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Young A, Toraif N, Le C, Barnett KG, Augsberger A. Facing Power: Navigating Power Dynamics in a Youth Participatory Action Research Project Situated within a Healthcare Setting. JOURNAL OF COMMUNITY PRACTICE 2024; 32:315-336. [PMID: 39345874 PMCID: PMC11426412 DOI: 10.1080/10705422.2024.2385624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Youth Participatory Action Research (YPAR) is oftentimes cited as a method guided by social justice principles to uplift youth voice and pursue youth priorities in research. However, to uphold these principles, YPAR researchers must address how youth and adults alike negotiate power differentials to be equal partners in research and scholarship. We explore YPAR power sharing through a reflexive thematic analysis of in-depth, semi-structured interviews (n= 42) and focus groups (n=2) conducted at three timepoints (baseline, mid-point, and exit) with youth (n=8) and adult (n=6) researchers engaged in a YPAR exploring health equity at a large, safety-net hospital. Our analyses suggest that both youth and adult researchers negotiate power dynamics in a YPAR at every stage of the project. YPAR researchers made four recommendations to negotiate power: 1) preserve time for relationship building, 2) structure group expectations, 3) require training for adults working with youth of color, and 4) designate youth-only spaces. This study provides an in-depth analysis of youth and adult reflections on power across a YPAR project. Our findings indicate that YPAR requires significant investment in resources, including time to reflect on and process power, transparent and structured expectations, and ongoing training to uphold principles of YPAR.
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Sides TL, Jensen AC, Argust MM, Amundson EC, Thomas GR, Keller R, Mahaffey M, Krebs EE. Experiences and lessons learned from a patient-engagement service established by a national research consortium in the U.S. Veterans Health Administration. Learn Health Syst 2024; 8:e10421. [PMID: 39036526 PMCID: PMC11257060 DOI: 10.1002/lrh2.10421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/12/2024] [Accepted: 03/24/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Meaningful engagement of patients in the research process has increased over the past 20 years. Few accounts are available of engagement infrastructure and processes used by large research organizations. The Pain/Opioid Consortium of Research (Consortium) is a U.S. Department of Veterans Affairs (VA) research network that provides infrastructure to accelerate health research and implementation of evidence-based health care. The Consortium's key activities include facilitating Veteran-engaged research and building community between Veterans and VA researchers. This report sought to describe experiences and lessons learned from the first 3 years of a national research engagement service, featuring a Veteran Engagement (VE) Panel, established by the Consortium. Methods We gathered authors' experiences to describe development and operation of the Consortium's VE Panel. Engagement staff collected program evaluation data about partners (Veterans and researchers), projects about which the VE Panel consulted, and meeting attendance during operation of the engagement service. Results We created a 12-member VE Panel; all of whom had lived experience with chronic pain, prescription opioid medication use, or opioid use disorder. Engagement staff and VE Panel members implemented an engagement service operational model designed to continuously learn and adapt. The panel consulted on 48 projects spanning the research process. Seventy-eight percent of panel members, on average, attended each monthly meeting. VE Panel members and participating researchers reported high satisfaction with the quality, ease, and outcomes of their engagement service experiences. Conclusions This work provides an illustrative example of how a national research consortium facilitated Veteran-engaged research and built community between Veterans and VA researchers by developing and operating an ongoing engagement consulting service, featuring a VE Panel. The service, designed as a learning community, relied on skilled engagement staff to cultivate high quality experiences and outcomes for all partners.
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Affiliation(s)
- Tracy L. Sides
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
| | - Agnes C. Jensen
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
- U.S. Military VeteranVeniceFloridaUSA
| | - Malloree M. Argust
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
| | - Erin C. Amundson
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
| | | | - Rebecca Keller
- U.S. Military VeteranRed WingMinnesotaUSA
- VA Pain/Opioid Consortium of Research Veteran Engagement PanelMinneapolisMinnesotaUSA
| | - Mallory Mahaffey
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
| | - Erin E. Krebs
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs (VA) Health Care SystemMinneapolisMinnesotaUSA
- School of Medicine, University of MinnesotaMinneapolisMinnesotaUSA
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Gallan AS, Helkkula A, McConnell WR. Why did this happen to me? Causal attributions of illness and cultural health capital. Soc Sci Med 2024; 350:116923. [PMID: 38705076 DOI: 10.1016/j.socscimed.2024.116923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
This study examines how conversations between patients and clinicians about the causes of their health conditions relate to patient engagement in care. Leveraging cultural health capital (CHC) theory, we find that patient-physician discussions of health attributions are one mechanism to build patient understanding and activate engagement. We present a qualitative interpretive analysis of data collected in three phases with adult home health care patients: phone interviews (n = 28), field observations (n = 61), and semi-structured field interviews (n = 38). We find that engaging in discussions of causal health attributions with clinicians enables patients to overcome uncertainty, envision preventive actions, and engage in setting future goals. Such discussions must be supported by acknowledgement of the co-responsibility of individual factors and structural factors such as social determinants of health. These discussions are not easy to navigate but they can potentially help patients transition from a mindset of treating the disease (pathogenic approach) to an awareness of their available capabilities to improve health (salutogenic approach). This study contributes to research on attribution theory and cultural health capital theory by demonstrating how discussing causes for poor health can enable patients resolve doubts and accrue instrumental and symbolic resources that facilitate healing.
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Affiliation(s)
- Andrew S Gallan
- Florida Atlantic University, 777 Glades Road, Fleming Hall 209, Boca Raton, FL, 33431, USA.
| | | | - William R McConnell
- Florida Atlantic University, 777 Glades Road, CU 97 Room 253, Boca Raton, FL, 33431, USA.
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Tilahun B, Amare G, Endehabtu BF, Atnafu A, Derseh L, Gurmu KK, Delllie E, Nigusie A. Explore the practice and barriers of collaborative health policy and system research-priority setting exercise in Ethiopia. Health Res Policy Syst 2024; 22:64. [PMID: 38816760 PMCID: PMC11138033 DOI: 10.1186/s12961-024-01151-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Collaboration is gaining prominence in the priority setting of Health Policy And System Research (HPSR). However, its practice and challenges are not well explored in Ethiopia. Understanding the practice and barriers of collaborative Health Policy and System Research will help design approaches and platforms for setting inclusive and participatory policy and system-level health research topics. This paper explores the practice and barriers of collaborative HPSR-priority setting exercise in Ethiopia. METHODS This study investigates the practice and barriers of collaborative health policy and system research priority-setting exercises in Ethiopia. Utilizing a mixed-methods approach, we conducted Key Informant Interviews (KIIs) and an online self-administered survey with open-ended questionnaires to capture diverse perspectives from stakeholders involved in the research priority-setting process. Through conventional content analysis, we identified key contents related to current practices, challenges, and opportunities for enhancing collaboration in health policy and system research prioritization. RESULTS Our findings reveal a complex landscape characterized by varying levels of stakeholder engagement, institutional capacity constraints, and competing priorities within the health research ecosystem. Despite notable efforts to foster collaboration, stakeholders identified persistent challenges such as limited resources, institutional fragmentation, and inadequate coordination mechanisms as barriers to effective priority-setting processes. The implications of our research extend beyond academic discourse, with direct relevance to health policy and system research practice in Ethiopia. By shedding light on the dynamics of collaborative priority-setting exercises, our findings offer valuable insights for policymakers, researchers, and practitioners seeking to enhance the effectiveness and inclusivity of health research prioritization processes. Addressing the identified barriers and leveraging existing strengths in the research ecosystem can contribute to more evidence-informed health policies and programs, ultimately improving health outcomes for Ethiopian populations. CONCLUSIONS Most institutions do not apply health policy and system research-priority setting to conduct informed decision-making. The barriers explored were weak integration, lack of knowledge, system, and platforms for the priority setting of Health Policy and System Resreach. So, it is recommended to build skills of different actors in the Health Policy and System Research-priority setting exercise and design a system and platform to integrate different stakeholders for collaborative research topics priority setting.
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Affiliation(s)
- Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia
| | - Getasew Amare
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia
| | - Berhanu Fikadie Endehabtu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia
| | - Kassu Ketema Gurmu
- Universal Health Coverage Life Course Cluster, Health Systems Team, World Health Organization Country Office, Addis Ababa, Ethiopia
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
- Department of Health Policy and Global Health, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Endalkachew Delllie
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane Nigusie
- Department of Health Promotion and Health Behaviour, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, 196, Gondar, Ethiopia.
- eHealthLab Ethiopia, University of Gondar, Gondar, Ethiopia.
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Zittleman L, Westfall JM, Callen D, Herrick AM, Nkouaga C, Simpson M, Dickinson LM, Fernald D, Kaufman A, English AF, Dickinson WP, Nease DE. Does engagement matter? The impact of patient and community engagement on implementation of cardiovascular health materials in primary care settings. BMC PRIMARY CARE 2024; 25:135. [PMID: 38664665 PMCID: PMC11044409 DOI: 10.1186/s12875-024-02365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research. The purpose of this report is to describe the uptake by primary care practices of cardiovascular disease prevention materials produced through four different local community engagement efforts using BCT. METHODS EvidenceNOW Southwest (ENSW) was a randomized trial to increase cardiovascular disease (CVD) prevention in primary care practices. Because of its study design, Four BCTs were conducted, and the materials created were made available to participating practices in the "enhanced" study arm. As a result, ENSW offered one of the first opportunities to explore the impact of the BCT method by describing the uptake by primary care practices of health messages and materials created locally using the BCT process. Analysis compared uptake of locally translated BCT products vs. all other products among practices based on geography, type of practice, and local BCT. RESULTS Within the enhanced arm of the study that included BCT, 69 urban and 13 rural practices participated with 9 being federally qualified community health centers, 14 hospital owned and 59 clinician owned. Sixty-three practices had 5 or fewer clinicians. Two hundred and ten separate orders for materials were placed by 43 of the 82 practices. While practices ordered a wide variety of BCT products, they were more likely to order materials developed by their local BCT. CONCLUSIONS In this study, patients and community members generated common and unique messages and materials for cardiovascular disease prevention relevant to their regional and community culture. Primary care practices preferred the materials created in their region. The greater uptake of locally created materials over non-local materials supports the use of patient engagement methods such as BCT to increase the implementation and delivery of guideline-based care. Yes, patient and community engagement matters. TRIAL REGISTRATION AND IRB Trial registration was prospectively registered on July 31, 2015 at ClinicalTrials.gov (NCT02515578, protocol identifier 15-0403). The project was approved by the Colorado Multiple Institutional Review Board and the University of New Mexico Human Research Protections Office.
