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Masoud SS, Escareño JT, Flores B, Lesser J, Choi BY, White CL. Project ECHO Brain Health: Assessing the Impact of a Pilot Program to Promote Self-Efficacy Among Community Health Workers. FAMILY & COMMUNITY HEALTH 2024; 47:191-201. [PMID: 38742867 DOI: 10.1097/fch.0000000000000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
This mixed-methods study sought to examine the impact of the Project ECHO Brain Health program on participating community health workers' (CHWs') self-efficacy to address dementia, promote brain health, and advocate for research among Latinx South Texas communities. Using an explanatory sequential design, quantitative data collected from pre- and post-program surveys were analyzed to inform the collection of qualitative data, followed by an interpretation of all findings to better understand the impact of the program on self-efficacy. Pre- and post-surveys were collected from 25 CHWs, 13 of whom later participated in individual interviews. There was a statistically significant increase in mean self-efficacy scores between the pre- and post-surveys among participants. Three categories reflecting the experiences of participants were identified from the qualitative data: addressing training needs; impact on CHWs and their practice; and community of learning. The findings suggest that Project ECHO Brain Health program is a timely intervention that may facilitate increased self-efficacy among CHWs as they navigate the impacts of dementia in their communities.
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Affiliation(s)
- Sara S Masoud
- Author Affiliations: School of Nursing (Drs Masoud, Lesser and White), Department of Population Health Sciences (Dr Choi), University of Texas Health Science Center at San Antonio, San Antonio, Texas; Lower Rio Grande Valley Area Health Education Center (Ms Escareño, Harlingen, Texas); and South Coastal Area Health Education Center (Ms Flores), Corpus Christi, Texas
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Goudarzi Z, Marzaleh MA, Nikfar S, Kebriaeezadeh A, Zenouz RY, Abdollahiasl A, Nouhi M. Towards greater impact in health technology assessment: System dynamic approach for new and emerging technologies in Iran. Daru 2024; 32:25-45. [PMID: 37917419 PMCID: PMC11087392 DOI: 10.1007/s40199-023-00483-x] [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: 02/03/2023] [Accepted: 09/17/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE As classical health technology assessment models fail to predict the complexities of related impacts, the application of modeling techniques such as systems dynamics simulation (SD) is essential. This study aimed to develop an SD model to predict the outcomes of access to a new medicine in Iran. METHODS This study extracted the important and influential variables in providing access to new pharmaceutical technologies by comprehensively reviewing previous research and combining the technical knowledge of experts in this field. The variables were incorporated into the systems thinking framework and modeled using dynamic systems tools, followed by simulation and testing in VENSIM. The model was piloted for deferoxamine and deferasirox in thalassemia. Various tests were used to evaluate the validity and reliability of the model. The model was designed for a ten-year horizon (2018-2028) for medicines selected as the pilot. RESULTS The variables extracted from the panel of experts encompassed the primary and short-term impacts of access to newly emerged medicine and long-term impacts regarding the economy, health, and society. After modeling, the leverage points presented for the problem with the greatest impact or effectiveness in access to new medicine included the policy determining the amount of medicine supply, the import and production of medicine, the prevalence and incidence of disease, insurance coverage, and treatment adherence. CONCLUSION The SD models allow the researchers to evaluate the efficiency and health outcomes of a new pharmaceutical more precisely in the health system in Iran.
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Affiliation(s)
- Zahra Goudarzi
- Faculty of Medical Information and Management, Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
| | - Milad Ahmadi Marzaleh
- Department of Health in Disasters and Emergencies, Faculty of Medical Information and Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Qasr Al-Dasht St., 27 Alley, Shiraz, 7133654361, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran
| | - Reza Yousefi Zenouz
- Department of Operations and Information Technology Management, Faculty of Management, Kharazmi University, Tehran Between Shahid Qorani and Ostad Nejatollahi, Somia St, No 242, Tehran, 159996415, Iran
| | - Akbar Abdollahiasl
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Square,16 Azar St., Tehran, 1417614411, Iran.
