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Chiwanga F, Woodford J, Masika G, Richards DA, Savi V, von Essen L. Examining the involvement of guardians of children with acute lymphoblastic leukemia in Tanzania as public contributors to inform the design and conduct of the GuardiansCan project: A mixed-methods study protocol. Cancer Med 2024; 13:e70034. [PMID: 39041493 PMCID: PMC11264114 DOI: 10.1002/cam4.70034] [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: 05/23/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Public contribution in research can lead to the design and conduct of more feasible and relevant research. However, our understanding of the acceptability and feasibility of public contribution and the evidence base regarding its impact in low- and middle-income countries (LMICs) is limited. METHODS In this study protocol, we describe a mixed-method examination of public contribution activities in the GuardiansCan project. The GuardiansCan project aims to respond to Tanzanian guardians' poor adherence to children's follow-up care after treatment for acute lymphoblastic leukemia (ALL) with the help of Mobile Health technology. We aim to: (1) involve guardians of children treated for ALL as Guardians Advisory Board (GAB) members in the managing and undertaking, analysis and interpretation, and dissemination phases of the GuardiansCan project; and (2) examine the acceptability, feasibility, and perceived impact of GAB members' contribution to the GuardiansCan project from the perspective of the GAB members and public contribution coordinators. We will recruit six to eight guardians of children treated for ALL to the GAB. We will hold workshops where GAB members contribute to all project phases. Using impact logs, we will record GAB workshop activities and the perceived impact of these activities. We will interview GAB members and public contribution coordinators 6 months after establishing the GAB, and at the end of each study within the project, to examine the acceptability, feasibility, and perceived impact of public contribution activities. DISCUSSION We expect GAB contribution to increase project quality and relevance, and inform how to best embed public contribution in research in LMICs.
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Affiliation(s)
- Faraja Chiwanga
- Muhimbili National Hospital, Research and Consultancy UnitDar es SalaamUnited Republic of Tanzania
- Department of Women's and Children's Health, Healthcare Sciences and e‐HealthUppsala UniversityUppsalaSweden
| | - Joanne Woodford
- Department of Women's and Children's Health, Healthcare Sciences and e‐HealthUppsala UniversityUppsalaSweden
| | - Golden Masika
- Department of Clinical NursingUniversity of DodomaDodomaUnited Republic of Tanzania
| | - David A. Richards
- Department of Women's and Children's Health, Healthcare Sciences and e‐HealthUppsala UniversityUppsalaSweden
- Department of Health and Caring SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Victor Savi
- Department of Women's and Children's Health, Healthcare Sciences and e‐HealthUppsala UniversityUppsalaSweden
| | - Louise von Essen
- Department of Women's and Children's Health, Healthcare Sciences and e‐HealthUppsala UniversityUppsalaSweden
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Woodford J, Reuther C, Ljungberg JL, von Essen L. Involving parents of children treated for cancer in Sweden as public contributors to inform the design and conduct of an evaluation of internet-administered self-help for parents of children treated for cancer: a protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:2. [PMID: 38167254 PMCID: PMC10759441 DOI: 10.1186/s40900-023-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Public contribution in research can facilitate the design and conduct of meaningful research, resulting in feasible and sustainable solutions to healthcare challenges. However, the evidence concerning the acceptability, feasibility, and impact of public contribution in research is limited. We will embed a mixed-method examination of public contribution activities into the CHANGE trial. The overall aim of the CHANGE trial is to evaluate the efficacy and cost-effectiveness of an internet-administered, guided, low-intensity cognitive behavioral therapy-based self-help intervention (EJDeR) plus treatment as usual (TAU) versus TAU for symptoms of depression and/or Generalized Anxiety Disorder in a superiority randomized controlled trial with an internal pilot phase. In this protocol we describe how we aim to: (1) involve parents of children treated for cancer in the managing and undertaking, analysis and interpretation, and dissemination phases of the CHANGE trial; and (2) examine the acceptability, feasibility, and perceived impact of Parent Advisory Board contribution to the trial from the perspective of board members and public contribution coordinators. METHODS We will recruit around six parents of children treated for cancer to the Parent Advisory Board. Board members will contribute throughout the trial during online workshops and steering group meetings. An impact log will be used during workshops to record activities and examine the perceived impact of activities according to board members and public contribution coordinators, including anticipated and unanticipated changes to the research process and potential benefits and harms. Activities will be reported using the Guidance for Reporting Involvement of Patients and the Public checklist. We will conduct semi-structured interviews with board members and public contribution coordinators 6 months after the board is established and at the end of the trial to examine the acceptability, feasibility, and perceived impact of public contribution activities. We will also conduct interviews with board members and public contribution coordinators who withdraw participation. Findings will be reported in accordance with the Standards for Reporting Qualitative Research checklist. DISCUSSION We hope adding public contribution to the CHANGE trial will provide guidance on how to embed public contribution in research and add to the evidence base concerning the impact of public contribution.
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Affiliation(s)
- Joanne Woodford
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Christina Reuther
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Johan Lars Ljungberg
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and E-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds Väg 14B, 751 05, Uppsala, Sweden.
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Pierce M, Foley L, Kiely B, Croke A, Larkin J, Smith SM, Clyne B, Murphy E. Embedding formal and experiential public and patient involvement training in a structured PhD programme: process and impact evaluation. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:105. [PMID: 37996882 PMCID: PMC10668398 DOI: 10.1186/s40900-023-00516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Incorporating Public and Patient Involvement (PPI) into doctoral research is valued by PhD funders and scholars. Providing early career researchers with appropriate training to develop skills to conduct meaningful PPI involvement is important. The Health Research Board (HRB) Collaborative Doctoral Award in MultiMorbidity programme (CDA-MM) embedded formal PPI training in its structured education. The four participating PhD scholars established a PPI panel comprising people living with two or more chronic conditions, presenting an opportunity for experiential PPI training. This study aimed to evaluate the process and impact of embedding PPI training in a structured PhD programme. METHODS This study was a longitudinal mixed-methods evaluation, conducted over 24 months (June 2020 to June 2022). A process evaluation provided an understanding of how PPI was embedded and explored the experiences of key stakeholders involved. An impact evaluation assessed the impact of embedding PPI training in the programme. Participants included PhD scholars, PPI contributors and PhD supervisors. The data collection and analysis was led by an independent researcher not aligned with the CDA-MM. Data collection methods included five focus groups, individual interviews (n = 6), an impact log, activity logs and group reflections. Qualitative data were analysed using thematic and content analysis and quantitative data analysed using descriptive statistics. RESULTS Embedding formal and experiential PPI training in a structured PhD programme is feasible. Both approaches to training are fundamental to building PPI capacity. Involvement of an experienced and knowledgeable PPI lead throughout is perceived as critical. The PPI panel approach offered a good example of embedded consultation and worked well in a structured PhD programme, providing PhD scholars with ample opportunities for learning about PPI and its implementation. For PPI contributors, culture was the most important indicator of quality and was positively evaluated. Key roles for PhD supervisors were identified. Embedding formal and experiential PPI training impacted positively on many different aspects of individual PhD research projects and on PhD scholars as researchers. There were positive impacts for PPI contributors and PhD supervisors. CONCLUSIONS Embedding formal and experiential PPI training in a structured PhD programme is a novel approach. The evaluation has identified a number of lessons that can inform future doctoral programmes seeking to embed formal and experiential PPI training.
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Affiliation(s)
- Maria Pierce
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Louise Foley
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Bridget Kiely
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Aisling Croke
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - James Larkin
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Susan M Smith
- Discipline of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Barbara Clyne
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Edel Murphy
- PPI Ignite Network, University of Galway, Galway, Ireland.
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Chiwanga FS, Woodford J, Masika GM, Richards DA, Savi V, von Essen L. An mHealth Intervention to Improve Guardians' Adherence to Children's Follow-Up Care for Acute Lymphoblastic Leukemia in Tanzania (GuardiansCan Project): Protocol for a Development and Feasibility Study. JMIR Res Protoc 2023; 12:e48799. [PMID: 37403706 PMCID: PMC10433028 DOI: 10.2196/48799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/13/2023] [Accepted: 07/05/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Cancer is a leading cause of death during childhood and in low- and middle-income countries survival rates can be as low as 20%. A leading reason for low childhood cancer survival rates in low- and middle-income countries such as Tanzania is treatment abandonment. Contributing factors include poor communication between health care providers and children's guardians, insufficient cancer knowledge, and psychological distress. OBJECTIVE Our aim is to respond to Tanzanian guardians' poor adherence to children's follow-up care after treatment for acute lymphoblastic leukemia with the help of mobile health (mHealth) technology. Our goal is to increase guardians' adherence to children's medications and follow-up visits and to decrease their psychological distress. METHODS Following the Medical Research Council framework for developing and evaluating complex interventions, we will undertake the GuardiansCan project in an iterative phased approach to develop an mHealth intervention for subsequent testing. Public contribution activities will be implemented throughout via the establishment of a Guardians Advisory Board consisting of guardians of children with acute lymphoblastic leukemia. We will examine the acceptability, feasibility, and perceived impact of Guardians Advisory Board activities via an impact log and semistructured interviews (study I). In phase 1 (intervention development) we will explore guardians' needs and preferences for the provision of follow-up care reminders, information, and emotional support using focus group discussions and photovoice (study II). We will then co-design the mHealth intervention with guardians, health care professionals, and technology experts using participatory action research (study III). In phase 2 (feasibility), we will examine clinical, methodological, and procedural uncertainties associated with the intervention and study procedures to prepare for the design and conduct of a future definitive randomized controlled trial using a single-arm pre-post mixed methods feasibility study (study IV). RESULTS Data collection for the GuardiansCan project is anticipated to take 3 years. We plan to commence study I by recruiting Guardians Advisory Board members in the autumn of 2023. CONCLUSIONS By systematically following the intervention development and feasibility phases of the Medical Research Council Framework, and working alongside an advisory board of guardians, we intend to develop an acceptable, culturally appropriate, feasible, and relevant mHealth intervention with the potential to increase guardians' adherence to children's follow-up care after treatment of acute lymphoblastic leukemia, leading to a positive impact on children's health and chances to survive, and reducing distress for guardians. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48799.