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Affiliation(s)
- Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Danelle Callen
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Alisha M Herrick
- The Center for Health Innovation, New Mexico's Public Health Institute, Albuquerque, NM, USA
| | - Carolina Nkouaga
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Matthew Simpson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - L Miriam Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Douglas Fernald
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arthur Kaufman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Aimee F English
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - W Perry Dickinson
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Donald E Nease
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Stephens N, Evans S, Russell C, Brooker D. Understanding 'value' in the context of community-based interventions for people affected by dementia: A concept analysis. J Adv Nurs 2024; 80:935-947. [PMID: 37828689 DOI: 10.1111/jan.15886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/02/2023] [Accepted: 09/09/2023] [Indexed: 10/14/2023]
Abstract
AIM This study aimed to conduct a concept analysis of value in the context of community-based interventions for people affected by dementia. BACKGROUND Concepts of value play a critical role in shaping the delivery and distribution of community-based health interventions through related concepts. However, the use and meaning of 'value' is rarely clarified limiting the term's utility in practice and research. Increasing need for community healthcare and scarce public resources means developing understanding of value in community-based interventions for people affected by dementia is timely, and may support more informed approaches to exploring, explaining and delivering value. DESIGN Evolutionary Concept Analysis was used to systematically determine the characteristics of value. DATA SOURCES Peer-reviewed and grey literature databases were searched between April and July 2021, with 32 pieces of literature from different disciplines included in the final sample. No limits were set for the years of literature retrieved. METHODS Literature was thematically analysed for information on the antecedents, attributes and consequences of value. RESULTS AND DISCUSSION The analysis uncovered a need and/or desire to understand the experience of people affected by or that affect interventions; and to demonstrate, prove/disprove the (best) quality and nature of results of interventions as antecedents of value. Attributes of value were stakeholder/person centred, measurable, time and context dependent and multidimensional. Consequences of the concept included shared decision-making, valuation of interventions and internal/external investment and development of interventions. CONCLUSION Through concept analysis value can now be better understood and applied. The development of a conceptual model to illustrate the constituent elements and relationships of the concept adds transparency to where, why and how concepts of value are enabled that supports future concept development. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Nathan Stephens
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Chris Russell
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Worcester, UK
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Locke S, Osborne J. Determining the Right Levels of Health Coaching and Heart Rate Variability Biofeedback in a Workplace Behavior Change Intervention: Multiphase Optimization Strategy Preparation Study. JMIR Form Res 2024; 8:e47181. [PMID: 38354036 PMCID: PMC10902773 DOI: 10.2196/47181] [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: 03/10/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Work-related stress is associated with poor job performance and negative health outcomes. Changing health behaviors through corporate wellness programs can improve physical and mental health and help employees manage stress. This project sought to pilot the potential addition of brief coaching and biofeedback to an 8-week web-based self-help program to improve employee stress using the multiphase optimization strategy. OBJECTIVE This study aims to determine which candidate components will be tested in a later optimization phase and at what dose they will be tested, examine the feasibility and acceptability of delivering the different components, investigate whether the outcomes can be feasibly measured, and review evidence to build a conceptual model before the optimization phase. METHODS The study was positioned within the preparation phase of the multiphase optimization strategy. It is a 2×2×2×2 design with 4 components: 2 types of health coaching and 2 types of biofeedback. All components were tested by turning them on or off. A total of 16 adult office workers (mean age 40, SD 14.3 years; n=15 women) completed an 8-week self-paced web-based stress management and health behavior change program and were randomly assigned to 1 of the 16 conditions, created from a combination of the 4 candidate components. Assessments included web analytics, surveys, and interviews regarding program recommendations, likes, and dislikes. RESULTS Findings from the interviews provided suggestions to improve the intervention (eg, separating wellness from stress content) and trial conduct (eg, streamlining the onboarding process). On average, participants logged into the wellness program 83 times (range 36-291), with 75% (12/16) participant retention and 67% (8/12) survey completion. There were no reported problems with coaching or obtaining data from interviews or apps. The interview findings suggested potential mediators to include and assess in a future conceptual model. CONCLUSIONS The results provided areas to improve the intervention content and trial methods. Instead of progressing to the next scheduled large-scale optimization phase, our plan to iterate through a second preparation phase after making changes to the protocol, apps, and corporate coaching partner.
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Affiliation(s)
- Sean Locke
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
| | - Jenna Osborne
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
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Giannini AT, Leong M, Chan K, Ghaltaei A, Graham E, Robinson C, Skorska MN, Cross A, Gabison S. Patient, Family, Caregiver, and Community Engagement in Research: A Sensibility Evaluation of a Novel Infographic and Planning Guide. Physiother Can 2024; 76:64-77. [PMID: 38465302 PMCID: PMC10919359 DOI: 10.3138/ptc-2021-0057] [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: 05/20/2021] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 03/12/2024]
Abstract
Background Engaging patients, families, caregivers, and the community (PFCCs) throughout the research cycle ensures that research is meaningful for the target population. Although tools have been developed to promote PFCC engagement, many are lengthy, complex, and lack recommended behaviours. This study evaluated the sensibility of an infographic and accompanying planning guide for facilitating engagement of PFCCs in research. Methods Thirteen rehabilitation researchers reviewed the PFCC engagement tool and planning guide, participated in a semi-structured interview, and completed a 10-item sensibility questionnaire. Interviews were transcribed, imported into NVivo, and analyzed using direct content analysis. Median scores and proportions of responses for each of the 10 items in the questionnaire were calculated. Results Median scores for all questionnaire items were ≥ 4 on a 7-point Likert Scale. Participants reported the tool was easy to navigate, contained relevant items to promote PFCC engagement, and followed a logical sequence. Suggested modifications of the tool related to formatting, design, and changing the title. Conclusions The tool was deemed sensible for overt format, purpose and framework, face and content validity, and ease of usage and provides guidance to engage PFCCs across the research cycle. Further studies are recommended to assess the effectiveness of the tool to engage PFCCs in research.
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Affiliation(s)
| | - Megan Leong
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Kelvin Chan
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Arman Ghaltaei
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Eden Graham
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Craig Robinson
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Malvina N. Skorska
- Child & Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrea Cross
- School of Rehabilitation Science, Department of Paediatrics, CanChild Centre for Childhood Disability Research, McMaster University and the Institute of Applied Health Sciences, CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada
| | - Sharon Gabison
- From the:Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Haun JN, Nakase-Richardson R, Cotner BA, Agtarap SD, Martin AM, Tweed A, Hanks RA, Wittine L, Bergquist TF, Hoffman JM. Stakeholder Engagement to Identify Implementation Strategies to Overcome Barriers to Delivering Chronic Pain Treatments: A NIDILRR and VA TBI Model Systems Collaborative Project. J Head Trauma Rehabil 2024; 39:E29-E40. [PMID: 38167720 PMCID: PMC10768800 DOI: 10.1097/htr.0000000000000920] [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: 01/05/2024]
Abstract
OBJECTIVE The purpose of this article is to illustrate the process of stakeholder-engaged intervention mapping approach to identify implementation strategies to overcome data-driven prioritized barriers to receiving chronic pain services for persons with traumatic brain injury (TBI). SETTING Community. PARTICIPANTS Healthcare providers (n = 63) with 2 or more years' experience treating persons with TBI, interviewed between October 2020 and November 2021 provided data for identification of barriers. TBI, chronic pain, and qualitative research subject matter experts (SMEs) participated in the mapping approach. DESIGN Participatory-based research design, using descriptive and intervention mapping approaches. RESULTS Four barriers to accessing chronic pain treatment by persons with TBI which emerged from provider interviews were prioritized for intervention mapping: cognitive deficits of patients (67%); patient comorbidities (63%); mental health and/or substance abuse issues (59%); and patient participation (62%). SMEs used prioritized barriers to develop 4 primary objectives and implementation strategies designed to: (1) engage consumers to validate and identify strategies; (2) tailor pain treatment and delivery to overcome barriers; (3) develop and disseminate guidelines and best practices when delivering care to persons with TBI to support spread; and (4) increase awareness, skills, and readiness of workforce to deliver pain treatment to persons with TBI. SMEs used an evidence-based approach to develop a mapping matrix of the prioritized barriers, implementation objectives, and aligned implementation strategies to impact change. CONCLUSION Implementation science is needed to facilitate knowledge translation into practice for this complex population to overcome barriers to care. Implementation strategies to address barriers to accessing chronic pain care for individuals with TBI were chosen through a participatory approach to engaging SMEs to support these rehabilitation implementation efforts. Future work includes gathering input from individuals with TBI and chronic pain and to move the intervention (implementation) mapping matrix forward to inform future implementation research, policy, and practice.
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Affiliation(s)
- Jolie N Haun
- Research Service/Polytrauma (Drs Haun and Cotner) and Mental Health and Behavioral Sciences/Polytrauma (Drs Nakase-Richardson and Martin), James A. Haley Veterans' Hospital, Tampa, Florida; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City (Dr Haun); Sleep and Pulmonary Division, Department of Internal Medicine, University of South Florida, Tampa (Dr Nakase-Richardson); Traumatic Brain Injury Center of Excellence, Defense Health Agency, Tampa, Florida (Dr Nakase-Richardson and Ms Tweed); Department of Internal Medicine, University of South Florida, Tampa (Dr Cotner); Research Department, Craig Hospital, Englewood, Colorado (Dr Agtarap); 9Line, LLC, Tampa, Florida (Ms Tweed); Department of Physical Medicine and Rehabilitation, School of Medicine, Wayne State University, Detroit, Michigan (Dr Hanks); Medicine, James A. Haley Veterans' Hospital, Tampa, Florida (Dr Wittine); Mayo Clinic College of Medicine and Science, Rochester, Minnesota (Dr Bergquist); and Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle (Dr Hoffman)
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Boden-Albala B, Rebello V, Drum E, Gutierrez D, Smith WR, Whitmer RA, Griffith DM. Use of Community-Engaged Research Approaches in Clinical Interventions for Neurologic Disorders in the United States: A Scoping Review and Future Directions for Improving Health Equity Research. Neurology 2023; 101:S27-S46. [PMID: 37580148 DOI: 10.1212/wnl.0000000000207563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/09/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence suggests a significant prevalence of race and ethnic disparities in the United States among people with neurologic conditions including stroke, Alzheimer disease and related dementia (ADRD), Parkinson disease (PD), epilepsy, spinal cord injury (SCI), and traumatic brain injury (TBI). Recent neurologic research has begun the paradigm shift from observational health disparities research to intervention research in an effort to narrow the disparities gap. There is an evidence base that suggests that community engagement is a necessary component of health equity. While the increase in disparities focused neurologic interventions is encouraging, it remains unclear whether and how community-engaged practices are integrated into intervention design and implementation. The purpose of this scoping review was to identify and synthesize intervention studies that have actively engaged with the community in the design and implementation of interventions to reduce disparities in neurologic conditions and to describe the common community engagement processes used. METHODS Two databases, PubMed and CINAHL, were searched to identify eligible empirical studies within the United States whose focus was on neurologic interventions addressing disparities and using community engagement practices. RESULTS We identified 392 disparity-focused interventions in stroke, ADRD, PD, epilepsy, SCI, and TBI, of which 53 studies incorporated community engagement practices: 32 stroke studies, 15 ADRD, 2 epilepsy studies, 2 PD studies, 1 SCI study, and 1 TBI study. Most of the interventions were designed as randomized controlled trials and were programmatic in nature. The interventions used a variety of community engagement practices: community partners (42%), culturally tailored materials and mobile health (40%), community health workers (32%), faith-based organizations and local businesses (28%), focus groups/health need assessments (25%), community advisory boards (19%), personnel recruited from the community/champions (19%), and caregiver/social support (15%). DISCUSSION Our scoping review reports that the proportion of neurologic intervention studies incorporating community engagement practices is limited and that the practices used within those studies are varied. The major practices used included collaboration with community partners and utilization of culturally tailored materials. We also found inconsistent reporting and dissemination of results from studies that implemented community engagement measures in their interventions. Future directions include involving the community in research early and continuously, building curricula that address challenges to community engagement, prioritizing the inclusion of community engagement reporting in peer-reviewed journals, and prioritizing and incentivizing research of subpopulations that experience disparities in neurologic conditions.
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Affiliation(s)
- Bernadette Boden-Albala
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC.
| | - Vida Rebello
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Emily Drum
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Desiree Gutierrez
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Wally R Smith
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Rachel A Whitmer
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Derek M Griffith
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
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11
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Nanda JP, Clark RS, Harrison JA, Ouyang P, Lacanienta C, Himmelfarb C. Community-academic partnerships to embrace and ensure diversity, equity, and inclusion in translational science: Evidence of successful community engagement. J Clin Transl Sci 2023; 7:e188. [PMID: 37745925 PMCID: PMC10514689 DOI: 10.1017/cts.2023.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 09/26/2023] Open
Abstract
Community-Research Advisory Councils (C-RAC) provide a unique mechanism for building sustainable community-academic partnership, fostering bidirectional understanding of complex research issues, disseminating timely research findings, and thereby improving public trust in science. Created in 2009, the Johns Hopkins C-RAC has a mission to achieve diversity, equity, and inclusion (DEI) of stakeholders across the entire research continuum. It has nurtured over a decade of partnership among community and academic stakeholders toward addressing health disparity, health equity, structural racism, and discrimination. Evidence of successful strategies to ensure DEI in partnership and lessons learned are illustrated in this special communication.
