Lost in reviews: Looking for the involvement of stakeholders, patients, public and other non-researcher contributors in realist reviews. Res Synth Methods 2020; 12:239-247. [PMID: 32985074 DOI: 10.1002/jrsm.1459] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
The involvement of non-researcher contributors (eg, stakeholders, patients and the public, decision and policy makers, experts, lay contributors) has taken a variety of forms within evidence syntheses. Realist reviews are a form of evidence synthesis that involves non-researcher contributors yet this practice has received little attention. In particular, the role of patient and public involvement (PPI) has not been clearly documented. This review of reviews describes the ways in which contributor involvement, including PPI, is documented within healthcare realist reviews published over the last five years. A total of 448 papers published between 2014 and 2019 were screened, yielding 71 full-text papers included in this review. Statements about contributor involvement were synthesized across each review using framework analysis. Three themes are described in this article including nomenclature, nature of involvement, and reporting impact. Papers indicate that contributor involvement in realist reviews refers to stakeholders, experts, or advisory groups (ie, professionals, clinicians, or academics). Patients and the public are occasionally subsumed into these groups and in doing so, the nature and impact of their involvement become challenging to identify and at times, is lost completely. Our review findings indicate a need for the realist review community to develop guidance to support researchers in their future collaboration with contributors, including patients and the public.
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Affiliation(s)
- Ruth Abrams
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, England
| | - Sophie Park
- Department of Primary care and population health, UCL, London, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Juhi Rastogi
- Department of Primary care and population health, UCL, London, UK
| | - Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mila Petrova
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
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Booth A, Briscoe S, Wright JM. The "realist search": A systematic scoping review of current practice and reporting. Res Synth Methods 2019; 11:14-35. [PMID: 31714016 DOI: 10.1002/jrsm.1386] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 11/06/2022]
Abstract
The requirement for literature searches that identify studies for inclusion in systematic reviews should be systematic, explicit, and reproducible extends, at least by implication, to other types of literature review. However, realist reviews commonly require literature searches that challenge systematic reporting; searches are iterative and involve multiple search strategies and approaches. Notwithstanding these challenges, reporting of the "realist search" can be structured to be transparent and to facilitate identification of innovative retrieval practices. Our six-component search framework consolidates and extends the structure advanced by Pawson, one of the originators of realist review: formulating the question, conducting the background search, searching for program theory, searching for empirical studies, searching to refine program theory and identifying relevant mid-range theory, and documenting and reporting the search process. This study reviews reports of search methods in 34 realist reviews published within the calendar year of 2016. Data from all eligible reviews were extracted from the search framework. Realist search reports poorly differentiate between the different search components. Review teams often conduct a single "big bang" multipurpose search to fulfill multiple functions within the review. However, it is acknowledged that realist searches are likely to be iterative and responsive to emergent data. Overall, the search for empirical studies appears most comprehensive in conduct and reporting detail. In contrast, searches to identify and refine program theory are poorly conducted, if at all, and poorly reported. Use of this framework offers greater transparency in conduct and reporting while preserving flexibility and methodological innovation.
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Affiliation(s)
- Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Simon Briscoe
- Exeter HS&DR Evidence Synthesis Centre, Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Judy M Wright
- Academic Unit of Health Economics, Leeds Institute of Health Science, University of Leeds, Leeds, UK
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Harrison JD, Auerbach AD, Anderson W, Fagan M, Carnie M, Hanson C, Banta J, Symczak G, Robinson E, Schnipper J, Wong C, Weiss R. Patient stakeholder engagement in research: A narrative review to describe foundational principles and best practice activities. Health Expect 2019; 22:307-316. [PMID: 30761699 PMCID: PMC6543160 DOI: 10.1111/hex.12873] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Health research is evolving to include patient stakeholders (patients, families and caregivers) as active members of research teams. Frameworks describing the conceptual foundations underlying this engagement and strategies detailing best practice activities to facilitate engagement have been published to guide these efforts. OBJECTIVE The aims of this narrative review are to identify, quantify and summarize (a) the conceptual foundational principles of patient stakeholder engagement in research and (b) best practice activities to support these efforts. SEARCH STRATEGY, INCLUSION CRITERIA, DATA EXTRACTION AND SYNTHESIS: We accessed a publicly available repository of systematically identified literature related to patient engagement in research. Two reviewers independently screened articles to identify relevant articles and abstracted data. MAIN RESULTS We identified 990 potentially relevant articles of which 935 (94.4%) were excluded and 55 (5.6%) relevant. The most commonly reported foundational principles were "respect" (n = 25, 45%) and "equitable power between all team members" (n = 21, 38%). Creating "trust between patient stakeholders and researchers" was described in 17 (31%) articles. Twenty-seven (49%) articles emphasized the importance of providing training and education for both patient stakeholder and researchers. Providing financial compensation for patient stakeholders' time and expertise was noted in 19 (35%) articles. Twenty articles (36%) emphasized regular, bidirectional dialogue between patient partners and researchers as important for successful engagement. DISCUSSION AND CONCLUSIONS Engaging patient stakeholders in research as partners presents an opportunity to design, implement and disseminate patient-centred research. This review creates an overarching foundational framework for authentic and sustainable partnerships between patient stakeholders and researchers.