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Affiliation(s)
- Faraja S Chiwanga
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
- Directorate of Medical Services, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania
| | - Joanne Woodford
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
| | - Golden M Masika
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
- Department of Clinical Nursing, University of Dodoma, Dodoma, United Republic of Tanzania
| | - David A Richards
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Victor Savi
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Department of Women's and Children's health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden
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Minheere A, Lambrechts W, Mampaey J, Stough T, Caniëls MCJ, Semeijn J. Patient Power and Empowerment: Mitigating Elements of Valuable Patient Participation in Healthcare Collaboratives. Behav Sci (Basel) 2023; 13:bs13040347. [PMID: 37102861 PMCID: PMC10136329 DOI: 10.3390/bs13040347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/22/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
During the last decade, the public healthcare sector has had to deal with increased competition, a growing influence of patient associations, and a necessity to deliver health services more efficiently and effectively. Despite recognising the patient participant's role as a critical stakeholder in value creation, there is a limited body of research on the influence and power of patient participants. This article focuses on regional health improvement collaboratives that aim to develop coordinated, multi-stakeholder solutions to their healthcare cost and quality problems. They meet regularly and include health professionals, health insurance providers, and patient participants. In this article, we explore the relationships between these stakeholders and patient participants' interpersonal dimensions regarding empowerment and valuable collaboration. Data were collected through stakeholder observations during meetings of three regional health improvement collaboratives, as well as through semi-structured interviews with the patient participants involved in these cases. Results show that patient participants can be empowered on a personal level. However, this does not imply that patient participants are empowered within the group dynamics. Interpersonal relationships constitute a crucial hidden aspect of building trust. More dialogue and inquiry are needed to examine how patient engagement is enacted and positioned within healthcare collaboratives.
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Affiliation(s)
- Anja Minheere
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Wim Lambrechts
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Jelle Mampaey
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Talia Stough
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Marjolein C J Caniëls
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
| | - Janjaap Semeijn
- Faculty of Management, Open Universiteit of the Netherlands, 6419 AT Heerlen, The Netherlands
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McVey L, Frost T, Issa B, Davison E, Abdulkader J, Randell R, Alvarado N, Zaman H, Hardiker N, Cheong VL, Woodcock D. Working together: reflections on how to make public involvement in research work. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:14. [PMID: 36966339 PMCID: PMC10039333 DOI: 10.1186/s40900-023-00427-4] [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: 11/15/2022] [Accepted: 03/16/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The importance of involving members of the public in the development, implementation and dissemination of research is increasingly recognised. There have been calls to share examples of how this can be done, and this paper responds by reporting how professional and lay researchers collaborated on a research study about falls prevention among older patients in English acute hospitals. It focuses on how they worked together in ways that valued all contributions, as envisaged in the UK standards for public involvement for better health and social care research. METHODS The paper is itself an example of working together, having been written by a team of lay and professional researchers. It draws on empirical evidence from evaluations they carried out about the extent to which the study took patient and public perspectives into account, as well as reflective statements they produced as co-authors, which, in turn, contributed to the end-of-project evaluation. RESULTS Lay contributors' deep involvement in the research had a positive effect on the project and the individuals involved, but there were also difficulties. Positive impacts included lay contributors focusing the project on areas that matter most to patients and their families, improving the quality and relevance of outcomes by contributing to data analysis, and feeling they were 'honouring' their personal experience of the subject of study. Negative impacts included the potential for lay people to feel overwhelmed by the challenges involved in achieving the societal or organisational changes necessary to address research issues, which can cause them to question their rationale for public involvement. CONCLUSIONS The paper concludes with practical recommendations for working together effectively in research. These cover the need to discuss the potential emotional impacts of such work with lay candidates during recruitment and induction and to support lay people with these impacts throughout projects; finding ways to address power imbalances and practical challenges; and tips on facilitating processes within lay groups, especially relational processes like the development of mutual trust.
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Affiliation(s)
- Lynn McVey
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Tina Frost
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Basma Issa
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Eva Davison
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Jamil Abdulkader
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Rebecca Randell
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Natasha Alvarado
- Faculty of Health Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Hadar Zaman
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | - V.-Lin Cheong
- Pharmacist Elderly and Interfaces of Care, Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust and School of Healthcare, University of Leeds, Leeds, UK
| | - David Woodcock
- Pharmacist Elderly and Interfaces of Care, Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust and School of Healthcare, University of Leeds, Leeds, UK
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Atkinson T, Brown E, Jones G, Sage K, Wang X. "I Assumed It Would Be Somebody Who Had a Stroke That Was Doing This": Views of Stroke Survivors, Caregivers, and Health Professionals on Tailoring a Relaxation and Mindfulness Intervention. Healthcare (Basel) 2023; 11:healthcare11030399. [PMID: 36766974 PMCID: PMC9914663 DOI: 10.3390/healthcare11030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023] Open
Abstract
Stroke survivors and informal caregivers experience high levels of stress and anxiety, linked to heightened risk of secondary stroke in survivors. Relaxation and mindfulness could reduce stress and anxiety; being most effective when tailored to the target populations. Aims of the PPI include to: (1) consult on possible alterations to an existing relaxation and mindfulness intervention, delivered via YouTube/DVD and (2) discuss relevance and preference of prompts and cues designed to facilitate the daily practice of the intervention. Eleven UK PPI contributors were consulted during 2020: four stroke survivors (F = 2, M = 2), three caregivers (F = 1, M = 2), and four HCPs (F = 4) (range = 23-63 years). Contributors watched the existing intervention and provided feedback via online discussions. Transcripts were analysed using thematic analysis. Five themes were identified, highlighting several necessary alterations to the intervention: "Who represents the stroke population?"; "The paradox of age"; "Specifically selected language"; "Visual presentation of the intervention"; and the "Audio qualities". Contributors ranked the prompts and cues in order of preference with setting alarms and email alerts as the most popular. The PPI consultations resulted in several alterations enabling a revised version of the intervention. Including a PPI consultation at an early stage of the research improves the relevance and appropriateness of the research. The revised intervention is more representative of the stroke population thus more likely to be practised by survivors and caregivers, which will enhance the extent of effectiveness, reducing the risk of a secondary stroke.
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Affiliation(s)
- Thomas Atkinson
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
- Correspondence:
| | - Emma Brown
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Georgina Jones
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Karen Sage
- Applied Clinical Research, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Xu Wang
- Psychology, Leeds School of Social Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
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Lauzon-Schnittka J, Audette-Chapdelaine S, Boutin D, Wilhelmy C, Auger AM, Brodeur M. The experience of patient partners in research: a qualitative systematic review and thematic synthesis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:55. [PMID: 36192817 PMCID: PMC9528123 DOI: 10.1186/s40900-022-00388-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 09/16/2022] [Indexed: 05/26/2023]
Abstract
CONTEXT Patient engagement in research consists in involving patients as partners across the research cycle. This practice has quickly become an international standard, with funding bodies actively encouraging it. As the increased incentive to engage patients can lead to tokenistic partnerships, it is important to consider the experiences of patient-partners. OBJECTIVE To synthesize the qualitative literature on the experience of patients as partners in research. DESIGN A systematic review of the literature with thematic synthesis was realized, guided by the framework developed by Thomas and Harden (Bmc Med Res Methodol 8: 45, 2008). DATA COLLECTION A search strategy was developed to encompass keywords relating to patient-partners in research, their experience, and the qualitative nature of the target studies. 10 databases were searched using the EBSCO-host engine, along with the Scopus engine to include EMBASE. The search results were screened for the following inclusion criteria: articles written in English; articles reporting on the experience of patient-partners in research; qualitative studies or mixed-methods studies with a distinct qualitative section. ANALYSIS Included articles were charted for general information. The CASP qualitative checklist was used for critical appraisal. The "results" section of each article was coded line by line. Codes were aggregated inductively to form descriptive themes and analytical themes, in order to synthesize the ideas found in the selection of articles. RESULTS The initial search yielded 10,222 results. After the removal of duplicates, 5534 titles and abstracts were screened, 88 full-text reports were evaluated, and 41 studies were included. Articles reporting on these studies were published between 2005 and 2020. Seven themes emerged from the analysis: "motivations to engage in research", "activities in patient engagement", "structure", "competence", "team dynamics", "impacts on broader life", and "illness". Articles reported varying degrees of perceived impact on research and satisfaction concerning the level of engagement. The importance of power differentials and team dynamics were widely stated. CONCLUSIONS Findings provide an in-depth view of the experiences of patient-partners in research. Most articles reported a generally positive experience, but challenges and pitfalls of patient engagement were identified. This will serve research teams by highlighting good practices and possible improvements.
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Affiliation(s)
| | - Sophie Audette-Chapdelaine
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Denis Boutin
- Comité Stratégique Patient-Partenaire, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Catherine Wilhelmy
- Comité Stratégique Patient-Partenaire, Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Anne-Marie Auger
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Magaly Brodeur
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Département de Médecine Familiale et de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada.
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A report on parent involvement in planning a randomised controlled trial in neonatology and lactation – insights for current and future research. Int Breastfeed J 2022; 17:69. [PMID: 36104819 PMCID: PMC9472727 DOI: 10.1186/s13006-022-00509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patient and Public Involvement (PPI) is a rich and valuable part of the process of planning, designing, carrying out and disseminating research. It is important to communicate PPI findings in detail so that the contributions of those involved are fully utilised and disseminated. The extended and iterative PPI process used within a neonatal randomised controlled trial related to the expression of breastmilk after very preterm birth is reported here. Methods Seven iterative stages of PPI were used. Stage 1 was informal PPI using historical interaction with parents and publicly available resources. Stage 2 was an online questionnaire open to parents of premature babies and advertised via a charity collaborator. Stage 3 was partnership with a charity collaborator. Stage 4 was a set of online panels focusing on study design and documents. Stage 5 was an interactive exercise to modify the trial intervention. Stage 6 is the presence of PPI contributors on the trial steering committee. Stage 7 is a dissemination panel. At each stage attention was paid to the diversity of participants involved, with strategies to increase the involvement of parents from under-reached groups. Results Six hundred and seventy-five participants responded at Stage 2, six parents were involved at Stage 4 and 12 parents at Stage 5. PPI contributed to the choice of study question, outcomes and produced a set of questions for future research. PPI impacted on the study design, with specific emphasis on reducing participant distress related to lactation, and reducing the burden of being involved in research at a time of significant stress. Conclusions PPI had a far-reaching influence on this neonatal randomised controlled trial during the planning and design phase, which reinforces the importance of PPI at the earliest stages of the research cycle. The online questionnaire format elicited an unexpectedly deep and broad pool of transferable insights, which will have an impact on future research focus and design in the area of lactation and prematurity. Approaches to increasing PPI involvement from under-reached populations are important and can be successful despite resource constraints. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00509-1.