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Affiliation(s)
- Joy P. Nanda
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
| | - Roger S. Clark
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
| | - Jennifer Ayana Harrison
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
| | - Pamela Ouyang
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
- Johns Hopkins University, Baltimore, MD, USA
| | - Cyd Lacanienta
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
- Johns Hopkins University, Baltimore, MD, USA
| | - Cheryl Himmelfarb
- Community Research Advisory Council, Johns Hopkins Institute of Clinical and Translational Research, Baltimore, MD, USA
- Johns Hopkins University, Baltimore, MD, USA
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12
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Kang S, Jones A, Shaffer RC, Erickson CA, Schmitt LM. Developing improved outcome measures in FXS: Key stakeholder feedback. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104502. [PMID: 37080087 PMCID: PMC10875734 DOI: 10.1016/j.ridd.2023.104502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND There is a critical need for the development of improved outcome measures in Fragile X Syndrome (FXS). Because the majority of respondents of behavior outcome measures are caregivers or individuals with FXS, it is important to consider stakeholders' firsthand experiences when designing a caregiver- or self-report measure. AIMS The current research study aimed to understand experiences of completing commonly used caregiver-/self-report measures of behavior in FXS via focus groups. METHODS AND PROCEDURES This study employed a focus group methodology. Semi-structured focus groups were conducted with 22 caregivers and 3 self-advocates. All interviews occurred via secured videoconferencing. A thematic analysis was used to identify major themes and subthemes. OUTCOMES AND RESULTS We identified four themes: (1) content of measure, (2) structure of the measure, (3) potential accommodations to complete measure, and (4) impact of measure on family. Importantly, focus groups revealed that certain aspects of content, structure, and implementation of the available measures were related to distress and negative emotions of caregivers of FXS and individuals with FXS themselves. CONCLUSIONS AND IMPLICATIONS The focus group data yielded a wide range of feedback and has significant implications, highlighting the critical need to take key stakeholder perspectives into account when using and/or developing caregiver- or self-report measures for FXS.
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Affiliation(s)
- Sungeun Kang
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Angelina Jones
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rebecca C Shaffer
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Craig A Erickson
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lauren M Schmitt
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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13
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Sweeney SM, Hamadeh HK, Abrams N, Adam SJ, Brenner S, Connors DE, Davis GJ, Fiore L, Gawel SH, Grossman RL, Hanlon SE, Hsu K, Kelloff GJ, Kirsch IR, Louv B, McGraw D, Meng F, Milgram D, Miller RS, Morgan E, Mukundan L, O'Brien T, Robbins P, Rubin EH, Rubinstein WS, Salmi L, Schaller T, Shi G, Sigman CC, Srivastava S. Challenges to Using Big Data in Cancer. Cancer Res 2023; 83:1175-1182. [PMID: 36625843 PMCID: PMC10102837 DOI: 10.1158/0008-5472.can-22-1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/29/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023]
Abstract
Big data in healthcare can enable unprecedented understanding of diseases and their treatment, particularly in oncology. These data may include electronic health records, medical imaging, genomic sequencing, payor records, and data from pharmaceutical research, wearables, and medical devices. The ability to combine datasets and use data across many analyses is critical to the successful use of big data and is a concern for those who generate and use the data. Interoperability and data quality continue to be major challenges when working with different healthcare datasets. Mapping terminology across datasets, missing and incorrect data, and varying data structures make combining data an onerous and largely manual undertaking. Data privacy is another concern addressed by the Health Insurance Portability and Accountability Act, the Common Rule, and the General Data Protection Regulation. The use of big data is now included in the planning and activities of the FDA and the European Medicines Agency. The willingness of organizations to share data in a precompetitive fashion, agreements on data quality standards, and institution of universal and practical tenets on data privacy will be crucial to fully realizing the potential for big data in medicine.
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Affiliation(s)
- Shawn M. Sweeney
- American Association for Cancer Research, Philadelphia, Pennsylvania
| | | | - Natalie Abrams
- Division of Cancer Prevention, Early Detection Research Network, National Cancer Institute, Rockville, Maryland
| | - Stacey J. Adam
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | - Sara Brenner
- Office of In Vitro Diagnostics, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Dana E. Connors
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | - Gerard J. Davis
- Abbott Diagnostics Division, Abbott Laboratories, Lake Forest, Illinois
| | - Louis Fiore
- Boston University School of Medicine, Boston and New England Department of Veterans Affairs, Bedford, Massachusetts
| | - Susan H. Gawel
- Abbott Diagnostics Division, Abbott Laboratories, Lake Forest, Illinois
| | - Robert L. Grossman
- Center for Translational Data Science, The University of Chicago, Chicago, Illinois
| | - Sean E. Hanlon
- Center for Strategic Scientific Initiatives, National Cancer Institute, Bethesda, Maryland
| | | | - Gary J. Kelloff
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland
| | | | - Bill Louv
- Project Data Sphere, Morrisville, North Carolina
| | - Deven McGraw
- Ciitizen Platform at Invitae, San Francisco, California
| | - Frank Meng
- Boston University and Veterans Administration Boston Healthcare System, Boston, Massachusetts
| | | | - Robert S. Miller
- CancerLinQ, American Society of Clinical Oncology, Alexandria, Virginia
| | - Emily Morgan
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | - Wendy S. Rubinstein
- Office of In Vitro Diagnostics, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Liz Salmi
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | | | - George Shi
- Abbott Diagnostics Division, Abbott Laboratories, Lake Forest, Illinois
| | - Caroline C. Sigman
- Boston University and Veterans Administration Boston Healthcare System, Boston, Massachusetts
| | - Sudhir Srivastava
- Cancer Biomarkers Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
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14
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Besterman-Dahan K, Hahm B, Chavez M, Heuer J, Melillo C, Lind J, Dillahunt-Aspillaga C, Ottomanelli L. Enhancing Veteran Community Reintegration Research (ENCORE): Protocol for a Mixed Methods and Stakeholder Engagement Project. JMIR Res Protoc 2023; 12:e42029. [PMID: 36917162 PMCID: PMC10131720 DOI: 10.2196/42029] [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: 08/19/2022] [Revised: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service. OBJECTIVE Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration's Health Service Research and Development Service. The goal of ENCORE is to maximize veteran and family reintegration by promoting innovative research and knowledge translation (KT) that informs and improves equitable Department of Veterans Affairs (VA) policies, programs, and services. Overall, 2 strategic objectives guide ENCORE activities: mobilize veteran CR research and promote innovation, relevance, and acceleration of veteran CR research and KT. METHODS ENCORE uses a mixed methods and stakeholder-engaged approach to achieve objectives and to ensure that the KT products generated are inclusive, innovative, and meaningful to stakeholders. Project activities will occur over 5 years (2019-2024) in 5 phases: plan, engage, mobilize, promote, and evaluate. All activities will be conducted remotely owing to the ongoing COVID-19 pandemic. Methods used will include reviewing research funding and literature examining the gaps in veteran CR research, conducting expert informant interviews with VA program office representatives, and assembling and working with a Multistakeholder Partnership (MSP). MSP meetings will use external facilitation services, group facilitation techniques adapted for virtual settings, and a 6-step group facilitation process to ensure successful execution of meetings and accomplishment of goals. RESULTS As of December 2022, data collection for ENCORE is ongoing, with the team completing interviews with 20 stakeholders from 16 VA program offices providing veteran CR-related services. ENCORE developed and assembled the MSP, reviewed the VA funding portfolio and veteran CR research literature, and conducted a scientific gap analysis. The MSP developed a veteran CR research agenda in 2021 and continues to work with the ENCORE team to prepare materials for dissemination. CONCLUSIONS The goal of this program is to improve the impact of veteran CR research on policies and programs. Using a stakeholder-engaged process, insights from key stakeholder groups are being incorporated to set a research agenda that is more likely to result in a relevant and responsive veteran CR research program. Future products will include the development of an effective and relevant dissemination plan and the generation of innovative and relevant dissemination products designed for rapid KT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42029.
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Affiliation(s)
- Karen Besterman-Dahan
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States
| | - Bridget Hahm
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States
| | - Margeaux Chavez
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States
| | - Jacquelyn Heuer
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States.,Department of Anthropology, College of Arts and Sciences, University of South Florida, Tampa, FL, United States
| | - Christine Melillo
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States
| | - Jason Lind
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States
| | | | - Lisa Ottomanelli
- Research and Development Service, James A Haley Veterans Hospital and Clinics, Tampa, FL, United States.,Department of Rehabilitation & Mental Health Counseling, University of South Florida, Tampa, FL, United States
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15
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Desikan A, MacKinney T, Kalman C, Carter JM, Reed G, Goldman GT. An equity and environmental justice assessment of anti-science actions during the Trump administration. J Public Health Policy 2023; 44:147-162. [PMID: 36737622 PMCID: PMC9896454 DOI: 10.1057/s41271-022-00390-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 02/05/2023]
Abstract
In the United States, science shapes federal health and safety protections, but political officials can and do politicize federal science and science-based safeguards. Many presidential administrations have politicized science, but under the administration of President Trump, these attacks on science-such as buried research, censored scientists, halted data collection-increased in number to unprecedented levels. Underserved communities bore the brunt of the harms. Such attacks disproportionately harm Black, Indigenous, low-income communities, and communities of color, all of whom have long been burdened by pollution exposure and other stressors. We analyze the effects on underserved communities of the Trump administration's anti-science environmental and public health policy actions and offer policy recommendations for current and future administrations. Our goal is to strengthen scientific integrity, prioritize health disparity research, and meaningfully engage affected communities in federal rulemaking.
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Affiliation(s)
- Anita Desikan
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA.
| | - Taryn MacKinney
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
| | - Casey Kalman
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
| | - Jacob M Carter
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
| | - Genna Reed
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
| | - Gretchen T Goldman
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
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16
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Beaudoin AJ, Gagnon M, Ouellette J, Foley V, Couture M, Camden C. [Description of a Pilot Project for Pediatric Occupational Therapy in Daycare and Community Settings]. Can J Occup Ther 2023; 90:34-43. [PMID: 36069023 DOI: 10.1177/00084174221121421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Occupational therapy interventions that promote and prevent children's health and well-being aim to reduce health inequalities and foster protective factors. The purpose of this study is to describe a pilot community-based occupational therapy project for preschoolers in partnership with community organizations and childcare services. Method. A participatory action research approach was implemented with support from an advisory committee. An occupational therapist provided community-based occupational therapy services in a tiered organization model over one year. Findings. Services were offered in three tiers: 7 awareness workshops for parents and caregivers (Tier 1), 57 visits and 27 consultations in 8 community agencies (Tier 2), and 23 individual follow-ups (Tier 3). Implications. There is an opportunity to implement with community agencies and daycare settings an occupational therapy service based on community-based rehabilitation for children under 5 years of age.
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17
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Borthwick J, Evertsz N, Pratt B. How should communities be meaningfully engaged (if at all) when setting priorities for biomedical research? Perspectives from the biomedical research community. BMC Med Ethics 2023; 24:6. [PMID: 36747191 PMCID: PMC9900561 DOI: 10.1186/s12910-022-00879-5] [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: 09/08/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is now rising consensus that community engagement is ethically and scientifically essential for all types of health research. Yet debate continues about the moral aims, methods and appropriate timing in the research cycle for community engagement to occur, and whether the answer should vary between different types of health research. Co-design and collaborative partnership approaches that involve engagement during priority-setting, for example, are common in many forms of applied health research but are not regular practice in biomedical research. In this study, we empirically examine the normative question: should communities be engaged when setting priorities for biomedical research projects, and, if so, how and for what purpose? METHODS We conducted in-depth interviews with 31 members of the biomedical research community from the UK, Australia, and African countries who had engaged communities in their work. Interview data were thematically analysed. RESULTS Our study shows that biomedical researchers and community engagement experts strongly support engagement in biomedical research priority-setting, except under certain circumstances where it may be harmful to communities. However, they gave two distinct responses on what ethical purpose it should serve-either empowerment or instrumental goals-and their perspectives on how it should achieve those goals also varied. Three engagement approaches were suggested: community-initiated, synergistic, and consultative. Pre-engagement essentials and barriers to meaningful engagement in biomedical research priority-setting are also reported. CONCLUSIONS This study offers initial evidence that meaningful engagement in priority-setting should potentially be defined slightly differently for biomedical research relative to certain types of applied health research and that engagement practice in biomedical research should not be dominated by instrumental goals and approaches, as is presently the case.
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Affiliation(s)
- Josephine Borthwick
- Royal Australian College of General Practitioners, Melbourne, Australia
- Queensland Bioethics Centre, Australian Catholic University, 1100 Nudgee Rd., Brisbane, Australia
| | | | - Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University, 1100 Nudgee Rd., Brisbane, Australia.