| | - Mojtaba Nouhi
- National Institute for Health Research, Tehran University of Medical Sciences, Keshahvarz Blvd, Vasal Shirazi Street, Bozorgmehr East Street, Number 70, Tehran, 62921000, Iran
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Blazey P, Scott A, Ardern CL, Davis JC, Whittaker JL, Losciale JM, Khan KM. Consensus methods in patellofemoral pain: how rigorous are they? A scoping review. Br J Sports Med 2024:bjsports-2023-107552. [PMID: 38777386 DOI: 10.1136/bjsports-2023-107552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Clinicians treating patients with patellofemoral pain (PFP) rely on consensus statements to make the best practice recommendations in the absence of definitive evidence on how to manage PFP. However, the methods used to generate and assess agreement for these recommendations have not been examined. Our objective was to map the methods used to generate consensus-based recommendations for PFP and apply four novel questions to assess the rigour of consensus development. DESIGN Scoping review. DATA SOURCES We searched Medline, SPORTDiscus, CINAHL and Embase from inception to May 2022 to identify consensus-derived statements or practice guidelines on PFP. The Joanna Briggs Institute Manual for Evidence Synthesis was followed to map the existing evidence. We measured the consensus methods based on four sets of questions addressing the panel composition, application of the consensus method chosen, agreement process and the use of evidence mapping. ELIGIBILITY CRITERIA All consensus statements or clinical guidelines on PFP were considered. RESULTS Twenty-two PFP consensus statements were identified. Panel composition: 3 of the 22 (14%) consensus groups reported the panellists' experience, 2 (9%) defined a desired level of expertise, 10 (45%) reported panellist sex and only 2 (9%) included a patient. Consensus method: 7 of 22 (32%) reported using an established method of consensus measurement/development. Agreement process: 10 of 22 (45%) reported their consensus threshold and 2 (9%) acknowledged dissenting opinions among the panel. Evidence mapping: 6 of 22 (27%) reported using systematic methods to identify relevant evidence gaps. CONCLUSIONS PFP consensus panels have lacked diversity and excluded key partners including patients. Consensus statements on PFP frequently fail to use recognised consensus methods, rarely describe how 'agreement' was defined or measured and often neglect to use systematic methods to identify evidence gaps.
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Affiliation(s)
- Paul Blazey
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Alex Scott
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Clare L Ardern
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer C Davis
- Applied Health Economics Laboratory, Faculty of Management, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Justin M Losciale
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Karim M Khan
- Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
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Ameen S, Shafiq SS, Ashrafee S, Saberin A, Saha PK, Alam HMS, Nahar S, Sarkar S, Adnan SD, ANM Ehtesham K, Amena B, Ahmed S, Khan MN, Banik G, Jabeen S, Hossain AT, Sarkar SS, Ahmed A, Chisti MJ, Islam MS, Islam MJ, El Arifeen S, Rahman AE. Stakeholder engagement to introduce a standardised register for improved inpatient care of newborns and sick children in Bangladesh. J Glob Health 2024; 14:04082. [PMID: 38751308 PMCID: PMC11096775 DOI: 10.7189/jogh.14.04082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
Background Despite a global decrease of 59% in under-five mortality rates from 1990 to 2021, child survival remains a pressing issue. This holds true for Bangladesh, as well. In response, the Government of Bangladesh introduced a standardised register for strengthening the inpatient management of newborns and sick children in 2021. Methods We employed a comprehensive four-phase stakeholder engagement process to implement an inpatient register for newborns and sick children. The first stage included identifying and prioritising potential stakeholders at the national and district levels. We identified eight organisations involved in newborn and child health and selected 24 participants from various other sectors for workshops aimed at raising awareness about the register's introduction. These stakeholders also participated in the register's design, development strategies planning, and implementation phases. These phases were led by the 'National Newborn Health and IMCI programme' with support from various partners. A technical working group reviewed existing registers and helped prepare training materials. Feedback from each workshop was crucial in finalising the register. Results The Government of Bangladesh has recognised the need for an indoor register for newborns and sick children, which was to be established in collaboration with development partners. This initiative can enhance the quality of care for sick children and increase service provider accountability. Due to its successful implementation, it will continue to be used in the Kushtia and Dinajpur districts, with plans for a nationwide scale-up. The Government has allocated funds in the next health sector programme for orientation and register printing. A strengths, weaknesses, opportunities, and threats (SWOT) analysis of the stakeholder engagement process highlighted strengths such as a context-specific approach and collaborative engagement, as well as challenges such as time resource requirements. Conclusions Implementing an inpatient register for newborns and sick children through stakeholder engagement can effectively improve child health care services. Aside from challenges such as resource intensiveness and stakeholder commitments, success depended on the organising authority's expertise in relationship building, budget allocation, time management, and workforce dedication. Therefore, strategic planning, staff recruitment, networking, and budgeting are crucial for successful stakeholder engagement and health care initiatives.