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Charalambous M, Kountouri A, Phylactou P, Triantafyllidou I, Annoni JM, Kambanaros M. The views of people living with chronic stroke and aphasia on their potential involvement as research partners: a thematic analysis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:48. [PMID: 36064623 PMCID: PMC9446531 DOI: 10.1186/s40900-022-00379-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) is the active partnership between researchers, patients and laypeople in the process of creating research. PPI in stroke aphasia research aims to ensure equal opportunities for informed decision-making and guarantee democratic representation of patient partners within the research team. Yet, little is known about the factors that hinder and/or promote the autonomous involvement of people with aphasia in stroke and aphasia PPI projects. This study aimed to explore the views and perspectives of people who live with chronic stroke, with and without aphasia, with experience in research prior to stroke, on their potential involvement as research partners. METHODS The research team included a PPI partner with chronic stroke-induced aphasia. Semi-structured interviews were conducted online with people with chronic stroke (n = 8), four with aphasia and four without. Interviews were subject to thematic analysis. RESULTS Inductive thematic analysis generated four themes: (1) the kinds of Restrictions that make involvement in research difficult, (2) the preferred levels and ways of Involvement during the research process, (3) the Support required for active and collaborative involvement, and (4) the Impact of their involvement and how it benefits the study's outcomes. CONCLUSION People experiencing chronic stroke and aphasia are willing to be involved as PPI partners if the research team provides the necessary support. Recommendations for researchers to consider before commencing co-produced research with people with stroke and aphasia are provided.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Alexia Kountouri
- Solidarity Network Nicosia In Action” (NicInAct), Multifunctional Foundation, Nicosia Municipality, Eptanisou 11, 1016 Nicosia, Cyprus
| | - Phivos Phylactou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Ioanna Triantafyllidou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
| | - Maria Kambanaros
- Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
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11
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Gibbins KJ, Lo JO. What Matters to Whom: Patient and Public Involvement in Research. Clin Obstet Gynecol 2022; 65:268-276. [PMID: 35476620 PMCID: PMC9060323 DOI: 10.1097/grf.0000000000000694] [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: 11/26/2022]
Abstract
We outline a call to action for reproductive health researchers to include patient and public involvement (PPI) in research. PPI prioritizes the patient perspective from study design through dissemination of results which centers the people research intends to serve. PPI highlights the patient as an expert in their own condition. PPI that includes groups harmed by health care disparities can draw attention to these harms and generate novel approaches to address them. Numerous frameworks exist for the use of PPI in research. Because obstetrics and gynecology conditions can be particularly sensitive, PPI is crucial in our field.
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12
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Murphy M, Wong G, Scott A, Wilson V, Salisbury C. The person-based development and realist evaluation of a summary report for GP consultations. NIHR OPEN RESEARCH 2022; 2:20. [PMID: 35935674 PMCID: PMC7613240 DOI: 10.3310/nihropenres.13258.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Use of telephone, video and e-consultations is increasing. These can make consultations more transactional. This study aimed to develop a complex intervention to address patients’ concerns more comprehensively in general practice and test the feasibility of this in a cluster-randomised framework. The complex intervention used two technologies: a patient-completed pre-consultation form used at consultation opening and a doctor-provided summary report provided at consultation closure. This paper reports on the development and realist evaluation of the summary report. Methods A person-based approach was used to develop the summary report. An electronic protocol was designed to automatically generate the report after GPs complete a clinical template in the patient record. This was tested with 45 patients in 3 rounds each, with iterative adjustments made based on feedback after each round. Subsequently, an intervention incorporating the pre-consultation form with the summary report was then tested in a cluster-randomised framework with 30 patients per practice in six practices: four randomised to intervention, and two to control. An embedded realist evaluation was carried out. The main feasibility study results are reported elsewhere. Results Conclusions The person-based approach was successful. The summary report creates clarity, empowerment and reassurance in certain consultations and patients. As it takes a few minutes per patient, GPs prefer to select patients who will benefit most.
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13
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Aguayo GA, Goetzinger C, Scibilia R, Fischer A, Seuring T, Tran VT, Ravaud P, Bereczky T, Huiart L, Fagherazzi G. Methods to Generate Innovative Research Ideas and Improve Patient and Public Involvement in Modern Epidemiological Research: Review, Patient Viewpoint, and Guidelines for Implementation of a Digital Cohort Study. J Med Internet Res 2021; 23:e25743. [PMID: 34941554 PMCID: PMC8738987 DOI: 10.2196/25743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/16/2021] [Accepted: 10/08/2021] [Indexed: 01/20/2023] Open
Abstract
Background Patient and public involvement (PPI) in research aims to increase the quality and relevance of research by incorporating the perspective of those ultimately affected by the research. Despite these potential benefits, PPI is rarely included in epidemiology protocols. Objective The aim of this study is to provide an overview of methods used for PPI and offer practical recommendations for its efficient implementation in epidemiological research. Methods We conducted a review on PPI methods. We mirrored it with a patient advocate’s viewpoint about PPI. We then identified key steps to optimize PPI in epidemiological research based on our review and the viewpoint of the patient advocate, taking into account the identification of barriers to, and facilitators of, PPI. From these, we provided practical recommendations to launch a patient-centered cohort study. We used the implementation of a new digital cohort study as an exemplary use case. Results We analyzed data from 97 studies, of which 58 (60%) were performed in the United Kingdom. The most common methods were workshops (47/97, 48%); surveys (33/97, 34%); meetings, events, or conferences (28/97, 29%); focus groups (25/97, 26%); interviews (23/97, 24%); consensus techniques (8/97, 8%); James Lind Alliance consensus technique (7/97, 7%); social media analysis (6/97, 6%); and experience-based co-design (3/97, 3%). The viewpoint of a patient advocate showed a strong interest in participating in research. The most usual PPI modalities were research ideas (60/97, 62%), co-design (42/97, 43%), defining priorities (31/97, 32%), and participation in data analysis (25/97, 26%). We identified 9 general recommendations and 32 key PPI-related steps that can serve as guidelines to increase the relevance of epidemiological studies. Conclusions PPI is a project within a project that contributes to improving knowledge and increasing the relevance of research. PPI methods are mainly used for idea generation. On the basis of our review and case study, we recommend that PPI be included at an early stage and throughout the research cycle and that methods be combined for generation of new ideas. For e-cohorts, the use of digital tools is essential to scale up PPI. We encourage investigators to rely on our practical recommendations to extend PPI in future epidemiological studies.
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Affiliation(s)
- Gloria A Aguayo
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Catherine Goetzinger
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Renza Scibilia
- Diabetes Australia, Melbourne, Australia.,Diabetogenic, Melbourne, Australia
| | - Aurélie Fischer
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Till Seuring
- Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Viet-Thi Tran
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tamás Bereczky
- European Patients' Academy on Therapeutic Innovation, Brussels, Belgium
| | - Laetitia Huiart
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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14
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Finucane E, O'Brien A, Treweek S, Newell J, Das K, Chapman S, Wicks P, Galvin S, Healy P, Biesty L, Gillies K, Noel-Storr A, Gardner H, O'Reilly MF, Devane D. Does reading a book in bed make a difference to sleep in comparison to not reading a book in bed? The People's Trial-an online, pragmatic, randomised trial. Trials 2021; 22:873. [PMID: 34996514 PMCID: PMC8740874 DOI: 10.1186/s13063-021-05831-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The best way of comparing healthcare treatments is through a randomised trial. In a randomised trial, we compare something (a treatment or intervention) to something else, often another treatment. Who gets what is decided at random, meaning everyone has an equal chance of getting any of the treatments. This means any differences found can be put down to the treatment received rather than other things, such as where people live, or health conditions they might have. The People's Trial aimed to help the public better understand randomised trials by inviting them to design and carry out a trial. The question chosen by the public for The People's Trial was: 'Does reading a book in bed make a difference to sleep, in comparison to not reading a book in bed?' This paper describes that trial, called 'The Reading Trial'. METHODS The Reading Trial was an online, randomised trial. Members of the public were invited to take part through social media campaigns. People were asked to either read a book in bed before going to sleep (intervention group) or not read a book in bed before going to sleep (control group). We asked everyone to do this for 7 days, after which they measured their sleep quality. RESULTS During December 2019, a total of 991 people took part in The Reading Trial, half (496 (50%)) in the intervention group and half (495 (50%)) in the control group. Not everyone finished the trial: 127 (25.6%) people in the intervention group and 90 (18.18%) people in the control group. Of those providing data, 156/369 (42%) people in the intervention group felt their sleep improved, compared to 112/405 (28%) of those in the control group, a difference of 14%. When we consider how certain we are of this finding, we estimate that, in The Reading Trial, sleep improved for between 8 and 22% more people in the intervention group compared to the control group. CONCLUSIONS Reading a book in bed before going to sleep improved sleep quality, compared to not reading a book in bed. TRIAL REGISTRATION ClinicalTrials.gov NCT04185818. Registered on 4 December 2019.