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Taffere GR, Abebe HT, Zerihun Z, Mallen C, Price HP, Mulugeta A. Systematic review of community engagement approach in research: describing partnership approaches, challenges and benefits. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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19
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Holden SK, Bedenfield N, Taylor AS, Bayram E, Schwilk C, Fleisher J, Duda J, Shill H, Paulson HL, Stacy K, Wood J, Corsentino P, Sha SJ, Litvan I, Irwin DJ, Quinn JF, Goldman JG, Amodeo K, Taylor JP, Boeve BF, Armstrong MJ. Research Priorities of Individuals and Caregivers With Lewy Body Dementia: A Web-based Survey. Alzheimer Dis Assoc Disord 2023; 37:50-58. [PMID: 36821177 PMCID: PMC9971616 DOI: 10.1097/wad.0000000000000545] [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: 06/29/2022] [Accepted: 12/01/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Lewy body dementia (LBD) is common, yet under-recognized and under-researched. To plan studies with the highest impact, engagement of the community personally affected by these conditions is essential. METHODS A web-based survey of people living with LBD and current and former caregivers of people with LBD queried research priorities through forced ranking and exploration of burden of LBD symptoms. Specific caregiving needs in LBD and perceptions of research participation were also investigated. RESULTS Between April 7, 2021 and July 1, 2021, 984 responses were recorded. Top research priorities included disease-modifying therapies and improved disease detection and staging. People with LBD were interested in pathophysiology and more bothered by motor symptoms; caregivers were interested in risk factors and symptomatic therapies and more bothered by neuropsychiatric symptoms. Few available LBD treatments and resources were rated as helpful, and many valuable services were never received. Previous participation in LBD research was infrequent, but interest was high. DISCUSSION People with LBD and caregivers highlighted the need for research across all aspects of LBD, from pathophysiology and disease modification to prognosis, education, symptomatic treatments, and caregiver support. Funders should increase support for all aspects of LBD research to target the many needs identified by individuals and families living with LBD.
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Affiliation(s)
- Samantha K. Holden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Noheli Bedenfield
- Department of Neurology, University of Florida, Dorothy Mangurian Clinical-Research Headquarters for Lewy Body Dementia, Gainesville, FL
| | | | - Ece Bayram
- Department of Neurosciences, University of California San Diego, San Diego, CA
| | | | - Jori Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - John Duda
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Holly Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ
| | | | - Kelly Stacy
- College of Nursing, University of Cincinnati, Cincinnati, OH
| | - Julia Wood
- Lewy Body Dementia Association, Liliburn, GA
| | | | - Sharon J. Sha
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, San Diego, CA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Joseph F. Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR
| | - Jennifer G. Goldman
- Shirley Ryan AbilityLab, Parkinson’s Disease and Movement Disorders Program, Northwestern University, Chicago, IL
| | - Katherine Amodeo
- Department of Neurology, Westchester Medical Center- MidHudson Regional Hospital, Poughkeepsie, NY
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | | | - Melissa J. Armstrong
- Department of Neurology, University of Florida, Dorothy Mangurian Clinical-Research Headquarters for Lewy Body Dementia, Gainesville, FL
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Smith WR, Valrie C, Sisler I. Structural Racism and Impact on Sickle Cell Disease. Hematol Oncol Clin North Am 2022; 36:1063-1076. [DOI: 10.1016/j.hoc.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dy T, Hamilton WJ, Kramer CB, Apter A, Krishnan JA, Stout JW, Teach SJ, Federman A, Elder J, Bryant-Stephens T, Bruhl RJ, Jackson S, Sumino K. Stakeholder engagement in eight comparative effectiveness trials in African Americans and Latinos with asthma. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:63. [PMID: 36434672 PMCID: PMC9694541 DOI: 10.1186/s40900-022-00399-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The effects of stakeholder engagement, particularly in comparative effectiveness trials, have not been widely reported. In 2014, eight comparative effectiveness studies targeting African Americans and Hispanics/Latinos with uncontrolled asthma were funded by the Patient-Centered Outcomes Research Institute (PCORI) as part of its Addressing Disparities Program. Awardees were required to meaningfully involve patients and other stakeholders. Using specific examples, we describe how these stakeholders substantially changed the research protocols and in other ways participated meaningfully as full partners in the development and conduct of the eight studies. METHODS Using the method content analysis of cases, we identified themes regarding the types of stakeholders, methods of engagement, input from the stakeholders, changes made to the research protocols and processes, and perceived benefits and challenges of the engagement process. We used summaries from meetings of the eight teams, results from an engagement survey, and the final research reports as our data source to obtain detailed information. The descriptive data were assessed by multiple reviewers using inductive and deductive qualitative methods and discussed in the context of engagement literature. RESULTS Stakeholders participated in the planning, conduct, and dissemination phases of all eight asthma studies. All the studies included clinicians and community representatives as stakeholders. Other stakeholders included patients with asthma, their caregivers, advocacy organizations, and health-system representatives. Engagement was primarily by participation in advisory boards, although six of the eight studies (75%) also utilized focus groups and one-on-one interviews. Difficulty finding a time and location to meet was the most reported challenge to engagement, noted by four of the eight teams (50%). Other reported challenges and barriers to engagement included recruitment of stakeholders, varying levels of enthusiasm among stakeholders, controlling power dynamics, and ensuring that stakeholder involvement was reflected and had true influence on the project. CONCLUSION Engagement-driven modifications led to specific changes in study design and conduct that were felt to have increased enrollment and the general level of trust and support of the targeted communities. The level of interaction described, between investigators and stakeholders in each study and between investigator-stakeholder groups, is-we believe-unprecedented and may provide useful guidance for other studies seeking to improve the effectiveness of community-driven research.
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Affiliation(s)
- Tiffany Dy
- Division of Allergy and Immunology, Department of Internal Medicine, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave, CB 8122, St. Louis, MO, 63110, USA.
| | - Winifred J Hamilton
- Environmental Health Service, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Andrea Apter
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois Chicago and Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - James W Stout
- Department of Pediatrics and Health Services, University of Washington, Seattle, WA, USA
| | - Stephen J Teach
- Division of Emergency Medicine and the Department of Pediatrics, Children's National Hospital, Washington, DC, USA
| | - Alex Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Elder
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Tyra Bryant-Stephens
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca J Bruhl
- Environmental Health Service, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Shawni Jackson
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kaharu Sumino
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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22
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Gilfoyle M, MacFarlane A, Hannigan A, Niranjan V, Hughes Z, Salsberg J. The public and patient involvement imperative in Ireland: Building on policy drivers. Front Public Health 2022; 10:1038409. [PMID: 36438293 PMCID: PMC9684639 DOI: 10.3389/fpubh.2022.1038409] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
What can we learn from the history of Public and Patient Involvement (PPI) in healthcare and research across global jurisdictions? Depending on region and context, the terminology and heritage of involvement in research vary. In this paper, we draw on global traditions to explore dominant themes and key considerations and critiques pertaining to PPI in order to inform a PPI culture shift in Ireland. We then describe the heritage of PPI in Ireland and present the case for combining methodological imperatives with policy drivers to support and encourage meaningful involvement. Specifically, we propose that PPI can be enriched by the theory and processes of participatory health research (PHR); and that implementation requires concurrent capacity building. We conclude with a call for Irish researchers (authors of this paper included) to consider the conceptual complexities and nuances of a participatory approach to build on the policy imperatives driving PPI and to contribute to the international evidence base and research culture. Specifically, we call for Irish health researchers and funders to consider and reflect on: (1) the rich literature of PHR as a resource for enacting meaningful PPI; (2) the roots and origins of varying participatory health research methods; (3) how community/patient groups can lead health research; and (4) co-learning and partnership synergy to create space for both academic and community expertise; and (5) the importance of using standardized reporting tools.
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Affiliation(s)
- Meghan Gilfoyle
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anne MacFarlane
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland,Health Research Institute, University of Limerick, Limerick, Ireland,*Correspondence: Jon Salsberg
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23
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Pacheco J, LaCombe S. The Link between Democratic Institutions and Population Health in the American States. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2022; 47:527-554. [PMID: 35576321 DOI: 10.1215/03616878-9978103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT This project investigates the role of state-level institutions in explaining variation in population health in the American states. Although cross-national research has established the positive effects of democracy on population health, little attention has been given to subnational units. The authors leverage a new data set to understand how political accountability and a system of checks and balances are associated with state population health. METHODS The authors estimate error correction models and two-way fixed effects models to estimate how the strength of state-level democratic institutions is associated with infant mortality rates, life expectancy, and midlife mortality. FINDINGS The authors find institutions that promote political accountability are associated with lower infant mortality across the states, while those that promote checks and balances are associated with longer life expectancy. They also find that policy liberalism is associated with better health outcomes. CONCLUSIONS Subnational institutions play an important role in population health outcomes, and more research is needed to understand the link between democracy and health. The authors are the first to explore the link between democratic institutions and population health within the United States, contributing to both the social science literature on the positive effects of democracy and the epidemiological literature on subnational health outcomes.
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24
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Okpalauwaekwe U, Ballantyne C, Tunison S, Ramsden VR. Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review. BMC Public Health 2022; 22:1630. [PMID: 36038858 PMCID: PMC9422134 DOI: 10.1186/s12889-022-14047-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous youth in Canada face profound health inequities which are shaped by the rippling effects of intergenerational trauma, caused by the historical and contemporary colonial policies that reinforce negative stereotypes regarding them. Moreover, wellness promotion strategies for these youth are replete with individualistic Western concepts that excludes avenues for them to access holistic practices grounded in their culture. Our scoping review explored strategies, approaches, and ways health and wellness can be enhanced by, for, and with Indigenous youth in Canada by identifying barriers/roadblocks and facilitators/strengths to enhancing wellness among Indigenous youth in Canada. METHODS We applied a systematic approach to searching and critically reviewing peer-reviewed literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews [PRISMA-ScR] as a reporting guideline. Our search strategy focused on specific keywords and MeSH terms for three major areas: Indigenous youth, health, and Canada. We used these keywords, to systematically search the following electronic databases published in English between January 01, 2017, to May 22, 2021: Medline [Ovid], PubMed, ERIC, Web of Science, Scopus, and iportal. We also used hand-searching and snowballing methods to identify relevant articles. Data collected were analysed for contents and themes. RESULTS From an initial 1695 articles collated, 20 articles met inclusion criteria for this review. Key facilitators/strengths to enhancing health and wellness by, for, and with Indigenous youth that emerged from our review included: promoting culturally appropriate interventions to engage Indigenous youth; using strength-based approaches; reliance on the wisdom of community Elders; taking responsibility; and providing access to wellness supports. Key barriers/roadblocks included: lack of community support for wellness promotion activities among Indigenous youth; structural/organizational issues within Indigenous communities; discrimination and social exclusion; cultural illiteracy among youth; cultural discordance with mainstream health systems and services; and addictions and risky behaviours. CONCLUSION This scoping review extracted 20 relevant articles about ways to engage Indigenous youth in health and wellness enhancement. Our findings demonstrate the importance of promoting health by, and with Indigenous youth, by engaging them in activities reflexive of their cultural norms, rather than imposing control measures that are incompatible with their value systems.
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Affiliation(s)
- Udoka Okpalauwaekwe
- Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5E5, Canada.
| | - Clifford Ballantyne
- Sturgeon Lake Youth Center, Sturgeon Lake First Nation, Sturgeon Lake, Saskatchewan, S0J 2E1, Canada
| | - Scott Tunison
- University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0X1, Canada
| | - Vivian R Ramsden
- Research Division, Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7M 3Y5, Canada.
