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Liabo K, Asare L, Ruthen P, Burton J, Staunton P, Day J. Emotion in public involvement: A conceptual review. Health Expect 2024; 27:e14020. [PMID: 38504467 PMCID: PMC10951420 DOI: 10.1111/hex.14020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Experiential knowledge can aid in designing research by highlighting what an idea looks like from a patient and carer perspective. Experiential knowledge can be emotional, and this can create challenges at formal research meetings. OBJECTIVE The aim of this study was to consider the role of emotions in public involvement. METHODS This is a conceptual review informed by relevant literature and reflection within the author team. A structured Scopus search was conducted in November 2021 and December 2022, identifying 18 articles that presented findings from patient and public involvement (PPI) research related to 'emotion'. We complemented the search with theory-generating articles related to the role of emotion and emotional labour in human life. FINDINGS Study findings from the structured search were tabulated to identify recurring themes; these were as follows: emotional connections to the research topic can cause stressful as well as cathartic experiences of PPI, 'emotional work' is part of PPI when people are contributing with their experiential knowledge and the emotional aspect of 'lived experience' needs to be recognised in how PPI is planned and facilitated. These points were considered in relation to theoretical works and experiences within the author team. DISCUSSION 'Emotion work' is often required of public collaborators when they contribute to research. They are asked to contribute to research alongside researchers, with knowledge that often contains emotions or feelings. This can be both upsetting and cathartic, and the environment of the research study can make the experience worse or better. CONCLUSIONS The emotional component of experiential knowledge can be challenging to those invited to share this knowledge. It is imperative that researchers, research institutions and health and care professionals adjust research meeting spaces to show an awareness of the emotional labour that is involved in PPI. PATIENT OR PUBLIC CONTRIBUTION This review was initiated after a meeting between carers and family members of residents in care homes and researchers. The review is co-written by a group of three researchers and three carers and family members. Regular online meetings were held during the draft stages to incorporate people's views and ideas. Data extracted from the review were presented to the group of public collaborators in a variety of formats (e.g., posters, slideshows, text and verbally) to facilitate shared sense-making and synthesis of the literature.
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Affiliation(s)
- Kristin Liabo
- Department of Community and Health Sciences, Faculty of Health and Life Sciences, University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Lauren Asare
- Department of Community and Health Sciences, Faculty of Health and Life Sciences, University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Philip Ruthen
- Exeter Lived Experience Group (LEG), Department of Psychology, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Julia Burton
- National Institute for Health Research Applied Research Collaboration South West Peninsula Public Engagement Group (PenPEG)University of ExeterExeterUK
| | - Pamela Staunton
- National Institute for Health Research Applied Research Collaboration South West Peninsula Public Engagement Group (PenPEG)University of ExeterExeterUK
| | - Joanne Day
- Department of Community and Health Sciences, Faculty of Health and Life Sciences, University of Exeter Medical SchoolUniversity of ExeterExeterUK
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Pittalis C, Drury G, Mwapasa G, Borgstein E, Cheelo M, Kachimba J, Juma A, Chilonga K, Cahill N, Brugha R, Lavy C, Gajewski J. Using participatory action research to empower district hospital staff to deliver quality-assured essential surgery to rural populations in Malawi, Zambia, and Tanzania. Front Public Health 2023; 11:1186307. [PMID: 37780427 PMCID: PMC10536269 DOI: 10.3389/fpubh.2023.1186307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background In 2017 the SURG-Africa project set out to institute a surgical, obstetric, trauma and anesthesia (SOTA) care capacity-building intervention focused on non-specialist providers at district hospitals in Zambia, Malawi and Tanzania. The aim was to scale up quality-assured SOTA care for rural populations. This paper reports the process of developing the intervention and our experience of initial implementation, using a participatory approach. Methods Participatory Action Research workshops were held in the 3 countries in July-October 2017 and in October 2018-July 2019, involving representatives of key local stakeholder groups: district hospital (DH) surgical teams and administrators, referral hospital SOTA specialists, professional associations and local authorities. Through semi-structured discussions, qualitative data were collected on participants' perceptions and experiences of barriers to the provision of SOTA care at district level, and on the training and supervision needs of district surgical teams. Data were compared for themes across countries and across surgical team cadres. Results All groups reported a lack of in-service training to develop essential skills to manage common SOTA cases; use and care of equipment; essential anesthesia care including resuscitation skills; and infection prevention and control. Very few district surgical teams had access to supervision. SOTA providers at DHs reported a demand for more feedback on referrals. Participants prioritized training needs that could be addressed through regular in-service training and supervision visits from referral hospital specialists to DHs. These data were used by participants in an action-planning cycle to develop site-specific training plans for each research site. Conclusion The inclusive, participatory approach to stakeholder involvement in SOTA system strengthening employed by this study supported the design of a locally relevant and contextualized intervention. This study provides lessons on how to rebalance power dynamics in Global Surgery, through giving a voice to district surgical teams.