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Affiliation(s)
- Elaine Finucane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland. .,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland. .,Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
| | - Ann O'Brien
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Shaun Treweek
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - John Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Kishor Das
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Sarah Chapman
- Cochrane UK, hosted by Oxford University Hospitals NHS Foundation Trust, and funded by the National Institute for Health Research, London, UK
| | - Paul Wicks
- Wicks Digital Health, Lichfield, England, UK
| | - Sandra Galvin
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Patricia Healy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Linda Biesty
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Katie Gillies
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - Anna Noel-Storr
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Heidi Gardner
- Health Services Research Unit, Health Sciences Building, University of Aberdeen, Forester Hill, Aberdeen, AB25 2ZD, UK
| | - Mary Frances O'Reilly
- Formerly - Nursing and Midwifery Planning and Development Unit, West Mid-West, Merlin Park University Hospital, Galway, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Cochrane Ireland, National University of Ireland Galway, Galway, Ireland
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15
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Selman LE, Clement C, Douglas M, Douglas K, Taylor J, Metcalfe C, Lane JA, Horwood J. Patient and public involvement in randomised clinical trials: a mixed-methods study of a clinical trials unit to identify good practice, barriers and facilitators. Trials 2021; 22:735. [PMID: 34688304 PMCID: PMC8542312 DOI: 10.1186/s13063-021-05701-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/08/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND While patient and public involvement (PPI) in clinical trials is beneficial and mandated by some funders, formal guidance on how to implement PPI is limited and challenges have been reported. We aimed to investigate how PPI is approached within a UK Clinical Trials Unit (CTU)'s portfolio of randomised controlled trials, perceived barriers to/facilitators of its successful implementation, and perspectives on the CTU's role in PPI. METHODS A mixed-methods study design, involving (1) an online survey of 26 trial managers (TMs) and (2) Interviews with Trial Management Group members and public contributors from 8 case-study trials. Quantitative survey data were summarised using descriptive statistics and interview transcripts analysed thematically. Two public contributors advised throughout and are co-authors. RESULTS (1) 21 TMs completed the survey; (2) 19 in-depth interviews were conducted with public contributors (n=8), TMs (n=5), chief investigators (n=3), PPI coordinators (n=2) and a researcher. 15/21 TMs surveyed reported that a public contributor was on the trial team, and 5 used another PPI method. 12/21 TMs reported that public contributors were paid (range £10-50/h). 5 TMs reported that training was provided for public contributors and few staff members had received any formal PPI training. The most commonly reported tasks undertaken by public contributors were the review of participant-facing materials/study documents and advising on recruitment/retention strategies. Public contributors wanted and valued feedback on changes made due to their input, but it was not always provided. Barriers to successful PPI included recruitment challenges, group dynamics, maintaining professional boundaries, negative attitudes to PPI amongst some researchers, a lack of continuity of trial staff, and the academic environment. Successful PPI required early and explicit planning, sharing of power and ownership of the trial with public contributors, building and maintaining relationships, and joint understanding and clarity about expectations/roles. CTUs have an important role to play in supporting recruitment, signposting and coordinating PPI. CONCLUSIONS While highly valuable, PPI in trials is currently variable. PPI representatives are recruited informally, may not be provided with any training and are paid inconsistently across trials. Study findings can help optimise PPI in trials and ensure researchers and public contributors are adequately supported.
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Affiliation(s)
- Lucy Ellen Selman
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Clare Clement
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Margaret Douglas
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Keith Douglas
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jodi Taylor
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Chris Metcalfe
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - J Athene Lane
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jeremy Horwood
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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16
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Paddock K, Woolfall K, Frith L, Watkins M, Gamble C, Welters I, Young B. Strategies to enhance recruitment and consent to intensive care studies: a qualitative study with researchers and patient-public involvement contributors. BMJ Open 2021; 11:e048193. [PMID: 34551943 PMCID: PMC8461270 DOI: 10.1136/bmjopen-2020-048193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Clinical trials and studies in intensive care units (ICUs) have complex consent processes and often encounter problems in recruiting patients. By interviewing research team members about the challenges in critical care research, we aimed to identify strategies to enhance recruitment and consent to ICU studies. METHODS Semistructured interviews with UK-based researchers (N=17) and patient-public involvement (PPI) contributors (N=8) with experience of ICU studies. Analysis of transcripts of audio-recorded interviews drew on thematic approaches. RESULTS Seven themes were identified. Participants emphasised the need for substitute decision-making processes in critical care studies, yet some researchers reported that research ethics committees (RECs) were reluctant to approve such processes. Researchers spoke about the potential benefits of research without prior consent (RWPC) for studies with narrow recruitment windows but believed RECs would not approve them. Participants indicated that the activity of PPI contributors was limited in critical care studies, though researchers who had involved PPI contributors more extensively were clear that their input when designing consent processes was important. Researchers and PPI contributors pointed to resource and staffing limitations as barriers to patient recruitment. Researchers varied in whether and how they used professional consultees as substitute decision-makers, in whether they approached families by telephone to discuss research and in whether they disclosed details of research participation to bereaved relatives. CONCLUSION Critical care research could benefit from RECs having expertise in consent processes that are suited to this setting, better staffing at research sites, more extensive PPI and an evidence base on stakeholder perspectives on critical care research processes. Guidance on professional consultee processes, telephoning relatives to discuss research, RWPC and disclosure of research participation to bereaved relatives could help to harmonise practice in these areas and enhance recruitment and consent to critical care studies.
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Affiliation(s)
- Katie Paddock
- Faculty of Health and Education, School of Childhood, Youth and Education Studies, Manchester Metropolitan University, Manchester, UK
- Institute of Population Health, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Kerry Woolfall
- Institute of Population Health, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Lucy Frith
- Faculty of Humanities and Social Sciences, Department of Law and Philosophy, University of Liverpool, Liverpool, UK
| | - Megan Watkins
- Institute of Population Health, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Carrol Gamble
- Institute of Population Health, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Ingeborg Welters
- Institute of Life Course and Medical Science, University of Liverpool, Liverpool, UK
- Department of Critical Care, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Bridget Young
- Institute of Population Health, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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17
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McCarron TL, Clement F, Rasiah J, Moran C, Moffat K, Gonzalez A, Wasylak T, Santana M. Patients as partners in health research: A scoping review. Health Expect 2021; 24:1378-1390. [PMID: 34153165 PMCID: PMC8369093 DOI: 10.1111/hex.13272] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The role of patient involvement in health research has evolved over the past decade. Despite efforts to engage patients as partners, the role is not well understood. We undertook this review to understand the engagement practices of patients who assume roles as partners in health research. METHODS Using a recognized methodological approach, two academic databases (MEDLINE and EMBASE) and grey literature sources were searched. Findings were organized into one of the three higher levels of engagement, described by the Patient and Researcher Engagement framework developed by Manafo. We examined and quantified the supportive strategies used during involvement, used thematic analysis as described by Braun and Clarke and themed the purpose of engagement, and categorized the reported outcomes according to the CIHR Engagement Framework. RESULTS Out of 6621 records, 119 sources were included in the review. Thematic analysis of the purpose of engagement revealed five themes: documenting and advancing PPI, relevance of research, co-building, capacity building and impact on research. Improved research design was the most common reported outcome and the most common role for patient partners was as members of the research team, and the most commonly used strategy to support involvement was by meetings. CONCLUSION The evidence collected during this review advanced our understanding of the engagement of patients as research partners. As patient involvement becomes more mainstream, this knowledge will aid researchers and policy-makers in the development of approaches and tools to support engagement. PATIENT/USER INVOLVEMENT Patients led and conducted the grey literature search, including the synthesis and interpretation of the findings.
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Affiliation(s)
- Tamara L. McCarron
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Fiona Clement
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Jananee Rasiah
- Faculty of Nursing3‐141 Edmonton Clinic Health Academy (ECHA)University of AlbertaEdmontonABCanada
| | - Chelsea Moran
- The Department PsychologyUniversity of CalgaryCalgaryABCanada
| | - Karen Moffat
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
- Patient PartnerCalgaryABCanada
| | - Andrea Gonzalez
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Tracy Wasylak
- Alberta Health ServicesCalgaryABCanada
- Faculty of NursingUniversity of CalgaryCalgaryABCanada
| | - Maria Santana
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
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18
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Svedin F, Brantnell A, Farrand P, Blomberg O, Coumoundouros C, von Essen L, Åberg AC, Woodford J. Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA): a study protocol using codesign and participatory action research. BMJ Open 2021; 11:e048097. [PMID: 34272221 PMCID: PMC8287613 DOI: 10.1136/bmjopen-2020-048097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Dementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context. METHODS AND ANALYSIS A mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings. ETHICS AND DISSEMINATION The study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.
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Affiliation(s)
- Frida Svedin
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anders Brantnell
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Division of Industrial Engineering and Management, Department of Civil and Industrial Engineering, Uppsala University, Uppsala, Sweden
| | - Paul Farrand
- Clinical Education Development and Research (CEDAR), University of Exeter, Exeter, Devon, UK
| | - Oscar Blomberg
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Cristina Åberg
- Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Medical Science, School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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19
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Foley L, Kiely B, Croke A, Larkin J, Smith SM, Clyne B, Pierce M, Murphy E. A protocol for the evaluation of the process and impact of embedding formal and experiential Public and Patient Involvement training in a structured PhD programme. JOURNAL OF COMORBIDITY 2021; 11:26335565211024793. [PMID: 34262878 PMCID: PMC8243087 DOI: 10.1177/26335565211024793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 11/17/2022]
Abstract
Background: Incorporating Public and Patient Involvement (PPI) into doctoral research is
valued by PhD scholars. The importance of providing early career researchers
with appropriate education and training to develop skills to conduct
meaningful involvement has been articulated. The Collaborative Doctoral
Award in MultiMorbidity (CDA-MM) PhD programme embedded formal PPI training
as a postgraduate education component. Four PhD scholars taking part in the
CDA-MM established a PPI panel comprising people, and carers of people,
living with multimorbidity (≥2 chronic conditions), presenting an
opportuning for experiential PPI training. The proposed study aims to
evaluate the process and impact of formal and experiential PPI training
during a PhD programme. Design: Embedding PPI training in a PhD programme is a novel approach. This
evaluation will include a process evaluation to provide an understanding of
the workings of the PPI panel and explore the experiences of key
stakeholders involved, and an impact evaluation to assess the impact of
embedding PPI training in a PhD programme. This study is a longitudinal
mixed-methods evaluation, conducted over 24 months. Participants include PhD
scholars, PPI contributors and PhD supervisors. An independent researcher
not aligned with the CDA-MM will lead the evaluation. Data collection
methods include focus groups, individual interviews, an impact log and group
reflections. Qualitative data will be analysed using thematic and content
analysis and quantitative data will be analysed using descriptive
statistics. Discussion: This evaluation will report the learnings from embedding formal and
experiential PPI training and education across a PhD programme.