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Affiliation(s)
- James D. Harrison
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | - Andrew D. Auerbach
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | - Wendy Anderson
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
| | | | - Martha Carnie
- Center for Patients and FamiliesBrigham and Women’s HospitalBostonMassachusetts
| | | | - Jim Banta
- Intensive Care Unit Patient and Family Advisory CouncilUniversity of California San FranciscoSan FranciscoCalifornia
| | - Gina Symczak
- Intensive Care Unit Patient and Family Advisory CouncilUniversity of California San FranciscoSan FranciscoCalifornia
| | - Edmondo Robinson
- Department of MedicineChristiana Care Health SystemWilmingtonDelaware
| | - Jeffrey Schnipper
- Department of MedicineBrigham and Women’s HospitalBostonMassachusetts
| | - Celene Wong
- Center for Patients and FamiliesBrigham and Women’s HospitalBostonMassachusetts
| | - Rachel Weiss
- Division of Hospital MedicineUniversity of California San FranciscoSan FranciscoCalifornia
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Conklin J, Farrell B, Suleman S. Implementing deprescribing guidelines into frontline practice: Barriers and facilitators. Res Social Adm Pharm 2019; 15:796-800. [DOI: 10.1016/j.sapharm.2018.08.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
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Greenhalgh T, Hinton L, Finlay T, Macfarlane A, Fahy N, Clyde B, Chant A. Frameworks for supporting patient and public involvement in research: Systematic review and co-design pilot. Health Expect 2019; 22:785-801. [PMID: 31012259 PMCID: PMC6737756 DOI: 10.1111/hex.12888] [Citation(s) in RCA: 397] [Impact Index Per Article: 79.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/13/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022] Open
Abstract
Background Numerous frameworks for supporting, evaluating and reporting patient and public involvement in research exist. The literature is diverse and theoretically heterogeneous. Objectives To identify and synthesize published frameworks, consider whether and how these have been used, and apply design principles to improve usability. Search strategy Keyword search of six databases; hand search of eight journals; ancestry and snowball search; requests to experts. Inclusion criteria Published, systematic approaches (frameworks) designed to support, evaluate or report on patient or public involvement in health‐related research. Data extraction and synthesis Data were extracted on provenance; collaborators and sponsors; theoretical basis; lay input; intended user(s) and use(s); topics covered; examples of use; critiques; and updates. We used the Canadian Centre for Excellence on Partnerships with Patients and Public (CEPPP) evaluation tool and hermeneutic methodology to grade and synthesize the frameworks. In five co‐design workshops, we tested evidence‐based resources based on the review findings. Results Our final data set consisted of 65 frameworks, most of which scored highly on the CEPPP tool. They had different provenances, intended purposes, strengths and limitations. We grouped them into five categories: power‐focused; priority‐setting; study‐focused; report‐focused; and partnership‐focused. Frameworks were used mainly by the groups who developed them. The empirical component of our study generated a structured format and evidence‐based facilitator notes for a “build your own framework” co‐design workshop. Conclusion The plethora of frameworks combined with evidence of limited transferability suggests that a single, off‐the‐shelf framework may be less useful than a menu of evidence‐based resources which stakeholders can use to co‐design their own frameworks.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Teresa Finlay
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Nick Fahy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ben Clyde
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Alan Chant