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Affiliation(s)
- Shafiqul Ameen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabit Saad Shafiq
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Ashfia Saberin
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Palash Kumar Saha
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Husam Md Shah Alam
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Salmun Nahar
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Supriya Sarkar
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sheikh Daud Adnan
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | | | - Sabbir Ahmed
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | | | | | - Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Aniqa Tasnim Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sadman Sowmik Sarkar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Md Jahurul Islam
- Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Alsadaan N, Ramadan OME, Alqahtani M. From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes. BMC Nurs 2024; 23:325. [PMID: 38741096 DOI: 10.1186/s12912-024-01996-9] [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: 02/13/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Nursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses' well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals. METHODS This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction. RESULTS More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.
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Affiliation(s)
- Nourah Alsadaan
- College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia.
| | | | - Mohammed Alqahtani
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
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Jabeen S, Chandrima RM, Hasan M, Rahman MM, Rahman QSU, AKM TH, Dewan F, Alim A, Nadia N, Mahmud M, Sarker MH, Islam J, Islam MS, Ashrafee S, Haider MS, Chisti MJ, Sheikh MZH, Miah MS, Al-Mahmud M, Ameen S, Ahmed A, El Arifeen S, Rahman AE. A context-driven approach through stakeholder engagement to introduce a digital emergency obstetric and newborn care register into routine obstetric health care services in Bangladesh. J Glob Health 2024; 14:04098. [PMID: 38721686 PMCID: PMC11079701 DOI: 10.7189/jogh.14.04098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Emergency obstetric and newborn care (EmONC) in Bangladesh focusses on maternal health, whereby it addresses childbirth and postpartum complications to ensure women's health and well-being. It was transitioned to a digital platform to overcome challenges with the paper-based EmONC register and we conducted implementation research to assess the outcome. Here we outline the stakeholder engagement process integral to the implementation research process. Methods We adopted a four-step stakeholder engagement model based on the identification, sensitisation, involvement, and engagement of stakeholders. The approach was informed by previous experience, desk reviews, and expert consultations to ensure comprehensive engagement with stakeholders at multiple levels. Led by the Maternal Health Programme of the Government of Bangladesh, we involved high-power and high-interest stakeholders in developing a joint action plan for digitisation of the paper-based EmONC register. Finally, we demonstrated this digital EmONC register in real-life settings to stakeholders at different levels. Results The successful demonstration process fostered government ownership and collaboration with multiple stakeholders, while laying the foundation for scalability and sustainability. Nevertheless, our experience highlighted that the stakeholder engagement process is context-driven, time-consuming, resource-intensive, iterative, and dynamic, and it requires involving stakeholders with varied expertise. Effective strategic planning, facilitation, and the allocation of sufficient time and resources are essential components for successful stakeholder engagement. Conclusions Our experience demonstrates the potential of adopting the 'identification, sensitisation, involvement, and engagement' stakeholder engagement model. Success in implementing this model in diverse settings depends on leveraging knowledge gained during implementation, maintaining robust communication with stakeholders, and harnessing the patience and determination of the facilitating organisation.