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Affiliation(s)
- Louise Foley
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Bridget Kiely
- HRB Centre for Primary Care Research, Royal College of Surgeons, Dublin, Ireland
| | - Aisling Croke
- HRB Centre for Primary Care Research, Royal College of Surgeons, Dublin, Ireland
| | - James Larkin
- HRB Centre for Primary Care Research, Royal College of Surgeons, Dublin, Ireland
| | - Susan M Smith
- HRB Centre for Primary Care Research, Royal College of Surgeons, Dublin, Ireland
| | - Barbara Clyne
- HRB Centre for Primary Care Research, Royal College of Surgeons, Dublin, Ireland
| | | | - Edel Murphy
- PPI Ignite Network, National University of Ireland Galway, Galway, Ireland
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The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation. CHILDREN-BASEL 2021; 8:children8060526. [PMID: 34205496 PMCID: PMC8235222 DOI: 10.3390/children8060526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 01/01/2023]
Abstract
The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.
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Beaubrun en Famille Diant L, Durand MA, Witkowski V, Dordonne Honore M, Clastres N, Linon C, Journet P, Netens B, Lamouroux A. Les défis de l’inclusion des patients et du public dans la recherche interventionnelle pour lutter contre les inégalités sociales de santé. Glob Health Promot 2021. [DOI: 10.1177/1757975921991080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
L’implication des patients et du public (IPP) dans la recherche interventionnelle est incontournable mais présente des défis à relever. L’IPP requiert une réflexion éthique et collégiale en amont de la conception de l’étude, des moyens et une gouvernance adaptée afin de tenir compte des enjeux collectifs et individuels qui sous-tendent ce nouveau partenariat.
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Affiliation(s)
- Laury Beaubrun en Famille Diant
- Docteure en psychologie, psychologue clinicienne, Laboratoire Centre d’études et de recherche en psychopathologie et santé (CERPPS) (EA741), Université Toulouse II Jean Jaurès, Toulouse, France
| | - Marie-Anne Durand
- Chercheure, UMR 1295, Centre d’épidémiologie et de recherche en santé des Populations (CERPOP), équipe EQUITY, Université Toulouse III - Paul Sabatier, France. Professeure associée adjointe, Dartmouth College, Lebanon, USA. Adjointe scientifique, Unisanté, Lausanne, Suisse
| | - Veronique Witkowski
- Patient-expert, Aix-Marseille Université, Marseille, Provence-Alpes-Côte d’Azur, France
| | | | | | - Carole Linon
- Patient-expert, Aix-Marseille Université, Marseille, Provence-Alpes-Côte d’Azur, France
| | - Pascale Journet
- Patient-expert, Aix-Marseille Université, Marseille, Provence-Alpes-Côte d’Azur, France
| | - Béatrice Netens
- Patient-expert, Aix-Marseille Université, Marseille, Provence-Alpes-Côte d’Azur, France
| | - Aurore Lamouroux
- Assistance Publique des Hôpitaux de Marseille, Marseille, France. CoDES 84, Avignon, France
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Madden JM, Foxworth PM, Ross-Degnan D, Allen KG, Busch AB, Callahan MX, Lu CY, Wharam JF. Integrating Stakeholder Engagement With Claims-Based Research on Health Insurance Design and Bipolar Disorder. Psychiatr Serv 2021; 72:186-194. [PMID: 33167814 DOI: 10.1176/appi.ps.202000177] [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: 11/30/2022]
Abstract
Researchers increasingly recognize that stakeholder involvement enhances research relevance and validity. However, reports of patient engagement in research that relies on administrative records data are rare. The authors' collaborative project combined quantitative and qualitative studies of costs and access to care among U.S. adults with employer-sponsored insurance. The authors analyzed insurance claims to estimate the impacts on enrollee costs and utilization after patients with bipolar disorder were switched from traditional coverage to high-deductible health plans. In parallel, in-depth interviews explored people's experiences accessing treatment for bipolar disorder. Academic investigators on the research team partnered with the Depression and Bipolar Support Alliance (DBSA), a national advocacy organization for people with mood disorders. Detailed personal stories from DBSA-recruited volunteers informed and complemented the claims analyses. Several DBSA audience forums and a stakeholder advisor panel contributed regular feedback on study issues. These multiple engagement modes drew inputs of varying intensity from diverse community segments. Efforts to include new voices must acknowledge individuals' distinct interests and barriers to research participation. Strong engagement leadership roles ensure productive communication between researchers and stakeholders. The involvement of people with direct experience of care is especially necessary in research that uses secondary data. Longitudinal, adaptable partnerships enable colearning and higher-quality research that captures the manifold dimensions of patient experiences.
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Affiliation(s)
- Jeanne M Madden
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Phyllis M Foxworth
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Dennis Ross-Degnan
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Kimberly G Allen
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Alisa B Busch
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Matthew X Callahan
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - Christine Y Lu
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
| | - James F Wharam
- Department of Pharmacy and Health Systems Sciences, Northeastern University, Boston (Madden); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Madden, Ross-Degnan, Callahan, Lu, Wharam); Depression and Bipolar Support Alliance, Chicago (Foxworth, Allen); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch)
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Heckel M, Meesters S, Schildmann E, Ostgathe C. [Patient and public involvement (PPI) in palliative care research]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 158-159:107-113. [PMID: 33229253 DOI: 10.1016/j.zefq.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 09/15/2020] [Accepted: 10/07/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patient and public participation in health research is of increasing social importance. The participation of citizens (patients, their next or interested parties) is not yet structurally anchored in Germany. This manuscript aims to present and to discuss first experiences with patient and public involvement in two palliative care centers. METHODS In two centers, a general patient and public involvement committee (Erlangen) and a project-associated patient and public involvement group (Munich) were founded. Strategies for recruitment of potential members (public lectures, personal contact, information on the website, leaflets) were developed and applied. Sociodemographic data and motivations were assessed using survey and personal communication. 18 months after foundation citizens were asked to give feedback on participation during personal meetings. RESULTS The 20 members of the PPI committee (14 female) are between 52 and 86 years old in Erlangen. The PPI group in Munich has 7 members (5 female). Motivations to contribute are, for example, gratefulness for the care of a relative or the wish to share occupational competencies for a good purpose. Voluntary participation took place by consulting the research teams. Consultation was, among others, performed in joint sessions with brainstorming, moderated group discussions, piloting and commenting interview guides, texts or website content. Participation improved the quality of study material and data assessment instruments. Citizens appreciated that they were able to gain new information and meet people from different fields. They partly wished there was a more detailed preparation and debriefing after joint meetings. The research teams did not quantify the considerable staff and time expenses. DISCUSSION The recruitment strategies used have proved successful, and the experiences so far indicate a positive impact of PPI on research in the field of palliative care. Research is needed to evaluate the resources required and the effect of PPI in palliative care. On a structural level, discussion of PPI as one specification of voluntary engagement in palliative care, centralized provision of general information on PPI in palliative care and the possibilities of exchange between PPI groups and researchers of different facilities, should take place. CONCLUSION There is a need for networking and exchange among researchers and citizens of different project groups with experience in PPI. An institutionalized provision of expertise would pave the way for PPI in palliative research.
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Affiliation(s)
- Maria Heckel
- Universität Erlangen Nürnberg, Forschungsstelle der Palliativmedizin, Erlangen, Deutschland.
| | - Sophie Meesters
- Klinikum der Universität München, LMU München, Klinik und Poliklinik für Palliativmedizin, München, Deutschland
| | - Eva Schildmann
- Klinikum der Universität München, LMU München, Klinik und Poliklinik für Palliativmedizin, München, Deutschland
| | - Christoph Ostgathe
- Universität Erlangen Nürnberg, Forschungsstelle der Palliativmedizin, Erlangen, Deutschland
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Gesell SB, Coleman SW, Mettam LH, Johnson AM, Sissine ME, Duncan PW. How engagement of a diverse set of stakeholders shaped the design, implementation, and dissemination of a multicenter pragmatic trial of stroke transitional care: The COMPASS study. J Clin Transl Sci 2020; 5:e60. [PMID: 33948280 PMCID: PMC8057438 DOI: 10.1017/cts.2020.552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022] Open
Abstract
Evidence is limited on how to synthesize and incorporate the views of stakeholders into a multisite pragmatic trial and how much academic teams change study design and protocol in response to stakeholder input. This qualitative study describes how stakeholders contributed to the design, conduct, and dissemination of findings of a multisite pragmatic clinical trial, the COMprehensive Post-Acute Stroke Services (COMPASS) Study. We engaged stakeholders as integral research partners by embedding them in study committees and community resource networks that supported local sites. Data stemmed from formal focus groups and continuous participation in working groups. Guided by Grounded Theory, we extracted themes from focus group and meeting notes. These were discussed as a team and with other stakeholder groups for feasibility. A consensus approach was used. Stakeholder input changed many aspects of the study including: the care model that treated stroke as a chronic condition after hospital discharge, training for hospital-based providers who often lacked awareness of the barriers to recovery that patients face, support for caregivers who were essential for stroke patients' recovery, and for community-based health and social service providers whose services can support recovery yet often go underutilized. Stakeholders brought value to both pragmatic research and health service delivery. Future studies should test the impact of elements of study implementation informed by stakeholders vs those that are not.
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Affiliation(s)
- Sabina B. Gesell
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy & Department of Implementation Science, Division of Public Health Sciences, Winston-Salem, NC, USA
| | - Sylvia W. Coleman
- Wake Forest School of Medicine, Department of Neurology, Winston-Salem, NC, USA
| | - Laurie H. Mettam
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - Anna M. Johnson
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - Mysha E. Sissine
- Wake Forest School of Medicine, Department of Neurology, Winston-Salem, NC, USA
| | - Pamela W. Duncan
- Wake Forest School of Medicine, Department of Neurology, Winston-Salem, NC, USA
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García-Martín M, Amezcua-Prieto C, H Al Wattar B, Jørgensen JS, Bueno-Cavanillas A, Khan KS. Patient and Public Involvement in Sexual and Reproductive Health: Time to Properly Integrate Citizen's Input into Science. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218048. [PMID: 33142916 PMCID: PMC7663614 DOI: 10.3390/ijerph17218048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/17/2022]
Abstract
Evidence-based sexual and reproductive health is a global endeavor without borders. Inter-sectorial collaboration is essential for identifying and addressing gaps in evidence. Health research funders and regulators are promoting patient and public involvement in research, but there is a lack of quality tools for involving patients. Partnerships with patients are necessary to produce and promote robust, relevant and timely research. Without the active participation of women as stakeholders, not just as research subjects, the societal benefits of research cannot be realized. Creating and developing platforms and opportunities for public involvement in sexual and reproductive health research should be a key international objective. Cooperation between healthcare professionals, academic institutions and the community is essential to promote quality research and significant developments in women's health. This cooperation will be improved when involvement of citizens in the research process becomes standard.