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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White CL, Overbaugh KJ, Pickering CEZ, Piernik-Yoder B, James D, Patel DI, Puga F, Ford L, Cleveland J. Advancing Care for Family Caregivers of persons with dementia through caregiver and community partnerships. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:1. [PMID: 29387453 PMCID: PMC5776762 DOI: 10.1186/s40900-018-0084-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/08/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND There are currently 15 million Americans who provide over 80% of the care required by their family members with Alzheimer's disease and other dementias. Yet care for caregivers continues to be fragmented and few evidence-based interventions have been translated into routine clinical care and therefore remain inaccessible to most family caregivers. To address this gap, the Caring for the Caregiver program is being developed at UT Health San Antonio, School of Nursing to improve support services and health outcomes for family caregivers. Our purpose is to describe the engagement process undertaken to assess caregiver and community needs and how findings are informing program development. METHODS We are using a model of public engagement that consists of communication of information, collection of information from stakeholders, and collaboration where stakeholders are partners in an exchange of information to guide program activities. An assessment of the community was undertaken to identify resources/services for family caregivers. Subsequently, stakeholders were invited to a community-academic forum to discuss strategies to build on existing strengths for family caregiving and to identify gaps in care. Detailed notes were taken and all discussions were recorded and transcribed for analysis. Data were analyzed using thematic content analysis. RESULTS We conducted site visits with 15 community agencies, interviewed 13 family caregivers, and attended community events including support groups and health and senior fairs. Fifty-three diverse stakeholders attended the community-academic forum. Participants identified existing assets within our community to support family caregivers. Consistent among groups was the need to increase awareness in our community about family caregivers. Themes identified from the discussion were: making the invisible visible, you don't know what you don't know, learning too late, and anticipating and preparing for the future. CONCLUSIONS Incorporating caregiver and community stakeholders was critical to ensure that the priorities of our community are addressed in a culturally responsive accessible program for family caregivers. The forum served as important mechanism to partner with the community and will be an annual event where we can continue to work with our stakeholders around needs for practice, education, and research.
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Affiliation(s)
- Carole L. White
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Kristen J. Overbaugh
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | | | - Bridgett Piernik-Yoder
- School of Health Professions, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Debbie James
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Darpan I. Patel
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Frank Puga
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - Lark Ford
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
| | - James Cleveland
- School of Nursing, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229 USA
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Boscart V, McCleary L, Huson K, Sheiban L, Harvey K. Integrating gerontological competencies in Canadian health and social service education: An overview of trends, enablers, and challenges. GERONTOLOGY & GERIATRICS EDUCATION 2017; 38:17-46. [PMID: 27635670 DOI: 10.1080/02701960.2016.1230738] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
As the number of older adults increases, it is imperative that gerontological competencies are imbedded in health and social service education reviews of Canadian published and grey literature presents trends, barriers, and enablers of sustained movement toward graduating professionals with gerontology competencies. Overall, gerontological education remains insufficient. Main barriers include resources for faculty and teaching. This review also identified discipline-specific competency frameworks that could inform curriculum enhancement and education accreditations; however, most educators were unaware of these. Further limiting workforce development is the lack of gerontology competency statements within regulatory documents. This review concludes with recommendations for federal and provincial policies to establish educational accreditation programs in geriatrics, develop core competencies, and integrate these into regulatory frameworks. Failure to do so will continue the trend of insufficient preparation of health and social service professionals to care for older adults.