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25
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Persaud A, Castro I, Simione M, Smith JD, O'Connor G, Sharifi M, Perkins M, Torres S, Taveras EM, Kuhlthau K, Fiechtner L. Multi-sector stakeholder's perceptions of determinants of successful implementation of a pediatric weight management intervention. Front Public Health 2022; 10:954063. [PMID: 36091513 PMCID: PMC9454190 DOI: 10.3389/fpubh.2022.954063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
Background Multi-sector stakeholder engagement is essential in the successful implementation, dissemination, and sustainability of pediatric weight management interventions (PWMI), particularly in low-income settings where sustainability relies on external policies and reimbursement. The objective of this study was to engage stakeholders (1) to inform the creation of the intervention with adaptations needed for a successful PWMI in a primary care and community setting and (2) to identify barriers and facilitators to implementation and dissemination. Methods We sought to examine the perspectives of local, state, and national clinic and community stakeholders during the pre-implementation period of a two-arm, randomized trial of a Health Weight Clinic PWMI conducted in two health centers and a modified-Healthy Weight and Your Child PWMI at two local YMCAs that serve a predominantly lower income, Hispanic community. The Consolidated Framework for Implementation Research interview guide served as a template for the study but was modified to fit the PWMIs and the various professional roles. Interviews were transcribed and analyzed using the framework analysis approach and themes were linked to the CFIR domains and constructs. Results Twenty-six stakeholders perceived the following as needed components of a PWMI: a formal curriculum with illustrative examples, a patient- and family-centered program, group visits, and high-quality multidisciplinary personnel. These findings led to the creation of a group visit curriculum, implementation trainings and cross-site collaborative technical assistance. Additionally, creating partnerships between community and clinical organizations, and addressing patient barriers and unmet social needs (i.e., transportation, food) were identified as facilitators to successful implementation. These results led to the creation of community resource guides, connections to community organizations, and screening and referring for unmet social needs. Perceived facilitators of dissemination included proving cost-effectiveness of the PWMI to inform insurance reimbursement for long-term sustainability. Therefore, we collected cost data and engaged with Medicaid officials to discuss reimbursement. Conclusion Findings highlight the importance of engaging multi-sector stakeholders pre-implementation to ensure the components valued are included, ensuring the program minimizes barriers to participation, considering how staff training can improve implementation and how collected outcomes can inform sustainability and dissemination of PWMIs in clinic and community settings.
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Affiliation(s)
- Alicia Persaud
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Ines Castro
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Meg Simione
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Justin D. Smith
- Division of Health Systems Innovation and Research, Department of Population Health Sciences, School of Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, United States
| | - Giselle O'Connor
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States
| | - Meghan Perkins
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Shioban Torres
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA, United States
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Karen Kuhlthau
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Lauren Fiechtner
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA, United States
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26
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Chavez MA, Blevins KR, Brown C, Giles AJ, Matthieu MM, Wester M, Heuer J, Hahm B, Lind J, Melillo C, Dillahunt-Aspillaga C, Slone LO, Besterman-Dahan K. The Future of Veteran Community Engagement: Perspectives on Engaging Veterans and Other Stakeholders in Research Agenda Setting. JOURNAL OF VETERANS STUDIES 2022. [DOI: 10.21061/jvs.v8i2.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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27
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Leykum LK, Finley EP, Penney LS, Parish Johnson J, Pugh JA, Noel PH. Engaging Veterans, caregivers, and system stakeholders to improve VA home and community-based services. Health Serv Res 2022; 57 Suppl 1:66-76. [PMID: 35243641 PMCID: PMC9108224 DOI: 10.1111/1475-6773.13926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To understand Veterans', caregivers', and stakeholders' perceptions of home-based and caregiver support services and their suggestions for improvement to better align services with needs. DATA SOURCES We identified Veterans and caregivers at four EDCoE sites using the VA high-need, high-risk list, representing Veterans who qualify for home-based primary care. We randomly selected Veterans and their caregivers, stratifying by age. We also identified leaders and clinicians involved in clinical service delivery. STUDY DESIGN Between February and November 2019, we conducted in-person and telephone interviews and focus groups using semi-structured questions tailored to each group, analyzing them through a rapid qualitative analysis approach and providing real-time feedback to operational partners. DATA COLLECTION Thirty-four Veterans, 24 caregivers, and 39 leaders and clinicians participated. PRINCIPAL FINDINGS Respondents identified key categories of experience that could be monitored and improved, including navigating an increasingly complex system, coordinating and communicating across services, and unmet household and financial needs. Veterans and caregivers described quality in terms of reliability, timeliness, standardization, and accountability. Summaries were created to contextualize results and to highlight gaps and opportunities for new measures and policy development. CONCLUSIONS Collaborating with Veterans, caregivers, and stakeholders enables us to understand their daily experiences and to develop meaningful approaches to evaluating services that incorporate their perspectives. Providing regular, actionable feedback to operational partners informs policy and operational initiatives, such as the scope of services and infrastructure for system navigation.
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Affiliation(s)
- Luci K. Leykum
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Medicine and Research ServicesSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
- Dell Medical SchoolUniversity of Texas at AustinAustinTexasUSA
| | - Erin P. Finley
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
- Research ServicesVA Greater Los Angeles Health Care SystemLos AngelesCaliforniaUSA
| | - Lauren S. Penney
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Medicine and Research ServicesSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
- Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Julie Parish Johnson
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Medicine and Research ServicesSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
- Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Jacqueline A. Pugh
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Medicine and Research ServicesSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
- Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Polly H. Noel
- Department of Veterans AffairsElizabeth Dole Center of Excellence for Veterans and Caregiver ResearchUSA
- Medicine and Research ServicesSouth Texas Veterans Health Care SystemSan AntonioTexasUSA
- Long School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
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28
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Silver SR, Whooten RC, Kwete GM, Farrar-Muir H, Cournoyer RN, Barth EA, Kotelchuck M, Taveras EM. Stakeholder engagement in developing a father-inclusive early life obesity prevention intervention: First Heroes. BMC Pregnancy Childbirth 2022; 22:443. [PMID: 35624421 PMCID: PMC9145160 DOI: 10.1186/s12884-022-04759-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although paternal involvement in the perinatal period is associated with benefits for maternal-child health and reduced obesity risk, fathers are seldom included in perinatal or obesity prevention efforts. Engaging community leaders and fathers as stakeholders in intervention development is a critical step in designing a father-inclusive intervention that is efficacious and responsive to their needs. Methods We conducted a structured engagement study, including community stakeholder engagement and qualitative interviews with new fathers, to inform the development of a prospective randomized controlled trial that includes mothers and fathers as equal partners in infant obesity prevention. We interpreted stakeholder feedback through the Consolidated Framework for Implementation Research (CFIR) framework. Results Between September 2019 and April 2020, we held a Community Engagement meeting, formed a Community Advisory Board, and conducted 16 qualitative interviews with new fathers. Stakeholder engagement revealed insights across CFIR domains including intervention characteristics (relative advantage, complexity, design quality & packaging), outer setting factors (cosmopolitanism and culture), individual characteristics (including self-efficacy, state of change, identification with the organization) and process (engagement and adaptation). Stakeholders discussed the diverse challenges and rewards of fatherhood, as well as the intrinsic paternal motivation to be a loving, supportive father and partner. Both community leaders and fathers emphasized the importance of tailoring program delivery and content to meet specific parental needs, including a focus on the social-emotional needs of new parents. Conclusions A structured process of multidimensional stakeholder engagement was successful in improving the design of a father-inclusive perinatal obesity prevention interventions. Father engagement was instrumental in both reinforcing community ties and increasing our understanding of fathers’ needs, resulting in improvements to program values, delivery strategies, personnel, and content. This study provides a practical approach for investigators looking to involve key stakeholders in the pre-implementation phase of intervention development. Trial registration ClinicalTrials.gov, NCT04477577. Registered 20 July 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04759-z.
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Affiliation(s)
- Santana R Silver
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel C Whooten
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA.
| | - Gracia M Kwete
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Haley Farrar-Muir
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Rachel N Cournoyer
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Elizabeth A Barth
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Milton Kotelchuck
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Elsie M Taveras
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA.,Kraft Center for Community Health, Massachusetts General Hospital, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
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29
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Duea SR, Zimmerman EB, Vaughn LM, Dias S, Harris J. A Guide to Selecting Participatory Research Methods Based on Project and Partnership Goals. JOURNAL OF PARTICIPATORY RESEARCH METHODS 2022; 3:10.35844/001c.32605. [PMID: 35799626 PMCID: PMC9258244 DOI: 10.35844/001c.32605] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Participatory research engages community stakeholders in the research process, from problem identification and developing the research question, to dissemination of results. There is increasing recognition in the field of health research that community-engaged methods can be used throughout the research process. The volume of guidance for engaging communities and conducting participatory research has grown steadily in the past 40+ years, in many countries and contexts. Further, some institutions now require stakeholder engagement in research as a condition of funding. Interest in collaborating in the research process is also growing among patients and the public. This article provides an overview for selecting participatory research methods based on project and partnerships goals.
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Affiliation(s)
| | - Emily B. Zimmerman
- Department of Family Medicine and Population Health, Division of Epidemiology, VCU Center on Society and Health, Virginia Commonwealth University
| | - Lisa M. Vaughn
- College of Medicine, Cincinnati Children’s Hospital Medical Center/University of Cincinnati
| | - Sónia Dias
- Public Health Research Center, NOVA National School of Public Health
| | - Janet Harris
- School of Health & Related Research, University of Sheffield
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30
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Dermody TS, Ettinger A, Savage Friedman F, Chavis V, Miller E. The Pittsburgh Study: Learning with Communities About Child Health and Thriving. Health Equity 2022; 6:338-344. [PMID: 35651357 PMCID: PMC9148643 DOI: 10.1089/heq.2021.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic has highlighted structural inequities that are barriers to thriving for children in neighborhoods with concentrated disadvantage. Health systems are increasingly addressing health-related social needs. The “Pittsburgh Study” is a longitudinal, community-partnered study focused on child and adolescent thriving and racial equity. This initiative will elucidate critical influences on childhood health and thriving, evaluate developmentally appropriate interventions to improve outcomes from birth to high school, and establish a child health data hub. Integration of community members into scientific inquiry, rapid data-to-action cycles, and workforce development are strategies health systems may consider to enhance child health equity.
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Affiliation(s)
- Terence S. Dermody
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Institute of Infection, Inflammation, and Immunity, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anna Ettinger
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Val Chavis
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Community and Population Health, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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31
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Donald EE, Whitlock K, Dansereau T, Sands DJ, Small D, Stajduhar KI. A codevelopment process to advance methods for the use of patient-reported outcome measures and patient-reported experience measures with people who are homeless and experience chronic illness. Health Expect 2022; 25:2264-2274. [PMID: 35411709 PMCID: PMC9615092 DOI: 10.1111/hex.13489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/12/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction People who experience social disadvantage including homelessness suffer from numerous ill health effects when compared to the general public. Use of patient‐reported outcome measures (PROMs) and patient‐reported experience measures (PREMs) enables collection of information from the point of view of the person receiving care. Involvement in research and health care decision‐making, a process that can be facilitated by the use of PROMs and PREMs, is one way to promote equity in care. Methods This article reports on a codevelopment and consultation study investigating the use of PROMs and PREMs with people who experience homelessness and chronic illness. Data were analysed according to interpretative phenomenological analysis. Results Committee members with lived experience identified three themes for the role of PROMs and PREMs in health care measurement: trust and relationship‐building; health and quality of life; and equity, alongside specific recommendations for the design and administration of PROMs and PREMs. The codevelopment process is reported to demonstrate the meaningful investment in time, infrastructure and relationship‐building required for successful partnership between researchers and people with lived experience of homelessness. Conclusion PROMs and PREMs can be meaningful measurement tools for people who experience social disadvantage, but can be alienating or reproduce inequity if they fail to capture complexity or rely on hidden assumptions of key concepts. Patient or Public Contribution This study was conducted in active partnership between researchers and people with experience of homelessness and chronic illness, including priority setting for study design, data construction, analysis and coauthorship on this article.
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Affiliation(s)
- Erin E Donald
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia, Canada.,Faculty of Human and Social Development, School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - Kara Whitlock
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | | | | | | | - Kelli I Stajduhar
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia, Canada.,Faculty of Human and Social Development, School of Nursing, University of Victoria, Victoria, British Columbia, Canada
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Increasing Engagement of Women Veterans in Health Research. J Gen Intern Med 2022; 37:42-49. [PMID: 35349014 PMCID: PMC8993961 DOI: 10.1007/s11606-021-07126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/26/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Meaningful engagement of patients in health research has the potential to increase research impact and foster patient trust in healthcare. For the past decade, the Veterans Health Administration (VA) has invested in increasing Veteran engagement in research. OBJECTIVE We sought the perspectives of women Veterans, VA women's health primary care providers (WH-PCPs), and administrators on barriers to and facilitators of health research engagement among women Veterans, the fastest growing subgroup of VA users. DESIGN Semi-structured qualitative telephone interviews were conducted from October 2016 to April 2018. PARTICIPANTS Women Veterans (N=31), WH-PCPs (N=22), and administrators (N=6) were enrolled across five VA Women's Health Practice-Based Research Network sites. APPROACH Interviews were audio-recorded and transcribed. Consensus-based coding was conducted by two expert analysts. KEY RESULTS All participants endorsed the importance of increasing patient engagement in women's health research. Women Veterans expressed altruistic motives as a personal determinant for research engagement, and interest in driving women's health research forward as a stakeholder or research partner. Challenges to engagement included lack of awareness about opportunities, distrust of research, competing priorities, and confidentiality concerns. Suggestions to increase engagement include utilizing VA's patient-facing portals of the electronic health record for outreach, facilitating "warm hand-offs" between researchers and clinic staff, developing an accessible research registry, and communicating the potential research impact for Veterans. CONCLUSIONS Participants expressed support for increasing women Veterans' engagement in women's health research and identified feasible ways to foster and implement engagement of women Veterans. Given the unique healthcare needs of women Veterans, engaging them in research could translate to improved care, especially for future generations. Knowledge about how to improve women Veterans' research engagement can inform future VA policy and practice for more meaningful interventions and infrastructure.