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Affiliation(s)
- Chiara Pittalis
- School of Population Health, Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Grace Drury
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Gerald Mwapasa
- Deparment of Surgery, College of Medicine, Kamuzu University of Health Sciences (former University of Malawi), Blantyre, Malawi
| | - Eric Borgstein
- Deparment of Surgery, College of Medicine, Kamuzu University of Health Sciences (former University of Malawi), Blantyre, Malawi
| | | | | | - Adinan Juma
- East Central and Southern Africa Health Community, Arusha, Tanzania
| | - Kondo Chilonga
- Department of Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Niamh Cahill
- School of Medicine, University of South Carolina, Greenville, SC, United States
| | - Ruairi Brugha
- School of Population Health, Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Chris Lavy
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Jakub Gajewski
- School of Population Health, Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Boyle E, McGookin C, de Bhailís D, Gallachóir BÓ, Mullally G. The diffusion of sustainability and Dingle Peninsula 2030. UCL Open Environ 2022; 4:e052. [PMID: 37228479 PMCID: PMC10171406 DOI: 10.14324/111.444/ucloe.000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/29/2022] [Indexed: 05/27/2023]
Abstract
Instilling a collaborative approach can widen participation to a range of stakeholders, enabling the diffusion of sustainability and increasing local capacity to meet decarbonisation targets to mitigate against climate change. Dingle Peninsula 2030 has emerged as an international case study of a collaborative regional sustainability project, whereby a wide range of initiatives, beyond the initial remit of the project, have emerged in the area. This holistic scale of action is required for effective climate action. Using the Sustainable Development Goals (SDGs) as a framing, the interrelated nature of climate action has been shown through this study. In setting out to undergo energy projects a wide range of new initiatives emerged as community members became engaged in the process. Initiatives have emerged related to energy, transport, agriculture, education, tourism and employment, in what we have coined the 'diffusion of sustainability'.
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Affiliation(s)
- Evan Boyle
- MaREI, The SFI Research Centre for Energy, Climate and Marine, Cork, Ireland
- Department of Sociology and Criminology, University College Cork, Cork, Ireland
| | - Connor McGookin
- MaREI, The SFI Research Centre for Energy, Climate and Marine, Cork, Ireland
- School of Engineering, University College Cork, Cork, Ireland
| | | | - Brian Ó Gallachóir
- MaREI, The SFI Research Centre for Energy, Climate and Marine, Cork, Ireland
- School of Engineering, University College Cork, Cork, Ireland
| | - Gerard Mullally
- MaREI, The SFI Research Centre for Energy, Climate and Marine, Cork, Ireland
- Department of Sociology and Criminology, University College Cork, Cork, Ireland
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Childerhose JE, Finnila CH, Yu JH, Koenig BA, McEwen J, Berg SL, Wilfond BS, Appelbaum PS, Brothers KB. Participant Engagement in Translational Genomics Research: Respect for Persons-and Then Some. Ethics Hum Res 2019; 41:2-15. [PMID: 31541538 PMCID: PMC7199158 DOI: 10.1002/eahr.500029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The expansion of both formal and informal frameworks of "engaged" research in translational research settings raises emerging and substantial normative concerns. In this article, we draw on findings from a focus group study with members of a national consortium of translational genomic research sites. The goals were to catalog informal participant engagement practices, to explore the perceived roots of these practices and the motivations of research staff members for adopting them, and to reflect on their ethical implications. We learned that participant engagement is a deliberate strategy by research staff members both to achieve instrumental research goals and to "do research differently" in response to past research injustices. While many of the participant engagement practices used in translational genomic research are not new, important insights can be gained through a closer examination of the specific contours of participant engagement in this context. These practices appear to have been shaped by the professional training of genetic counselors and by the interests and needs of participants who enroll in clinical genomics studies. The contours of this contemporary application of engaged research principles have relevance not only to clinical genomics research but also to translational research broadly, particularly for how communities of clinical researchers are interpreting the principle of respect for persons. Our findings invite normative questions about the governance of these practices and sociological questions about whether and how clinical researchers in other professions are also engaging participants in translational research settings.