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Affiliation(s)
- Sabrina Jabeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mehedi Hasan
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Mahiur Rahman
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Tanvir Hossain AKM
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Farhana Dewan
- Obstetrical and Gynaecological Society of Bangladesh (OGSB), Dhaka, Bangladesh
| | - Azizul Alim
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Nuzhat Nadia
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mustufa Mahmud
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Moazzem Hossain Sarker
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sabbir Haider
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Md Al-Mahmud
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shafiqul Ameen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shams El Arifeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Deatrick JA. Adapting Psychosocial Interventions Using Participatory Methods: Lessons Learned for Family Nursing. JOURNAL OF FAMILY NURSING 2024; 30:87-93. [PMID: 38682440 DOI: 10.1177/10748407241232091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
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Rafaai NH, Lee KE. Reconciling and contextualising multi-dimensional aspects for consolidated water security index: A synthesis. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 359:121067. [PMID: 38718607 DOI: 10.1016/j.jenvman.2024.121067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/05/2024] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
The present paper aims to review and develop a Consolidated Water Security Index (CWSI) as a tool to evaluate water security status within river basins by considering five key dimensions, namely (i) water supply and sanitation, (ii) water demand and socio-economic, (iii) water ecosystem and environment, (iv) water-related disaster and (v) water governance. This index is a holistic assessment since it aims to capture the interconnected and complex nature of water-related issues by considering multiple dimensional aspects which helps stakeholders and policymakers to understand the overall status of water security. This framework uses the Analytic Hierarchy Process (AHP), involving pairwise comparison, normalisation and weighting. Then, a CWSI will be calculated using the Linear Aggregation method. The robustness of this consolidated index is validated using sensitivity analysis by modifying the weight in the linear aggregation formula. By following each step cautiously, a CWSI can be constructed and interpreted correctly, thus, becoming a powerful tool for conveying complex information to the different stakeholders and assessing the status of water security with river basins. The CWSI allows decision-makers to prioritise areas that are most at risk and facilitate sustainable planning and management of water resources.
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Affiliation(s)
- Nur Hairunnisa Rafaai
- Integrated Water Research Synergy Consortium (IWaReS), Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, 43600, UKM, Bangi, Selangor, Malaysia
| | - Khai Ern Lee
- Integrated Water Research Synergy Consortium (IWaReS), Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, 43600, UKM, Bangi, Selangor, Malaysia.
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Bagg MK, Hicks AJ, Hellewell SC, Ponsford JL, Lannin NA, O'Brien TJ, Cameron PA, Cooper DJ, Rushworth N, Gabbe BJ, Fitzgerald M. The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions. Neurotrauma Rep 2024; 5:424-447. [PMID: 38660461 PMCID: PMC11040195 DOI: 10.1089/neur.2023.0116] [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] [Indexed: 04/26/2024] Open
Abstract
The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.
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Affiliation(s)
- Matthew K. Bagg
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amelia J. Hicks
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Sarah C. Hellewell
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- National Trauma Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D. Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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Van den Wyngaert I, Van Pottelbergh G, Coteur K, Vaes B, Van den Bulck S. Developing a questionnaire to evaluate an automated audit & feedback intervention: a Rand-modified Delphi method. BMC Health Serv Res 2024; 24:433. [PMID: 38581009 PMCID: PMC10998400 DOI: 10.1186/s12913-024-10915-2] [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: 07/27/2023] [Accepted: 03/27/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Audit and feedback (A&F) is a widely used implementation strategy to evaluate and improve medical practice. The optimal design of an A&F system is uncertain and structured process evaluations are currently lacking. This study aimed to develop and validate a questionnaire to evaluate the use of automated A&F systems. METHODS Based on the Clinical Performance Feedback Intervention Theory (CP-FIT) and the REFLECT-52 (REassessing audit & Feedback interventions: a tooL for Evaluating Compliance with suggested besT practices) evaluation tool a questionnaire was designed for the purpose of evaluating automated A&F systems. A Rand-modified Delphi method was used to develop the process evaluation and obtain validation. Fourteen experts from different domains in primary care consented to participate and individually scored the questions on a 9-point Likert scale. Afterwards, the questions were discussed in a consensus meeting. After approval, the final questionnaire was compiled. RESULTS A 34-question questionnaire composed of 57 items was developed and presented to the expert panel. The consensus meeting resulted in a selection of 31 questions, subdivided into 43 items. A final list of 30 questions consisting of 42 items was obtained. CONCLUSION A questionnaire consisting of 30 questions was drawn up for the assessment and improvement of automated A&F systems, based on CP-FIT and REFLECT-52 theory and approved by experts. Next steps will be piloting and implementation of the questionnaire.