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Merker VL, Hyde JK, Herbst A, Solch AK, Mohr DC, Gaj L, Dvorin K, Dryden EM. Evaluating the Impacts of Patient Engagement on Health Services Research Teams: Lessons from the Veteran Consulting Network. J Gen Intern Med 2022; 37:33-41. [PMID: 35349028 PMCID: PMC8993982 DOI: 10.1007/s11606-021-06987-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite increasing commitment to patient engagement in research, evaluation of the impact of these efforts on research processes, products, and teams is limited. OBJECTIVE To explore the impacts of engaging patients as consultants to research studies by examining the experiences, impacts, and lessons learned from a program facilitating patient engagement at a Veterans Health Administration research center. DESIGN We developed a logic model to articulate the activities being implemented to support patient engagement and their anticipated outcomes. Then, we conducted qualitative, semi-structured interviews with participants in the local Veteran Consulting Network to qualitatively explore these outcomes. PARTICIPANTS Twelve researchers and eleven Veteran patients with experience working on at least one grant or funded study. APPROACH Interview transcripts were inductively coded using a consensus-based approach. Findings were synthesized using framework analysis and mapped back onto our logic model of expected patient engagement impacts. KEY RESULTS Patient engagement improved the perceived quality and relevance of research studies as patient consultants challenged researchers' assumptions about patient populations and clinical contexts and gave feedback that helped improve the feasibility of proposed grants, readability of study materials, comprehensiveness of study assessments, and cultural sensitivity and relevance of interventions. Patient engagement also had personal benefits to researchers and patients. Researchers reported improved communication skills and higher job satisfaction. Patients reported a sense of purpose and satisfaction from their work with greater awareness of and appreciation for research. CONCLUSIONS Engaging patients in research can have multiple benefits to the people and work involved. Our evaluation process can serve as a template for other organizations to plan for and assess the impact of their own patient engagement programs. Creating logic models and updating them based on feedback from program users make engagement goals explicit, help verify expected mechanisms to achieve impact, and facilitate organizational learning.
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Affiliation(s)
- Vanessa L Merker
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA. .,Department of Neurology and Cancer Center, Massachusetts General Hospital, MA, Boston, USA.
| | - Justeen K Hyde
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Abigail Herbst
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Amanda K Solch
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - David C Mohr
- Center of Helathcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, USA
| | - Lauren Gaj
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Kelly Dvorin
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Eileen M Dryden
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
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Hewitt J, Verbeek H. From Research to Impact in Long-Term Care: A Lived Experience Trajectory by Inaugural Winners of the Morley Award. J Am Med Dir Assoc 2022; 23:328-329. [DOI: 10.1016/j.jamda.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/15/2021] [Indexed: 10/19/2022]
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Cha J, West IW, Brockman TA, Soto MV, Balls-Berry JE, Eder M, Patten CA, Cohen EL. Use of Live Community Events on Facebook to Share Health and Clinical Research Information With a Minnesota Statewide Community: Exploratory Study. JMIR Form Res 2022; 6:e30973. [PMID: 35179514 PMCID: PMC8900910 DOI: 10.2196/30973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/18/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Community engagement can make a substantial difference in health outcomes and strengthen the capacity to deal with disruptive public health events such as the COVID-19 pandemic. Social media platforms such as Facebook are a promising avenue to reach the broader public and enhance access to clinical and translational science, and require further evaluation from the scientific community. OBJECTIVE This study aims to describe the use of live community events to enhance communication about clinical and health research through a Facebook platform case study (Minnesota [MN] Research Link) with a Minnesota statewide community. We examined variables associated with video engagement including video length and type of posting. METHODS From June 2019 to February 2021, MN Research Link streamed 38 live community events on its public Facebook page, MN Research Link. Live community events highlighted different investigators' clinical and health research in the areas of mental health, health and wellness, chronic diseases, and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, engagement metrics, and audience retention. An engagement rate was calculated by the total number of interactions (likes, shares, and comments) divided by the total length of the live event by the type of live community event. RESULTS The 38 live community events averaged 23 minutes and 1 second in duration. The total time viewed for all 38 videos was 10 hours, 44 minutes, and 40 seconds. Viewers' watch time averaged 23 seconds of content per video. After adjusting for video length, promotional videos and research presentations had the highest engagement and retention rates. Events that included audience participation did not have higher retention rates compared to events without audience participation. CONCLUSIONS The use of live community events showed adequate levels of engagement from participants. A view time of 23 seconds on average per video suggests that short informational videos engage viewers of clinical and translational science content. Live community events on Facebook can be an effective method of advancing health promotion and clinical and translational science content; however, certain types of events have more impact on engagement than others.
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Affiliation(s)
- Jinhee Cha
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
| | - Ian W West
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Tabetha A Brockman
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
| | - Miguel Valdez Soto
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Joyce E Balls-Berry
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St Louis, MO, United States
| | - Milton Eder
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Christi A Patten
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, United States
| | - Elisia L Cohen
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
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Pratt B, Prashanth NS, Seshadri T. How is Inclusiveness in Health Systems Research Priority-Setting Affected When Community Organizations Lead the Process? Health Policy Plan 2022; 37:811-821. [PMID: 35284932 PMCID: PMC9347025 DOI: 10.1093/heapol/czac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/19/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Community engagement is gaining prominence in health research. But communities rarely have a say in the agendas or conduct of the very health research projects that aim to help them. One way thought to achieve greater inclusion for communities throughout health research projects, including during priority-setting, is for researchers to partner with community organizations (COs). This paper provides initial empirical evidence as to the complexities such partnerships bring to priority-setting practice. Case study research was undertaken on a three-stage CO-led priority-setting process for health systems research. The CO was the Zilla Budakattu Girijana Abhivrudhhi Sangha, a district-level community development organization representing the Soliga people in Karnataka, India. Data on the priority-setting process was collected in 2018 and 2019 through in-depth interviews with researchers, Sangha leaders, and field investigators from the Soliga community who collected data as part of the priority-setting process. Direct observation and document collection were also performed, and data from all three sources were thematically analyzed. The case study demonstrates that, when COs lead health research priority-setting, their strengths and weaknesses in terms of representation and voice will affect inclusion at each stage of the priority-setting process. CO strengths can deepen inclusion by the CO and its wider community. CO weaknesses can create limitations for inclusion if not mitigated, exacerbating or reinforcing the very hierarchies that impede the achievement of improved health outcomes, e.g. exclusion of women in decision making processes related to their health. Based on these findings, recommendations are made to support inclusive CO-led health research priority-setting processes.
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Affiliation(s)
- Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University, Brisbane, Australia
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Australia
| | | | - Tanya Seshadri
- Institute of Public Health, Bangalore, India
- Vivekananda Girijana Kalyana Kendra, BR Hills, India
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Courvoisier M, Baddeliyanage R, Wilhelm L, Bayliss L, Straus SE, Fahim C. Evaluation of the partners in research course: a patient and researcher co-created course to build capacity in patient-oriented research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:76. [PMID: 34717764 PMCID: PMC8556807 DOI: 10.1186/s40900-021-00316-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In the past decade, patient-oriented research (POR) has been at the forefront of healthcare research in Canada because it has the potential to make research more meaningful and relevant to patient needs. Despite this growing emphasis on and expectation to conduct POR, there is limited guidance about how to apply POR in practice. To address this capacity building need, the Knowledge Translation (KT) Program and patient partners co-designed, delivered, and evaluated Partners in Research (PiR), a 2-month online course for patients and researchers to collectively learn how to conduct and engage in POR. METHODS PiR was delivered to 4 cohorts of patients and researchers between 2017 and 2018. For each cohort, we evaluated the impact of the course on participants' knowledge, self-efficacy, intentions, and use of POR using surveys at 3 time points: baseline, post-course and 6-months post-course. We also monitored the process of course design and delivery by assessing implementation quality of the PiR course. Participants were asked to rate their satisfaction with course format, course materials, quality of delivery and their level of engagement via a 7-point Likert scale in the post-course survey. RESULTS A total of 151 participants enrolled in the PiR course throughout the 4 cohorts. Of these, 49 patients and 33 researchers (n = 82 participants) consented to participate in the course evaluation. Process and outcome evaluations collected over a 9-month period indicated that participation in the PiR course increased knowledge of POR concepts for patients (p < .001) and for researchers (p < .001) from pre-course to post-course timepoints. Likewise, self-efficacy to engage in POR increased from baseline to post-course for both patients (p < .001) and researchers (p < .001). Moreover, participants reported high levels of satisfaction with content, delivery and interactive components of the course. CONCLUSIONS The PiR course increased capacity in POR for both researchers and patients. This work enhances our understanding of how to design useful and engaging education opportunities to increase patient and researcher capacity in POR.
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Affiliation(s)
| | - Richelle Baddeliyanage
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, ON, M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 500, Toronto, ON, M5T 3M7, Canada
| | - Linda Wilhelm
- The Canadian Arthritis Patient Alliance, Midland, Canada
| | - Lorraine Bayliss
- Transdisciplinary Understanding and Training On Research (TUTOR), Centre for Studies in Family Medicine, Western University, 1151 Richmond St., London, ON, N6A 3K7, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, ON, M5B 1T8, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada
| | - Christine Fahim
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria St., Toronto, ON, M5B 1T8, Canada.
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Kroese K, Porter K, Surridge H, Tembo D. Challenges and solutions: surveying researchers on what type of community engagement and involvement activities are feasible in low and middle income countries during the COVID-19 pandemic. BMJ Open 2021; 11:e052135. [PMID: 34706957 PMCID: PMC8551745 DOI: 10.1136/bmjopen-2021-052135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Measures to limit the spread of infection during the COVID-19 global pandemic have made engaging and involving members of the community in global health research more challenging. This research aimed to explore how global health researchers adapted to the imposed pandemic measures in low and middle income countries (LMICs) and how they overcame challenges to effective community engagement and involvement (CEI). DESIGN A qualitative two-stage mixed-methods study involving an online survey and a virtual round table. SETTING The survey and round table were completed online. PARTICIPANTS Of 53 participants, 43 were LMIC-based or UK-based global health researchers and/or CEI professionals, and 10 worked for the National Institute for Health Research or UK Government's Department of Health and Social Care. OUTCOME MEASURES This study aimed to capture data on: the number of CEI activities halted and adapted because of the COVID-19 pandemic; where CEI is possible; how it has been adapted; what the challenges and successes were; and the potential impact of adapted or halted CEI on global health research. RESULTS Pandemic control measures forced the majority of researchers to stop or amend their planned CEI activities. Most face-to-face CEI activities were replaced with remote methods, such as online communication. Virtual engagement enabled researchers to maintain already established relationships with community members, but was less effective when developing new relationships or addressing challenges around the inclusion of marginalised community groups. CONCLUSIONS COVID-19 has highlighted the need for contingency planning and flexibility in CEI. The redesigning and adopting of remote methods has come with both advantages and disadvantages, and required new skills, access to technology, funding, reliable services and enthusiasm from stakeholders. The methods suggested have the potential to augment or substitute previously preferred CEI activities. The effectiveness and impact of these remote CEI activities need to be assessed.