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Affiliation(s)
- Janet E. Childerhose
- Division of Pediatric Clinical and Translational Research, University of Louisville School of Medicine, 231 East Chestnut Street, N-97, Louisville, KY 40202
| | - Candice H. Finnila
- HudsonAlpha Institute for Biotechnology, 601 Genome Way, Huntsville, AL 35806
| | - Joon-Ho Yu
- Department of Pediatrics, University of Washington School of Medicine, Box 357371, 1959 NE Pacific St. HSB I607Q, Seattle, WA 98195
| | - Barbara A. Koenig
- Institute for Health and Aging, University of California San Francisco, 3333 California St., Suite 340, San Francisco, CA 94118
| | - Jean McEwen
- The Ethical, Legal and Social Implications Research Program, National Human Genome Research Institute, National Institutes of Health, 5635 Fishers Lane, Suite 4076, MSC 9305, Bethesda, MD 20892
| | - Stacey L. Berg
- Texas Children’s Cancer Center, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin St #1400, Houston, Texas 77030
- Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, Suite 450A, Houston, Texas 77030
| | - Benjamin S. Wilfond
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Hospital, 1900 Ninth Ave., M/S JMB-6, Seattle, WA 98101
| | - Paul S. Appelbaum
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032
| | - Kyle B. Brothers
- Division of Pediatric Clinical and Translational Research, University of Louisville School of Medicine, 231 East Chestnut Street, N-97, Louisville, KY 40202
- Institute for Bioethics, Health Policy, and Law, University of Louisville, 501 E. Broadway, Ste 310, Louisville, KY 40202
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Galloway TS, Baglin N, Lee BP, Kocur AL, Shepherd MH, Steele AM, Harries LW. An engaged research study to assess the effect of a 'real-world' dietary intervention on urinary bisphenol A (BPA) levels in teenagers. BMJ Open 2018; 8:e018742. [PMID: 29431133 PMCID: PMC5829847 DOI: 10.1136/bmjopen-2017-018742] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Bisphenol A (BPA) has been associated with adverse human health outcomes and exposure to this compound is near-ubiquitous in the Western world. We aimed to examine whether self-moderation of BPA exposure is possible by altering diet in a real-world setting. DESIGN An Engaged Research dietary intervention study designed, implemented and analysed by healthy teenagers from six schools and undertaken in their own homes. PARTICIPANTS A total of 94 students aged between 17 and 19 years from schools in the South West of the UK provided diet diaries and urine samples for analysis. INTERVENTION Researcher participants designed a set of literature-informed guidelines for the reduction of dietary BPA to be followed for 7 days. MAIN OUTCOME MEASURES Creatinine-adjusted urinary BPA levels were taken before and after the intervention. Information on packaging and food/drink ingested was used to calculate a BPA risk score for anticipated exposure. A qualitative analysis was carried out to identify themes addressing long-term sustainability of the diet. RESULTS BPA was detected in urine of 86% of participants at baseline at a median value of 1.22 ng/mL (IQR 1.99). No effect of the intervention diet on BPA levels was identified overall (P=0.25), but there was a positive association in those participants who showed a drop in urinary BPA concentration postintervention and their initial BPA level (P=0.003). Qualitative analysis identified themes around feelings of lifestyle restriction and the inadequacy of current labelling practices. CONCLUSIONS We found no evidence in this self-administered intervention study that it was possible to moderate BPA exposure by diet in a real-world setting. Furthermore, our study participants indicated that they would be unlikely to sustain such a diet long term, due to the difficulty in identifying BPA-free foods.
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Affiliation(s)
- Tamara S Galloway
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Nigel Baglin
- Research Projects, St Lukes campus, University of Exeter, Exeter, UK
| | - Benjamin P Lee
- RNA-Mediated Disease Mechanisms Group, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, UK
| | - Anna L Kocur
- RNA-Mediated Disease Mechanisms Group, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, UK
| | - Maggie H Shepherd
- National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, UK
- Medical School Building 03.11, University of Exeter Medical School, Exeter, UK
| | - Anna M Steele
- National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, UK
- Medical School Building 03.11, University of Exeter Medical School, Exeter, UK
| | - Lorna W Harries
- RNA-Mediated Disease Mechanisms Group, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, UK
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