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Affiliation(s)
- Miguel García-Martín
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Correspondence: ; Tel.: +34-95824100 (ext. 20287)
| | - Bassel H Al Wattar
- Reproductive Medicine Unit, Institute for Women’s Health, University College London Hospitals, London WC1E 6BT, UK;
- Warwick Medical School, University of Warwick, Coventry CV4 7 AL, UK
| | - Jan Stener Jørgensen
- Department of Obstetrics and Gynaecology CIMT-Centre for Innovative Medical Technologies Odense University Hospital, 5000 Odense C, Denmark;
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (M.G.-M.); (A.B.-C.); (K.S.K.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Charalambous M, Kambanaros M, Annoni JM. Are People with Aphasia (PWA) Involved in the Creation of Quality of Life and Aphasia Impact-Related Questionnaires? A Scoping Review. Brain Sci 2020; 10:E688. [PMID: 33003493 PMCID: PMC7600175 DOI: 10.3390/brainsci10100688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Quality of Life (QoL) questionnaires are used to describe the impact of aphasia on stroke survivors' life. People with aphasia (PWA) are traditionally excluded from research, potentially leading to a mismatch between the factors chosen in the tools and the realistic needs of PWA. The purpose of this review was to determine the direct involvement of PWA in the creation of QoL and aphasia impact-related questionnaires (AIR-Qs). METHODS A scoping review methodology was conducted by an expert librarian and two independent reviewers on health sciences based on the Preferred Reporting Items for Systematic Reviews and Metanalyses extension for Scoping Reviews (PRISMA-ScR) protocol, through a literature search in five databases: Medline Complete, PubMed, PsychINFO, Scopus, and Google Scholar. Search terms included 'stroke', 'people with aphasia', 'communication', 'well-being', and 'quality of life'. RESULTS Of 952 results, 20 studies met the eligibility criteria. Of these, only four AIR-Qs studies (20%) were found reporting the direct involvement of PWA, while no QoL tools did so. Evidence showed involvement in the creation phase of AIR-Q, mainly in a consultation role. CONCLUSIONS There is an absence of a framework for conducting and reporting the involvement of PWA in qualitative participatory research studies, which limits effectiveness to promote equitable best practice in aphasia rehabilitation.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, University of Fribourg, CH-1700 Fribourg, Switzerland;
| | - Maria Kambanaros
- Allied Health and Human Performance, University of South Australia, Adelaide SA 5001, Australia;
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, University of Fribourg, CH-1700 Fribourg, Switzerland;
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Vat LE, Warren M, Goold S, Davidge E(B, Porter N, Schuitmaker-Warnaar TJ, Broerse JEW, Etchegary H. Giving patients a voice: a participatory evaluation of patient engagement in Newfoundland and Labrador Health Research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:39. [PMID: 32670610 PMCID: PMC7350650 DOI: 10.1186/s40900-020-00206-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/20/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Efforts to engage patients as partners in health research have grown and thereby the need for feedback and evaluation. In this pilot evaluation study, we aimed to 1) evaluate patient engagement in health research projects in Newfoundland and Labrador, Canada, and 2) learn more about how to best monitor and evaluate patient engagement. This paper presents the results of our participatory evaluation study and the lessons learned. The evaluation of the projects was driven by questions patients wanted answered. METHODS We conducted a formative evaluation of patient engagement in health research projects. Projects spanned a variety of topics, target groups, research designs and methods of patient engagement. Participants included principal investigators (n = 6) and their patient partners (n = 14). Furthermore, graduate students (n = 13) working on their own research projects participated. Participants completed an online survey with closed and open-ended questions about their patient engagement efforts, experiences and preliminary outcomes. Patients were involved as co-investigators in the entire evaluation study. We used qualitative methods to evaluate our participatory process. RESULTS The evaluation study results show that most patients and researchers felt prepared and worked together in various phases of the research process. Both groups felt that the insights and comments of patients influenced research decisions. They believed that patient engagement improved the quality and uptake of research. Students felt less prepared and were less satisfied with their patient engagement experience compared to researchers and their patient partners. Involvement of patient co-investigators in this evaluation resulted in learnings, transparency, validation of findings and increased applicability. Challenges were to select evaluation questions relevant to all stakeholders and to adapt evaluation tools to local needs. CONCLUSIONS Our findings show that researchers, patient partners and students value patient engagement in health research. Capacity building at the supervisor level in academic institutions is needed to better support students. Sufficient time is also needed to permit observable outcomes. Participatory evaluation may increase the relevance and usefulness of information, but it also raises issues such as who defines and designs the content of evaluation tools. A co-creation process is required to develop appropriate monitoring and evaluation strategies.
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Affiliation(s)
- Lidewij Eva Vat
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Memorial University of Newfoundland, St. Johns, Canada
| | - Mike Warren
- NL SUPPORT Patient Advisory Council, Newfoundland and Labrador, Canada
| | - Susan Goold
- NL SUPPORT Patient Advisory Council, Newfoundland and Labrador, Canada
| | | | - Nicole Porter
- Government of Newfoundland and Labrador, St. Johns, Canada
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Arnstein L, Wadsworth AC, Yamamoto BA, Stephens R, Sehmi K, Jones R, Sargent A, Gegeny T, Woolley KL. Patient involvement in preparing health research peer-reviewed publications or results summaries: a systematic review and evidence-based recommendations. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:34. [PMID: 32587753 PMCID: PMC7313171 DOI: 10.1186/s40900-020-00190-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 03/31/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND There are increasing calls for patient involvement in sharing health research results, but no evidence-based recommendations to guide such involvement. Our objectives were to: (1) conduct a systematic review of the evidence on patient involvement in results sharing, (2) propose evidence-based recommendations to help maximize benefits and minimize risks of such involvement and (3) conduct this project with patient authors. METHODS To avoid research waste, we verified that no systematic reviews were registered or published on this topic. We co-created, with patients, a PRISMA-P-compliant protocol. We included peer-reviewed publications reporting the effects of patient involvement in preparing peer-reviewed publications or results summaries from health research studies. We searched (9/10/2017) MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews, and secondary information sources (until 11/06/2018). We assessed the risk of bias in eligible publications and extracted data using standardized processes. To evaluate patient involvement in this project, we co-created a Patient Authorship Experience Tool. RESULTS All nine eligible publications reported on patient involvement in preparing publications; none on preparing results summaries. Evidence quality was moderate. A qualitative synthesis of evidence indicated the benefits of patient involvement may outweigh the risks. We have proposed 21 evidence-based recommendations to help maximize the benefits and minimize the risks when involving patients as authors of peer-reviewed publications. The recommendations focus on practical actions patient and non-patient authors can take before (10 recommendations), during (7 recommendations) and after (4 recommendations) manuscript development. Using the Patient Authorship Experience Tool, both patient and non-patient authors rated their experience highly. CONCLUSIONS Based on a systematic review, we have proposed 21 evidence-based recommendations to help maximize the benefits and minimize the risks of involving patients as authors of peer-reviewed publications.
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Affiliation(s)
- Lauri Arnstein
- Envision the Patient – Envision Pharma Group, Suite 5.11, 5th Floor, 1 Lyric Square, London, W6 0NB UK
| | - Anne Clare Wadsworth
- Envision the Patient – Envision Pharma Group, Suite 5.11, 5th Floor, 1 Lyric Square, London, W6 0NB UK
- Alligent EU – Envision Pharma Group, Wilmslow, UK
| | - Beverley Anne Yamamoto
- Osaka University, Osaka, Japan
- Hereditary Angioedema Japan (Registered NPO), Hyogo, Japan
- Hereditary Angioedema International (Registered NPO/Charity), Fairfax City, VA USA
| | - Richard Stephens
- Consumer Forum, National Cancer Research Institute, London, UK
- Research Involvement and Engagement, London, UK
| | - Kawaldip Sehmi
- International Alliance of Patients’ Organizations, London, UK
| | | | | | | | - Karen L. Woolley
- Envision the Patient – Envision Pharma Group, Suite 5.11, 5th Floor, 1 Lyric Square, London, W6 0NB UK
- ProScribe KK – Envision Pharma Group, Tokyo, Japan
- University of Queensland, Brisbane, Queensland Australia
- University of the Sunshine Coast, Maroochydore DC, Queensland Australia
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Mitchell C, Burke K, Halford N, Rothwell K, Darley S, Woodward-Nutt K, Bowen A, Patchwood E. Value and learning from carer involvement in a cluster randomised controlled trial and process evaluation - Organising Support for Carers of Stroke Survivors (OSCARSS). RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:21. [PMID: 32419954 PMCID: PMC7210672 DOI: 10.1186/s40900-020-00193-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/14/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Patient, Carer and Public Involvement (PCPI) should be embedded in health care research. Delivering PCPI can be challenging, but even when PCPI is carried out it is rarely reported resulting in lost opportunities for learning. This paper aims to describe PCPI in the OSCARSS study, a pragmatic-cluster randomised controlled trial with an embedded economic and process evaluation. METHODS A carer research user group (RUG) co-developed OSCARSS to evaluate how to best deliver support to caregivers of stroke survivors. The PCPI activity involved regular meetings and preparatory work, from the initial conceptualisation of the study through to dissemination. Written reports, structured group discussions and individual interviews were carried out with the RUG and researchers to capture the added value and learning. This paper was co-authored by two of the RUG members with contributions from the wider RUG and researchers. RESULTS The core six members of the caregiver RUG attended the majority of the meetings alongside three researchers, one of whom was the co-chief investigator. PCPI was instrumental in changing many aspects of the research protocol, design and delivery and contributed to dissemination and sharing of good practice. There were challenges due to the emotional toll when PCPI members shared their stories and the extensive time commitment. Positive experiences of learning and fulfilment were reported by the individual researchers and PCPI members. Wider organisational administrative and financial support facilitated the PCPI. The researchers' existing positive regard for PCPI and the clear focus of the group were key to the successful co-design of this research. CONCLUSIONS The value and learning from the PCPI collaborative work with the researchers was of benefit to the study and the individuals involved. Specific PCPI influences were a challenge to pinpoint as successful co-design meant the researchers' and carers' contributions were intertwined and decision-making shared.