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Affiliation(s)
- Karolin Kroese
- NIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK
| | - Katie Porter
- Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Heidi Surridge
- Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Doreen Tembo
- Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK
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Smith-Merry J, O'Donovan MA, Dew A, Hemsley B, Imms C, Carey G, Darcy S, Ellem K, Gallego G, Gilroy J, Guastella A, Marella M, McVilly K, Plumb J. The future of disability research in Australia: protocol for a multi-phase research agenda-setting exercise. JMIR Res Protoc 2021; 11:e31126. [PMID: 34706859 PMCID: PMC8764607 DOI: 10.2196/31126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/24/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022] Open
Abstract
Background For people with disabilities to live a good life, it is essential that funded research in health and social care addresses their interests, meets their needs, and fills gaps in our understanding of the impact that services, systems, and policies may have on them. Decisions about research funding should be based on an understanding of the research priorities of people with disabilities, their supporters and allies, disability researchers, service providers, and policy makers working in the field. Objective The aim of this protocol is to describe the research design and methods of a large-scale, disability research agenda–setting exercise conducted in 2021 in Australia. Methods The research agenda–setting exercise involves 3 integrated phases of work. In the first phase, a previous audit of disability research in Australia is updated to understand previous research and continuing gaps in the research. Building on this, the second phase involves consultation with stakeholders—people with disabilities and their supporters and family members, the disability workforce, and people working within services and connected sectors (eg, aging, employment, education, and housing), academia, and public policy. Data for the second phase will be gathered as follows: a national web-based survey; a consultation process undertaken through the government and nongovernment sector; and targeted consultation with Aboriginal and Torres Strait Islander people, children with disabilities and their families, people with cognitive disability, and people with complex communication needs. The third phase involves a web-based survey to develop a research agenda based on the outcomes of all phases. Results We have started working on 2 parts of the research prioritization exercise. Through the research-mapping exercise we identified 1241 journal articles and book chapters (referred to as research papers) and 225 publicly available reports (referred to as research reports) produced over the 2018-2020 period. Data collection for the national survey has also been completed. We received 973 fully completed responses to the survey. Analysis of these data is currently underway. Conclusions This multi-method research agenda–setting study will be the first to provide an indication of the areas of health and social research that people across the Australian disability community consider should be prioritized in disability research funding decisions. Project results from all phases will be made publicly available through reports, open-access journal publications, and Easy Read documents. International Registered Report Identifier (IRRID) DERR1-10.2196/31126
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Affiliation(s)
- Jennifer Smith-Merry
- Centre for Disability Research and Policy, Faculty of Medicine and Health, The University of Sydney, School of Health SciencesSusan Wakil Health Building, The University of Sydney, Camperdown, AU
| | - Mary-Ann O'Donovan
- Centre for Disability Studies, Faculty of Medicine and Health, The University of Sydney, Camperdown, AU
| | - Angela Dew
- Disability and Inclusion, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, AU
| | - Bronwyn Hemsley
- Disability Research Network, University of Technology Sydney, Sydney, AU.,Faculty of Education and Arts, The University of Newcastle, Newcastle, AU
| | - Christine Imms
- Murdoch Children's Research Institute, The University of Melbourne, Melbourne, AU
| | - Gemma Carey
- Centre for Social Innovation, University of New South Wales, Sydney, AU
| | - Simon Darcy
- Disability Research Network, University of Technology Sydney, Sydney, AU
| | - Kathy Ellem
- School of Nursing, midwifery and Social Work, The University of Queensland, Brisbane, AU
| | - Gisselle Gallego
- Centre for Disability Research and Policy, Faculty of Medicine and Health, The University of Sydney, School of Health SciencesSusan Wakil Health Building, The University of Sydney, Camperdown, AU
| | - John Gilroy
- Centre for Disability Research and Policy, Faculty of Medicine and Health, The University of Sydney, School of Health SciencesSusan Wakil Health Building, The University of Sydney, Camperdown, AU
| | - Adam Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, AU
| | - Manjula Marella
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, AU
| | - Keith McVilly
- School of Social and Political Sciences, The University of Melbourne, Melbourne, AU
| | - Jenny Plumb
- Disability and Inclusion, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, AU
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Zibrowski E, Carr T, McDonald S, Thiessen H, van Dusen R, Goodridge D, Haver C, Marciniuk D, Stobart C, Verrall T, Groot G. A rapid realist review of patient engagement in patient-oriented research and health care system impacts: part one. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:72. [PMID: 34629118 PMCID: PMC8504114 DOI: 10.1186/s40900-021-00299-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/15/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Patient-oriented research affords individuals with opportunities to genuinely contribute to health care research as members of research teams. While checklists and frameworks can support academic researchers' awareness of patient engagement methods, less guidance appears available to support their understanding of how to develop and maintain collaborative relationships with their patient partners. This knowledge is essential as patient partners report that the social atmospheres of research teams significantly impacts the quality of their experiences. This study sought to develop theory regarding how academic researchers support and sustain patient engagement in patient-oriented research. METHODS A six-step, rapid realist review was conducted: (1) research question development, (2) preliminary theory development, (3) search strategy development; (4) study selection and appraisal, (4) data extraction, analysis and synthesis (5) identification of relevant formal theories, and (6) theory refinement with stakeholders. Findings were additionally distilled by collective competence theory. RESULTS A program theory was developed from 62 international studies which illuminated mechanisms supporting academic researchers to engage patient partners, contexts supporting these mechanisms, and resources that enabled mechanism activation. Interaction between seven contexts (patient-oriented research belief, prior interaction with a healthcare system, prior interaction with a particular academic researcher, educational background of patient partner, prior experience with patient-oriented research, study type, and time lived in a rural-urban setting) and seven mechanisms (deciding to become involved in patient-oriented research, recognizing valuable experiential knowledge, cultural competence, reducing power differentials, respectful team environment, supporting patient partners to feel valued, and readiness to research) resulted in an intermediate outcome (sense of trust). Trust then acted as an eighth mechanism which triggered the final-level outcome (empowered patient-centred lens). CONCLUSIONS Our theory posits that if patient partners trust they are a member of a supportive team working alongside academic researchers who authentically want to incorporate their input, then they are empowered to draw upon their experiential knowledge of health care systems and contribute as researchers in patient-oriented research. Our theory extends conceptual thinking regarding the importance of trust on patient-oriented research teams, how patient partners' trust is shaped by team interactions, and the role that academic researchers have within those interactions.
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Affiliation(s)
- Elaine Zibrowski
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | | | | | | | - Donna Goodridge
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Charlene Haver
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Darcy Marciniuk
- University of Saskatchewan, College of Medicine, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Christine Stobart
- Saskatchewan Centre for Patient-Oriented Research, Health Sciences Building, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada
| | - Tanya Verrall
- Saskatchewan Health Quality Council, Atrium Building, Innovation Place, 241 - 111 Research Drive, Saskatoon, SK, S7N 3R2, Canada
| | - Gary Groot
- Department of Community Health and Epidemiology, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
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O’Loughlin K, Huffstetler AN, Shadowen H, Brooks EM, Hinesley J, Huebschmann AG, Glasgow RE, Bohannon A, Krist AH. Stakeholder input on a care planning tool to address unhealthy behaviors, mental health needs, and social risks: The value of different stakeholder perspectives. J Clin Transl Sci 2021; 5:e188. [PMID: 34849263 PMCID: PMC8596059 DOI: 10.1017/cts.2021.864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/07/2022] Open
Abstract
This report describes how stakeholder groups informed a web-based care planning tool's development for addressing root causes of poor health. Stakeholders included community members (n = 6), researchers (n = 6), community care providers (n = 9), and patients (n = 17). Feedback was solicited through focus groups, semi-structured interviews, and user experience observations and then qualitatively analyzed to identify themes. Each group contributed a unique perspective. Researchers wanted evidence-based content; community members and providers focused on making goals manageable; patients wanted care team support and simple action-oriented language. Our findings highlight the benefits of stakeholder input. Blending perspectives from multiple groups results in a more robust intervention design.
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Affiliation(s)
- Kristen O’Loughlin
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alison N. Huffstetler
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Hannah Shadowen
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - E. Marshall Brooks
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer Hinesley
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Amy G. Huebschmann
- Department of Medicine, Division of General Internal Medicine, University of Colorado, Aurora, CO, USA
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado, Aurora, CO, USA
| | - Russell E. Glasgow
- Adult and Child Consortium for Outcomes Research and Delivery Science, University of Colorado, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Arline Bohannon
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Alex H. Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
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Moczygemba LR, Brown C, Johnsrud M. "It's Time to Represent": shifting the paradigm to improve the quality of inputs into value assessment frameworks. J Manag Care Spec Pharm 2021; 27:S19-S23. [PMID: 34534005 DOI: 10.18553/jmcp.2021.27.9-a.s19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
"It's Time to Represent" integrates 2 strategies that challenge the status quo to increase the diversity of populations that participate in research and address drivers of health disparities to better inform value assessment. The first, a community-engaged campaign, proposes to develop authentic, long-term partnerships with community members, their health care providers, and researchers to tailor recruitment and retention methods for underrepresented groups and hold researchers accountable for equitable selection of study participants. The second proposes to create an expectation for researchers to routinely collect patient-reported, actionable social determinants of health data to generate enhanced real-world evidence and thereby improve the quality of inputs utilized in value assessment frameworks. DISCLOSURE: No specific funding was received for this manuscript. The authors report no potential conflicts of interest.
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Affiliation(s)
- Leticia R Moczygemba
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
| | - Carolyn Brown
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
| | - Michael Johnsrud
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
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Abstract
Supplemental Digital Content is available in the text. New York state implemented the first state-level sepsis regulations in 2013. These regulations were associated with improved mortality, leading other states to consider similar steps. Our objective was to provide insight into New York state’s sepsis policy making process, creating a roadmap for policymakers in other states considering similar regulations.
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Pratt B. Achieving inclusive research priority-setting: what do people with lived experience and the public think is essential? BMC Med Ethics 2021; 22:117. [PMID: 34481506 PMCID: PMC8418727 DOI: 10.1186/s12910-021-00685-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Engagement of people with lived experience and members of the public is an ethically and scientifically essential component of health research. Authentic engagement means they are involved as full partners in research projects. Yet engagement as partnership is uncommon in practice, especially during priority-setting for research projects. What is needed for agenda-setting to be shared by researchers and people with lived experience and/or members of the public (or organisations representing them)? At present, little ethical guidance exists on this matter, particularly that which has been informed by the perspectives of people with lived experience and members of the public. This article provides initial evidence about what they think are essential foundations and barriers to shared decision-making in health research priority-setting and health research more broadly. Methods An exploratory, qualitative study was conducted in 2019. 22 semi-structured interviews were performed with key informants from the UK and Australia. Results Three main types of foundations were thought to be essential to have in place before shared decision-making can occur in health research priority-setting: relational, environmental, and personal. Collectively, the three types of foundations addressed many (but not all) of the barriers to power sharing identified by interviewees. Conclusions Based on study findings, suggestions are made for what researchers, engagement practitioners, research institutions, and funders should do in their policy and practice to support meaningful engagement. Finally, key international research ethics guidelines on community engagement are considered in light of study findings.
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Affiliation(s)
- Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University, 1100 Nudgee Road, Banyo, QLD, 4014, Australia.
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Moczygemba LR, Brown C, Johnsrud M. "It's Time to Represent": shifting the paradigm to improve the quality of inputs into value assessment frameworks. J Manag Care Spec Pharm 2021; 27:S17-S21. [PMID: 34579541 PMCID: PMC10408409 DOI: 10.18553/jmcp.2021.27.9-a.s17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
"It's Time to Represent" integrates 2 strategies that challenge the status quo to increase the diversity of populations that participate in research and address drivers of health disparities to better inform value assessment. The first, a community-engaged campaign, proposes to develop authentic, long-term partnerships with community members, their health care providers, and researchers to tailor recruitment and retention methods for underrepresented groups and hold researchers accountable for equitable selection of study participants. The second proposes to create an expectation for researchers to routinely collect patient-reported, actionable social determinants of health data to generate enhanced real-world evidence and thereby improve the quality of inputs utilized in value assessment frameworks. DISCLOSURE: No specific funding was received for this manuscript. The authors report no potential conflicts of interest.