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Affiliation(s)
- Veronique Boscart
- a School of Health & Life Sciences and Community Services , Conestoga College Institute of Technology & Advanced Learning , Kitchener , Ontario , Canada
- d Schlegel-University of Waterloo Research Institute for Aging , Kitchener , Ontario , Canada
| | - Lynn McCleary
- b Faculty of Applied Health Sciences - Department of Nursing , Brock University , St. Catharines , Ontario , Canada
| | - Kelsey Huson
- a School of Health & Life Sciences and Community Services , Conestoga College Institute of Technology & Advanced Learning , Kitchener , Ontario , Canada
| | - Linda Sheiban
- a School of Health & Life Sciences and Community Services , Conestoga College Institute of Technology & Advanced Learning , Kitchener , Ontario , Canada
| | - Kelsey Harvey
- c Department of Health , Aging & Society, McMaster University , Hamilton , Ontario , Canada
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Garvelink MM, Emond J, Menear M, Brière N, Freitas A, Boland L, Perez MMB, Blair L, Stacey D, Légaré F. Development of a decision guide to support the elderly in decision making about location of care: an iterative, user-centered design. RESEARCH INVOLVEMENT AND ENGAGEMENT 2016; 2:26. [PMID: 29062524 PMCID: PMC5611600 DOI: 10.1186/s40900-016-0040-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 06/18/2016] [Indexed: 06/07/2023]
Abstract
PLAIN ENGLISH SUMMARY For the elderly to get the care and services they need, they may need to make the difficult decision about staying in their home or moving to another home. Many other people may be involved in their care too (friends, family and healthcare providers), and can support them in making the decision. We asked informal caregivers of elderly people to help us develop a decision guide to support them and their loved ones in making this decision. This guide will be used by health providers in home care who are trained to help people make decisions. The guide is in French and English. To design and test this decision guide we involved elderly people, their caregivers and health administrators. We first asked them what they needed for making the decision, and then designed a first version of the guide. Then we asked them to look at it and give feedback, which was used to make the final version. We then used scientific criteria to check its content and the language used. The final decision guide was acceptable to the caregivers, their elderly loved ones, and the health administrators. The guide is currently being evaluated in a large research project with home care teams in the province of Quebec. ABSTRACT Background As they grow older, many elderly people are faced with the difficult and preference-sensitive decision about staying in their home or moving to a residence better adapted to their evolving care needs. We aimed to develop an English and French decision aid (DA) for elderly people facing this decision, and to involve end-users in all phases of the development process. Methods A three-cycle design with involvement of end-users in Quebec. End-users were elderly people (n = 4) caregivers of the elderly (n = 5), health administrators involved in home-care service delivery or policy (n = 6) and an interprofessional research team (n = 19). Cycle 1: Decisional needs assessment and development of the first prototype based on existing tools and input from end-users; overview of reviews examining the impact of location of care on elderly people's health outcomes. Cycle 2: Usability testing with end-users, adaptation of prototype. Cycle 3: Refinement of the prototype with a linguist, graphic designer and end-users. The final prototype underwent readability testing and an International Patient Decision Aids (IPDAS) criteria compatibility assessment to verify minimal requirements for decision aids and was tested for usability by the elderly. ResultsCycle 1: We used the Ottawa Personal Decision Guide to design a first prototype. As the overview of reviews did not find definitive evidence regarding optimal locations of care for elderly people, we were not able to add evidence-based advantages and disadvantages to the guide. Cycle 2: Overall, the caregivers and health administrators who evaluated the prototype (n = 10) were positive. In response to their suggestions, we deleted some elements (overview of pros, cons, and consequences of the options) that were necessary to qualify the tool as a DA and renamed it a "decision guide". Cycle 3: We developed French and English versions of the guide, readable at a primary school level. The elderly judged the guide as acceptable. Conclusion We developed a decision guide to support elderly people and their caregivers in decision making about location of care. This paper is one of few to report on a fully collaborative approach to decision guide development that involves end-users at every stage (caregivers and health administrators early on, the frail elderly in the final stages). The guide is currently being evaluated in a cluster randomized trial. Trial registration: NCT02244359.