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Affiliation(s)
- C. Mitchell
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - K. Burke
- Patient and Carer Public Involvement (PCPI) contributors: lay members of the OSCARSS Carer Research User Group, Manchester, UK
| | - N. Halford
- Patient and Carer Public Involvement (PCPI) contributors: lay members of the OSCARSS Carer Research User Group, Manchester, UK
| | - K. Rothwell
- Stroke Association support services, Stroke Association, London, UK
| | - S. Darley
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - K. Woodward-Nutt
- Research & Innovation, Northern Care Alliance NHS Group, Salford, UK
| | - A. Bowen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - E. Patchwood
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Moore L, Eggleton P, Smerdon G, Newcombe J, Holley JE, Gutowski NJ, Smallwood M. Engagement of people with multiple sclerosis to enhance research into the physiological effect of hyperbaric oxygen therapy. Mult Scler Relat Disord 2020; 43:102084. [PMID: 32442882 DOI: 10.1016/j.msard.2020.102084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Thousands of people with multiple sclerosis (MS) have used self-administered oxygen therapy in the UK. Clinical trials have been performed, with scant evidence that people with MS have been consulted to explore how they benefit from or how to optimize this treatment. The conventional MS disease disability scores used in trials seldom reflect the effects individuals report when using oxygen therapy to treat their symptoms. METHODS Three people with MS and the manager of an MS Centre formed a public involvement group and collaborated with clinicians and scientists to inform a lab-based study to investigate the physiological effects of oxygen therapy on microvascular brain endothelial cells. RESULTS People with MS often use oxygen therapy at a later stage when their symptoms worsen and only after using other treatments. The frequency of oxygen therapy sessions and hyperbaric pressure is individualized and varies for people with MS. Despite direct comparisons of efficacy proving difficult, most individuals are exposed to 100% O2 at 1.5 atmosphere absolute (ATA; 1140 mmHg absolute) for 60 min. In a laboratory-based study human brain endothelial cells were exposed in vitro to 152 mmHg O2 for 60 min with and without pressure, as this equates to 20% O2 achievable via hyperbarics, which was then replicated at atmospheric pressure. A significant reduction in endothelial cells ICAM-1 (CD54) implicated in inflammatory cell margination across the blood brain barrier was observed under oxygen treatment. CONCLUSIONS By collaborating with people living with MS, we were able to design laboratory-based experimental protocols that replicate their treatment regimens to advance our understanding of the physiological effects of hyperbaric oxygen treatment on brain cells and their role in neuroinflammation.
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Affiliation(s)
- Lucy Moore
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
| | - Paul Eggleton
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK.
| | - Gary Smerdon
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; DDRC Healthcare, Hyperbaric Medical Centre, Plymouth, UK
| | - Jia Newcombe
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; NeuroResource, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Janet E Holley
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK
| | - Nicholas J Gutowski
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
| | - Miranda Smallwood
- Institute of Biomedical and Clinical Sciences, College of Medicine & Healthcare, University of Exeter, Exeter, UK; Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK
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Seeralan T, Härter M, Koschnitzke C, Scholl M, Kohlmann S, Lehmann M, Eisele M, Braunschneider LE, Marx G, Scherer M, Löwe B, Magaard JL, Brütt AL. Patient involvement in developing a patient-targeted feedback intervention after depression screening in primary care within the randomized controlled trial GET.FEEDBACK.GP. Health Expect 2020; 24 Suppl 1:95-112. [PMID: 32286005 PMCID: PMC8137500 DOI: 10.1111/hex.13039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background Patient and public involvement (PPI) is increasingly required in mental health services research. To empower patients to actively address depression, the GET.FEEDBACK.GP study evaluates a patient‐targeted feedback intervention after depression screening using the Patient Health Questionnaire (PHQ‐9). Objective To refine the patient‐targeted feedback from a previous study within a participatory research team (PRT) by conducting workshops to investigate patients' needs and preferences for feedback. To evaluate the process and outcome of PPI. Design Patient and public involvement was carried out on the levels of collaboration and consultation. A PRT of patient partners and researchers planned and conducted three workshops with patients. Patients' needs were investigated using a focus group. Participants prioritized needs, discussed feedback drafts and evaluated two drafts using cognitive debriefings. Researchers of the PRT communicated the results at project level. PPI was evaluated using the Public and Patient Engagement Evaluation Tools (PPEET). Setting and Participants A purposeful sampling of N = 12 patients with experiences of depression participated in at least one workshop. Results Relevant content‐related needs about feedback (eg no distinction between severe and moderate symptoms), recommendations for action and patient‐relevant information were considered. Needs for comprehensible, valuing, nonstigmatizing language and design elements (eg dimensional bar) were implemented. Workshops and PRT were positively evaluated. Discussion and Conclusions Patient and public involvement influenced the content, wording and design of the feedback. Strengths include two levels of PPI, methodical diversity and purposeful sampling. Limitations include the lack of inclusion of patients who are unaware of their depression. The evaluated PPI concept can be useful for future studies.
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Affiliation(s)
- Tharanya Seeralan
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michael Scholl
- Member of the Participatory Research Team, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lea-Elena Braunschneider
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriella Marx
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Luise Magaard
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany.,Department for Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Coupe N, Mathieson A. Patient and public involvement in doctoral research: Impact, resources and recommendations. Health Expect 2020; 23:125-136. [PMID: 31613049 PMCID: PMC6978853 DOI: 10.1111/hex.12976] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND AIM Patient and public involvement (PPI) has potential to enhance health-care research and is increasingly an expectation, particularly for many funding bodies. However, PPI can be tokenistic, which may limit this potential. Furthermore, few studies report PPI processes and impact, particularly in doctoral research studies, which are seldom reported in peer-reviewed papers. The aim of this paper was to explore the impact of PPI on two health-related doctoral research studies and identify how PPI could be used meaningfully at this level. METHOD The PPI processes included (a) involvement of two 'Research Buddies' who informed the research design and ensured implementation of a booklet intervention was feasible for family carers, (b) data analysis workshops with 'Research Buddies' to identify emerging themes from practitioner interviews, (c) public and stakeholder involvement who informed data collection tool design, and the design of an intervention to help people with obesity who attend weight loss groups. FINDINGS The application of PPI enhanced both doctoral studies by assisting data analysis; problem solving and improving recruitment rates; improving the usability and appeal of data collection tools and interventions; and developing implementation strategies. Patient and public involvement was considered a rewarding experience for both researchers and PPI contributors. CONCLUSION This paper demonstrates the value of PPI in doctoral research in relation to its impact on research processes, researchers and contributors. We also present recommendations on how PPI could be incorporated into future doctoral research, including resources required, planning PPI processes and involving PPI contributors in all stages of research.
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Affiliation(s)
- Nia Coupe
- Manchester Centre for Health PsychologySchool of Health SciencesThe University of ManchesterManchesterUK
| | - Amy Mathieson
- Division of Nursing, Midwifery and Social WorkThe University of ManchesterManchesterUK
- Present address:
Department of Health Services ResearchUniversity of LiverpoolLiverpoolUK
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Hemphill R, Forsythe LP, Heckert AL, Amolegbe A, Maurer M, Carman KL, Mangrum R, Stewart L, Fearon N, Esmail L. What motivates patients and caregivers to engage in health research and how engagement affects their lives: Qualitative survey findings. Health Expect 2019; 23:328-336. [PMID: 31800154 PMCID: PMC7104645 DOI: 10.1111/hex.12979] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/31/2019] [Accepted: 09/08/2019] [Indexed: 01/05/2023] Open
Abstract
Background US research organizations increasingly are supporting patient and stakeholder engagement in health research with a goal of producing more useful, relevant and patient‐centered evidence better aligned with real‐world clinical needs. The Patient‐Centered Outcomes Research Institute (PCORI) engages patients, family caregivers and other health‐care stakeholders, including clinicians, payers and policymakers, as active partners in prioritizing, designing, conducting and disseminating research as a key strategy to produce useful evidence for health‐care decision making. Objective To inform effective engagement practices and policies, we sought to understand what motivates patients and caregivers to engage as partners on PCORI‐funded research projects and how such engagement changed their lives. Methods We conducted thematic analysis of open‐ended survey responses from 255 patients, family caregivers and individuals from advocacy and community‐based organizations who engaged as partners on 139 PCORI‐funded research projects focusing on a range of health conditions. Results Partners' motivations for engaging in research were oriented primarily towards benefiting others, including a desire to improve patients' lives and to support effective health‐care interventions. In addition to feeling they made a positive difference, many partners reported direct benefits from engagement, such as new relationships and improved health habits. Discussion and Conclusions By identifying patient and caregiver motivations for engaging in research partnerships and what they get out of the experience, our study may help research teams and organizations attract partners and foster more satisfying and sustainable partnerships. Our findings also add to evidence that engagement benefits the people involved as partners, strengthening the case for more widespread engagement.