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Affiliation(s)
- Leticia R Moczygemba
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
| | - Carolyn Brown
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
| | - Michael Johnsrud
- Health Outcomes Division and Texas Center for Health Outcomes Research & Education (TxCORE), College of Pharmacy, University of Texas at Austin
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Shaw JL, Semmens E, Okihiro M, Lewis JL, Hirschfeld M, VanWagoner TM, Stephens L, Easa D, Ross JL, Graham N, Watson SE, Szyld EG, Dillard DA, Pyles LA, Darden PM, Carlson JC, Smith PG, McCulloh RJ, Snowden JN, Adeky SH, Singleton R. Best Practices for Conducting Clinical Trials With Indigenous Children in the United States. Am J Public Health 2021; 111:1645-1653. [PMID: 34436921 PMCID: PMC8494399 DOI: 10.2105/ajph.2021.306372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/04/2022]
Abstract
We provide guidance for conducting clinical trials with Indigenous children in the United States. We drew on extant literature and our experience to describe 3 best practices for the ethical and effective conduct of clinical trials with Indigenous children. Case examples of pediatric research conducted with American Indian, Alaska Native, and Native Hawaiian communities are provided to illustrate these practices. Ethical and effective clinical trials with Indigenous children require early and sustained community engagement, building capacity for Indigenous research, and supporting community oversight and ownership of research. Effective engagement requires equity, trust, shared interests, and mutual benefit among partners over time. Capacity building should prioritize developing Indigenous researchers. Supporting community oversight and ownership of research means that investigators should plan for data-sharing agreements, return or destruction of data, and multiple regulatory approvals. Indigenous children must be included in clinical trials to reduce health disparities and improve health outcomes in these pediatric populations. Establishment of the Environmental Influences on Child Health Outcomes Institutional Development Award States Pediatric Clinical Trials Network (ECHO ISPCTN) in 2016 creates a unique and timely opportunity to increase Indigenous children's participation in state-of-the-art clinical trials.
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Affiliation(s)
- Jennifer L Shaw
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Erin Semmens
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - May Okihiro
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Johnnye L Lewis
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Matthew Hirschfeld
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Timothy M VanWagoner
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Lancer Stephens
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - David Easa
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Judith L Ross
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Niki Graham
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Sara E Watson
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Edgardo G Szyld
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Denise A Dillard
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Lee A Pyles
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Paul M Darden
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - John C Carlson
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Paul G Smith
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Russell J McCulloh
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Jessica N Snowden
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Sarah H Adeky
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
| | - Rosalyn Singleton
- Jennifer L. Shaw and Denise A. Dillard are with the Southcentral Foundation Research Department, Anchorage, AK. Rosalyn Singleton is with the Alaska Native Tribal Health Consortium, Anchorage. May Okihiro and David Easa are with the University of Hawaii at Manoa, Honolulu. Erin Semmens, Paul G. Smith, and Niki Graham are with the University of Montana, Missoula. Johnnye L. Lewis is with the University of New Mexico Health Sciences Center, Albuquerque. Matthew Hirschfeld is with the Alaska Native Medical Center, Anchorage. Timothy M. VanWagoner, Paul M. Darden, Edgardo G. Szyld, and Lancer Stephens are with the University of Oklahoma Health Sciences Center, Oklahoma City. Judith L. Ross is with the Alfred I. duPont Hospital for Children, Wilmington, DE. Sara E. Watson is with the University of Louisville, Louisville, KY. Lee A. Pyles is with the West Virginia University, Morgantown. John C. Carlson is with Tulane University, New Orleans, LA. Russell J. McCulloh is with the University of Nebraska Medical Center, Omaha. Jessica N. Snowden is with the University of Arkansas for Medical Sciences, Little Rock. Sarah H. Adeky is with the Ramah Navajo Community, Pinehill, NM
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Lecours A, Gilbert MH, Lord MM, Labrecque C, Boucher F. Telework in a pandemic context: protocol of a participatory study on the effects of teleworking conditions on the well-being and social participation of workers. BMJ Open 2021; 11:e051099. [PMID: 34429318 PMCID: PMC8387739 DOI: 10.1136/bmjopen-2021-051099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Although several authors have been interested in the well-being and social participation of teleworkers in the context of the COVID-19 pandemic, it appears that most of the recommendations issued are based on literature reviews or expert opinions; yet few authors have documented the perspectives of the workers. The aim of this study is to explore workers' perspectives of teleworking in the context of the COVID-19 pandemic regarding the effects on their well-being and social participation. METHODS AND ANALYSIS Using a participatory study protocol involving the collaboration of a community organisation defending workers' rights, the first step will be to conduct focus groups to qualitatively describe workers' perspectives of their teleworking conditions. Then, an online questionnaire will be administered to a large pool or workers to quantitatively explore the influence of individual, organisational and environmental variables on the well-being and social participation of workers. The thematic and statistical analyses of the data collected will indicate successful practices to be adopted by workers and organisations. These successful practices will be validated by workers through a Technique for Research of Information by Animation of a Group of Experts group and will serve as concrete tools to better support workers' participation in teleworking. ETHICS AND DISSEMINATION The approval of the research ethics board of the Centre intégré universitaire de santé et de services sociaux de la Capitale Nationale has been obtained. Findings will be shared with various stakeholders including workers, employers, insurers and unions. Findings will be disseminated in webinars, peer-reviewed journals and lectures.
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada
| | | | - Marie-Michèle Lord
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
| | - Charlotte Labrecque
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada
| | - Frédéric Boucher
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Quebec, Canada
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Merker VL, Lessing AJ, Moss I, Hussey M, Oberlander B, Rose T, Thalheimer R, Wirtanen T, Wolters PL, Gross AM, Plotkin SR. Enhancing Neurofibromatosis Clinical Trial Outcome Measures Through Patient Engagement: Lessons From REiNS. Neurology 2021; 97:S4-S14. [PMID: 34230208 PMCID: PMC8594004 DOI: 10.1212/wnl.0000000000012430] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/08/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE As part of an evaluation of the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration patient representative program, we surveyed REiNS members to (1) identify facilitators and barriers to involving patient representatives and (2) understand whether and how involving patient representatives affected recommendations for clinical trial outcomes. METHODS We administered an anonymous online survey to all REiNS members. Facilitators and barriers to patient representative involvement were solicited using a modified free listing technique; responses were inductively grouped into higher-order categories and ranked based on saliency score (Smith s). Open-ended questions assessed patient representative expectations for engagement, perceived benefits/costs of patient engagement, and patient representative contributions; responses were analyzed using conventional content analysis. RESULTS A total of 63/172 (37%) members responded, including 18/30 (60%) patient representatives. Providing sufficient opportunities to meaningfully engage in research tasks and cultivating a respectful, inclusive atmosphere were key facilitators to patient representatives' satisfaction and ability to make an impact. Respondents perceived that patient representatives directly (through their input on research tasks) and indirectly (through effects on other stakeholders' knowledge and communication style) improved the organization's research, leading to selection of more meaningful, relevant, and feasible clinical trial outcome measures. Ongoing challenges to patient engagement include difficulty scheduling meetings and concerns about the level of scientific knowledge patient representatives needed to effectively engage. CONCLUSIONS Involving patient representatives in REiNS improved perceived quality of neurofibromatosis clinical trial outcome measures. Negotiating sufficient opportunities to engage, fostering an inclusive atmosphere, and navigating time pressures are key to effective patient engagement.
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Affiliation(s)
- Vanessa L Merker
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD.
| | - Andrés J Lessing
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Irene Moss
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Maureen Hussey
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Beverly Oberlander
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Traceann Rose
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Raquel Thalheimer
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Tracy Wirtanen
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Pamela L Wolters
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Andrea M Gross
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Scott R Plotkin
- From the Center for Healthcare Organization and Implementation Research (CHOIR) (V.L.M.), Edith Nourse Rogers Memorial Veterans Hospital, Bedford; Department of Neurology and Cancer Center (V.L.M., R.T., S.R.P.), Massachusetts General Hospital, Boston; Neurofibromatosis Northeast (A.J.L.), Burlington, MA; Children's Tumor Foundation (I.M., M.H., T.R.), New York, NY; Neurofibromatosis Inc. California (B.O.), Vacaville; Neurofibromatosis Network (B.O.), Wheaton, IL; Littlest Tumor Foundation (T.W.), Appleton, WI; and Pediatric Oncology Branch (P.L.W., A.M.G.), National Cancer Institute, National Institutes of Health, Bethesda, MD
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Masoud SS, Glassner AA, Patel N, Mendoza M, James D, Rivette S, White CL. Engagement with a diverse Stakeholder Advisory Council for research in dementia care. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:54. [PMID: 34301338 PMCID: PMC8300992 DOI: 10.1186/s40900-021-00297-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/14/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND The inclusion of stakeholders throughout the research process has been gaining recognition as an approach that can improve the quality and impact of research. Stakeholder engagement for dementia care research has been identified as a national priority, though evaluation of engagement strategies and their impact has been limited. In dementia care research, stakeholders can include individuals living with dementia, family care partners, and health and social care professionals in dementia care. A Stakeholder Advisory Council (SAC) was established to identify priorities for dementia care research that are most important to stakeholders. Strategies to build capacity for research and facilitate engagement among the SAC were used to identify the research priorities. This study describes the experiences of SAC members engaged in the research process. METHODS To evaluate stakeholder engagement, semi-structured interviews were conducted with members of the SAC to understand their experiences and perspectives on the strategies used to facilitate engagement and build capacity for research. Interviews were recorded, transcribed, and thematically analyzed using a mixed inductive and deductive approach. Findings were presented to members of the SAC to determine whether they felt their perspectives and experiences were accurately represented. Final domains and themes presented here were approved by the SAC. RESULTS Interviews (N = 11) were conducted with members of the SAC representing each stakeholder group; persons living with dementia (n = 2); family care partners (n = 4), and health and social care professionals in dementia care (n = 5). Ten themes were categorized into four overarching domains: accessibility, council infrastructure, values and environment, and benefits of involvement. CONCLUSIONS Findings from this qualitative study are a resource for researchers seeking to collaborate with diverse stakeholder groups to represent their perspectives in research, including individuals living with dementia. The domains and themes identified here support the inclusion of diverse stakeholders in the research process, centering engagement and capacity building strategies around individuals living with dementia.
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Affiliation(s)
- Sara S Masoud
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA.
| | - Ashlie A Glassner
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Neela Patel
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
- The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Mayra Mendoza
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Deborah James
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Sheran Rivette
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Carole L White
- The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
- The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
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Hwang DA, Lee A, Song JM, Han HR. Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis. J Med Internet Res 2021; 23:e23959. [PMID: 34255658 PMCID: PMC8314154 DOI: 10.2196/23959] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 04/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background Racial and ethnic minority groups are underrepresented in health research, contributing to persistent health disparities in the United States. Identifying effective recruitment and retention strategies among minority groups and their subpopulations is an important research agenda. Web-based intervention approaches are becoming increasingly popular with the ubiquitous use of the internet. However, it is not completely clear which recruitment and retention strategies have been successful in web-based intervention trials targeting racial and ethnic minorities. Objective This study aims to describe lessons learned in recruiting and retaining one of the understudied ethnic minority women—Korean Americans—enrolled in a web-based intervention trial and to compare our findings with the strategies reported in relevant published web-based intervention trials. Methods Multiple sources of data were used to address the objectives of this study, including the study team’s meeting minutes, participant tracking and contact logs, survey reports, and postintervention interviews. In addition, an electronic search involving 2 databases (PubMed and CINAHL) was performed to identify published studies using web-based interventions. Qualitative analysis was then performed to identify common themes addressing recruitment and retention strategies across the trials using web-based intervention modalities. Results A total of 9 categories of recruitment and retention strategies emerged: authentic care; accommodation of time, place, and transportation; financial incentives; diversity among the study team; multiple, yet standardized modes of communication; mobilizing existing community relationships with efforts to build trust; prioritizing features of web-based intervention; combined use of web-based and direct recruitment; and self-directed web-based intervention with human support. Although all the studies included in the analysis combined multiple strategies, prioritizing features of web-based intervention or use of human support were particularly relevant for promoting recruitment and retention of racial and ethnic minorities in web-based intervention trials. Conclusions The growing prevalence of internet use among racial and ethnic minority populations represents an excellent opportunity to design and deliver intervention programs via the internet. Future research should explore and compare successful recruitment and retention methods among race and ethnic groups for web-based interventions. Trial Registration ClinicalTrials.gov NCT03726619; https://clinicaltrials.gov/ct2/show/NCT03726619.
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Affiliation(s)
- DaSol Amy Hwang
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Alex Lee
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Jae Min Song
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
| | - Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
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