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Affiliation(s)
- Mirjam M. Garvelink
- CHU de Québec Research Centre - Hôpital St-Francois d’Assise, 10 Rue Espinay, Quebec City, QC G1L 3L5 Canada
| | - Julie Emond
- Centre de santé et de services sociaux de la Vieille-Capitale, 880, rue Père-Marquette, Quebec City, QC G1M 2R9 Canada
| | - Matthew Menear
- CHU de Québec Research Centre - Hôpital St-Francois d’Assise, 10 Rue Espinay, Quebec City, QC G1L 3L5 Canada
| | - Nathalie Brière
- Centre de santé et de services sociaux de la Vieille-Capitale, 880, rue Père-Marquette, Quebec City, QC G1M 2R9 Canada
| | - Adriana Freitas
- CHU de Québec Research Centre - Hôpital St-Francois d’Assise, 10 Rue Espinay, Quebec City, QC G1L 3L5 Canada
| | - Laura Boland
- Ottawa Hospital Research Institute, 725 Parkdale Ave., Ottawa, ON K1Y 4E9 Canada
| | | | - Louisa Blair
- CHU de Québec Research Centre - Hôpital St-Francois d’Assise, 10 Rue Espinay, Quebec City, QC G1L 3L5 Canada
| | - Dawn Stacey
- Ottawa Hospital Research Institute, 725 Parkdale Ave., Ottawa, ON K1Y 4E9 Canada
- University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5 Canada
| | - France Légaré
- CHU de Québec Research Centre - Hôpital St-Francois d’Assise, 10 Rue Espinay, Quebec City, QC G1L 3L5 Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, 1050, Ave de la Médecine, Pavillon Ferdinand-Vandry, Quebec City, QC G1V 0A6 Canada
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Holroyd-Leduc J, Resin J, Ashley L, Barwich D, Elliott J, Huras P, Légaré F, Mahoney M, Maybee A, McNeil H, Pullman D, Sawatzky R, Stolee P, Muscedere J. Giving voice to older adults living with frailty and their family caregivers: engagement of older adults living with frailty in research, health care decision making, and in health policy. RESEARCH INVOLVEMENT AND ENGAGEMENT 2016; 2:23. [PMID: 29062523 PMCID: PMC5611602 DOI: 10.1186/s40900-016-0038-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/31/2016] [Indexed: 05/13/2023]
Abstract
PLAIN ENGLISH SUMMARY The paper discusses engaging older adults living with frailty and their family caregivers. Frailty is a state that puts an individual at a higher risk for poor health outcomes and death. Understanding whether a person is frail is important because treatment and health care choices for someone living with frailty may be different from someone who is not (i.e., who is fit). In this review, we discuss strategies and hurdles for engaging older adults living with frailty across three settings: research, health and social care, and policy. We developed this review using published literature, expert opinion, and stakeholder input (including citizens). Engaging frail older individuals will be challenging because of their vulnerable health state - but it can be done. Points of consideration specific to engaging this vulnerable population include:In any setting, family caregivers (defined to include family, friends, and other social support systems) play an important role in engaging and empowering older adults living with frailtyEngagement opportunities need to be flexible (e.g., location, time, type)Incentivizing engagement for researchers and citizens (financial and otherwise) may be necessaryThe education and training of citizens, health and social care providers, and researchers on engagement practicesPatient-centered care approaches should consider the specific needs of individuals living with frailty including end-of-life care and advanced care planningInfluencing policy can occur in many ways including participating at institutional, regional, provincial or national committees that relate to health and social care. ABSTRACT Older adults are the fastest growing segment of Canada's population resulting in an increased number of individuals living with frailty. Although aging and frailty are not synonymous the proportion of those who are frail increases with age. Frailty is not defined by a single condition, but rather a health state characterized by an increased risk of physical, mental, or social decline, deterioration of health status, and death. Recognizing frailty is important because earlier detection allows for program implementation focused on prevention and management to reduce future hospitalization, improve outcomes, and enhance vitality and quality of life. Even though older adults living with frailty are significant users of health care resources, their input is under-represented in research, health care decision making, and health policy formulation. As such, engaging older adults living with frailty and their family caregivers is not only an ethical imperative, but their input is particularly important as health and social care systems evolve from single-illness focused to those that account for the complex and chronic needs that accompany frailty. In this review, we summarize existing literature on engaging older adults living with frailty and their family caregivers across three settings: research, health and social care, and policy. We discuss strategies and barriers to engagement, and ethical and cultural factors and implications. Although this review is mainly focused on Canada it is likely to be broadly applicable to many of the health systems in the developed world where aging and frailty pose important challenges.
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Affiliation(s)
- Jayna Holroyd-Leduc
- Department of Medicine and Community Health Services, University of Calgary, Calgary, AB Canada
| | - Joyce Resin
- Canadian Frailty Network, Vancouver, BC Canada
| | - Lisa Ashley
- Canadian Nurses Association, Ottawa, ON Canada
| | | | - Jacobi Elliott
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON Canada
| | - Paul Huras
- South East Local Health Integration Network, Belleville, ON Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Université Laval, Québec City, Québec Canada
| | - Megan Mahoney
- Canadian Frailty Network, Network for Centres of Excellence, Kingston, Canada
| | | | - Heather McNeil
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON Canada
| | - Daryl Pullman
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NF Canada
| | - Richard Sawatzky
- Trinity Western University, Langley, BC Canada
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC Canada
| | - Paul Stolee
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON Canada
| | - John Muscedere
- Department of Critical Care Medicine, Queen’s University, Kingston, ON Canada
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