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Affiliation(s)
- Rachel Hemphill
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Laura P Forsythe
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Andrea L Heckert
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | | | | | - Kristin L Carman
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Rikki Mangrum
- American Institutes for Research, Chapel Hill, NC, USA
| | - Lisa Stewart
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Ninma Fearon
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Laura Esmail
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
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Mann C, Shaw ARG, Guthrie B, Wye L, Man MS, Chaplin K, Salisbury C. Can implementation failure or intervention failure explain the result of the 3D multimorbidity trial in general practice: mixed-methods process evaluation. BMJ Open 2019; 9:e031438. [PMID: 31699734 PMCID: PMC6858134 DOI: 10.1136/bmjopen-2019-031438] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES During a cluster randomised trial, (the 3D study) of an intervention enacting recommended care for people with multimorbidity, including continuity of care and comprehensive biennial reviews, we examined implementation fidelity to interpret the trial outcome and inform future implementation decisions. DESIGN Mixed-methods process evaluation using cross-trial data and a sample of practices, clinicians, administrators and patients. Interviews, focus groups and review observations were analysed thematically and integrated with quantitative data about implementation. Analysis was blind to trial outcomes and examined context, intervention adoption, reach and maintenance, and delivery of reviews to patients. SETTING Thirty-three UK general practices in three areas. PARTICIPANTS The trial included 1546 people with multimorbidity. 11 general practitioners, 14 nurses, 7 administrators and 38 patients from 9 of 16 intervention practices were sampled for an interview. RESULTS Staff loss, practice size and different administrative strategies influenced implementation fidelity. Practices with whole administrative team involvement and good alignment between the intervention and usual care generally implemented better. Fewer reviews than intended were delivered (49% of patients receiving both intended reviews, 30% partially reviewed). In completed reviews >90% of intended components were delivered, but review observations and interviews with patients and clinicians found variation in style of component delivery, from 'tick-box' to patient-centred approaches. Implementation barriers included inadequate skills training to implement patient-centred care planning, but patients reported increased patient-centredness due to comprehensive reviews, extra time and being asked about their health concerns. CONCLUSIONS Implementation failure contributed to lack of impact of the 3D intervention on the trial primary outcome (quality of life), but so did intervention failure since modifiable elements of intervention design were partially responsible. When a decisive distinction between implementation failure and intervention failure cannot be made, identifying potentially modifiable reasons for suboptimal implementation is important to enhance potential for impact and effectiveness of a redesigned intervention. TRIAL REGISTRATION NUMBER ISRCTN06180958.
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Affiliation(s)
- Cindy Mann
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Ali R G Shaw
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Bruce Guthrie
- Division of Population Health Sciences, University of Dundee, Dundee, UK
| | - Lesley Wye
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Mei-See Man
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Katherine Chaplin
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Chris Salisbury
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, UK
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Costello W, Dorris E. Laying the groundwork: Building relationships for public and patient involvement in pre-clinical paediatric research. Health Expect 2019; 23:96-105. [PMID: 31625656 PMCID: PMC6978868 DOI: 10.1111/hex.12972] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 01/03/2023] Open
Abstract
CONTEXT Public and patient involvement is increasingly becoming an expectation of research funders and policy makers. Not all areas of health research are public-facing. Here, we outline an approach for building the skills and developing the relationships required for downstream public and patient involvement in pre-clinical adolescent rheumatology research. OBJECTIVE To design a methodology for improving researcher-adolescent communications specifically aimed at mutual relationship building for PPI. Deliberate and effective preparation in advance of research involvement to improve the downstream success of that involvement. DESIGN A research seminar and research skills workshop conducted entirely in 'plain English' for adolescents and their siblings aged 10-20. Upskilling of pre-clinical researchers for effective public involvement. SETTING AND PARTICIPANTS Study co-design between the voluntary charity Irish Children's Arthritis Network and the academic research centre UCD Centre for Arthritis Research. Fifteen adolescents aged 10-20 years old living with arthritis, four pre-clinical researchers and one qualitative researcher investigating adolescent or paediatric arthritis. MAIN VARIABLES STUDIED Relationship building and communications for effective downstream public involvement in pre-clinical and laboratory research. RESULTS The methodology outlined here was received extremely positively. Both researchers and adolescents living with arthritis felt more comfortable communicating, more knowledgeable about juvenile arthritis and research, and more able to engage in co-operative dialogue. DISCUSSION Engaging early, considering the needs of the community and developing appropriate involvement methodology can enable involvement in pre-clinical research. CONCLUSIONS Dedicating resources to building relationships and skills necessary for co-operative research involvement can overcome some of the barriers to public involvement in pre-clinical and laboratory-based research.
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Affiliation(s)
- Wendy Costello
- Irish Children's Arthritis Network, Co., Tipperary, Ireland
| | - Emma Dorris
- UCD Centre for Arthritis Research, School of Medicine, University College Dublin, Dublin, Ireland
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Vat LE, Finlay T, Jan Schuitmaker-Warnaar T, Fahy N, Robinson P, Boudes M, Diaz A, Ferrer E, Hivert V, Purman G, Kürzinger ML, Kroes RA, Hey C, Broerse JEW. Evaluating the "return on patient engagement initiatives" in medicines research and development: A literature review. Health Expect 2019; 23:5-18. [PMID: 31489988 PMCID: PMC6978865 DOI: 10.1111/hex.12951] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/02/2019] [Accepted: 07/17/2019] [Indexed: 12/25/2022] Open
Abstract
Background Showing how engagement adds value for all stakeholders can be an effective motivator for broader implementation of patient engagement. However, it is unclear what methods can best be used to evaluate patient engagement. This paper is focused on ways to evaluate patient engagement at three decision‐making points in the medicines research and development process: research priority setting, clinical trial design and early dialogues with regulators and health technology assessment bodies. Objective Our aim was to review the literature on monitoring and evaluation of patient engagement, with a focus on indicators and methods. Search strategy and inclusion criteria We undertook a scoping literature review using a systematic search, including academic and grey literature with a focus on evaluation approaches or outcomes associated with patient engagement. No date limits were applied other than a cut‐off of publications after July 2018. Data extraction and synthesis Data were extracted from 91 publications, coded and thematically analysed. Main results A total of 18 benefits and 5 costs of patient engagement were identified, mapped with 28 possible indicators for their evaluation. Several quantitative and qualitative methods were found for the evaluation of benefits and costs of patient engagement. Discussion and conclusions Currently available indicators and methods are of some use in measuring impact but are not sufficient to understand the pathway to impact, nor whether interaction between researchers and patients leads to change. We suggest that the impacts of patient engagement can best be determined not by applying single indicators, but a coherent set of measures.
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Affiliation(s)
- Lidewij Eva Vat
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
| | | | | | - Ana Diaz
- Alzheimer Europe, Luxembourg, Luxembourg
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Hall CL, Brown S, James M, Martin JL, Brown N, Selby K, Clarke J, Williams L, Sayal K, Hollis C, Groom MJ. Consensus workshops on the development of an ADHD medication management protocol using QbTest: developing a clinical trial protocol with multidisciplinary stakeholders. BMC Med Res Methodol 2019; 19:126. [PMID: 31215440 PMCID: PMC6582552 DOI: 10.1186/s12874-019-0772-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 06/09/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The study design and protocol that underpin a randomised controlled trial (RCT) are critical for the ultimate success of the trial. Although RCTs are considered the gold standard for research, there are multiple threats to their validity such as participant recruitment and retention, identifying a meaningful change, and non-adherence to the protocol. For clinical RCTs, involving patients and clinicians in protocol design provides the opportunity to develop research protocols that are meaningful to their target audience and may help overcome some of the inherent threats in conducting RCTs. However, the majority of protocols do not describe the methodology underpinning their development, limiting the amount of learned experience shared between research groups. METHOD With the purpose of reporting a collaborative approach towards developing a protocol, we present the findings from three sequential workshops that were conducted with the aim of developing a protocol to investigate the feasibility of adding a computerised test of attention, impulsivity and activity (QbTest) to medication management of children and young people with Attention deficit hyperactivity disorder (ADHD). Based on previous qualitative interviews with clinicians and families, each workshop prioritised topics for focused discussion. Information from the workshops was fed back to the participants for reflection in advance of the next workshop. RESULTS The workshops involved 21 multi-disciplinary ADHD experts, including clinicians, patient and public involvement (PPI) members, parents of young people with ADHD and researchers. The consensus workshops addressed key research issues such as: the most relevant outcome measures/ resource drivers; methods and time points for data collection; and the clinical protocol for utilising the QbTest, including when best to use this within the medication management process. The resulting protocol details a feasibility RCT design describing these factors. CONCLUSION Protocols which are co-developed may help overcome some of the risks associated with RCT completion (e.g. recruitment, retention, protocol adherence) and help prioritise outcomes of greater relevance to the populations under study. The methodology has potential value for researchers and organisations developing clinical guidelines, and offers insights into the valuable impact of PPI upon trial design. TRIAL REGISTRATION Clinicaltrials.gov NCT03368573, 11th December 2017 (retrospectively registered).
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Affiliation(s)
- Charlotte L. Hall
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Susan Brown
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Marilyn James
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Jennifer L. Martin
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Nikki Brown
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Kim Selby
- Department of Community Paediatrics, Medway NHS Foundation Trust, Kent, UK
| | - Julie Clarke
- Acting Consultant Community Paediatrics, Grantham and District Hospital, United Lincolnshire Hospitals NHS Trust, Grantham, UK
| | - Laura Williams
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Kapil Sayal
- Child and Adolescent, Developmental Psychiatry, School of Medicine, University of Nottingham and CANDAL (Centre for ADHD and Neuro-developmental Disorders across the Lifespan), Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Chris Hollis
- Devlopmental Psychiatry Queens Medical Centre, School of Medicine, and MindTech, Institute of Mental, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Madeleine J. Groom
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
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Dal-Ré R, Avendaño-Solà C, Bloechl-Daum B, de Boer A, Eriksson S, Fuhr U, Holm S, James SK, Mentz RJ, Perucca E, Rosendaal FR, Treweek S. Low risk pragmatic trials do not always require participants' informed consent. BMJ 2019; 364:l1092. [PMID: 30917969 DOI: 10.1136/bmj.l1092] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Rafael Dal-Ré
- Epidemiology Unit, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid, Avda Reyes Católicos 2, E-28040 Madrid, Spain
| | - Cristina Avendaño-Solà
- Clinical Pharmacology Service, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | | | - Anthonius de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Stefan Eriksson
- Centre for Research Ethics and Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Uwe Fuhr
- Universityof Cologne Faculty of Medicine and University Hospital Cologne Centre of Pharmacology,Department I of Pharmacology, Clinical Pharmacology Unit, Cologne, Germany
| | - Søren Holm
- Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester, UK
| | - Stefan K James
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Robert J Mentz
- Department of Medicine, Duke University Medical Centre and Clinical Research Institute, Durham, NC, USA
| | - Emilio Perucca
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Frits R Rosendaal
- Department of Clinical Epidemiology C7-P, Leiden University Medical Center, Leiden, The Netherlands
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen , UK
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