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Affiliation(s)
- Ine Van den Wyngaert
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
| | - Gijs Van Pottelbergh
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Kristien Coteur
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Bert Vaes
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Steve Van den Bulck
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
- Research Group Healthcare and Ethics, Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium
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Rioles N, March C, Muñoz CE, Ilkowitz J, Ohmer A, Wolf RM. Stakeholder Engagement in Type 1 Diabetes Research, Quality Improvement, and Clinical Care. Endocrinol Metab Clin North Am 2024; 53:165-182. [PMID: 38272594 DOI: 10.1016/j.ecl.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
The integration of stakeholder engagement (SE) in research, quality improvement (QI), and clinical care has gained significant traction. Type 1 diabetes is a chronic disease that requires complex daily management and care from a multidisciplinary team across the lifespan. Inclusion of key stakeholder voices, including patients, caregivers, health care providers and community advocates, in the research process and implementation of clinical care is critical to ensure representation of perspectives that match the values and goals of the patient population. This review describes the current framework for SE and its application to research, QI, and clinical care across the lifespan.
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Affiliation(s)
| | - Christine March
- Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Cynthia E Muñoz
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jeniece Ilkowitz
- Pediatric Diabetes Center, NYU Langone Health, New York, NY, USA
| | - Amy Ohmer
- International Children's Advisory Network, Atlanta, GA, USA
| | - Risa M Wolf
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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12
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Fernandes G, Williams S, Adab P, Gale N, de Jong C, de Sousa JC, Cheng KK, Chi C, Cooper BG, Dickens AP, Enocson A, Farley A, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stamenova A, Stavrikj K, Stelmach R, Turner A, Pan Z, Pang H, Zhang J, Jordan RE. Engaging stakeholders to level up COPD care in LMICs: lessons learned from the "Breathe Well" programme in Brazil, China, Georgia, and North Macedonia. BMC Health Serv Res 2024; 24:66. [PMID: 38216986 PMCID: PMC10790249 DOI: 10.1186/s12913-023-10525-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/24/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Effective stakeholder engagement in health research is increasingly being recognised and promoted as an important pathway to closing the gap between knowledge production and its use in health systems. However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned. MAIN BODY Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice. CONCLUSION Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment.
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Affiliation(s)
- Genevie Fernandes
- International Primary Care Respiratory Group, London, UK.
- Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - Siân Williams
- International Primary Care Respiratory Group, London, UK
| | - Peymané Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicola Gale
- Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Birmingham, UK
| | - Corina de Jong
- International Primary Care Respiratory Group, London, UK
| | - Jaime Correia de Sousa
- International Primary Care Respiratory Group, London, UK
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- PT Government Associate Laboratory, ICVS/3B's, Braga/Guimarães, Portugal
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chunhua Chi
- Department of General Practice, Peking University First Hospital, Beijing, China
| | | | - Andrew P Dickens
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Observational and Pragmatic Research Institute, Midview City, Singapore
| | - Alexandra Enocson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amanda Farley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Maka Maglakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Tamaz Maghlakelidze
- Georgian Respiratory Association, Tbilisi, Georgia
- Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Sonia Martins
- Family Medicine, ABC Medical School, São Paolo, Brazil
| | - Alice Sitch
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Aleksandra Stamenova
- Faculty of Medicine, Institute of Social Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Katarina Stavrikj
- Center for Family Medicine, Faculty of Medicine, Ss.Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paolo, Brazil
| | - Alice Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Zihan Pan
- Department of General Practice, Peking University First Hospital, Beijing, China
| | - Hui Pang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jianxin Zhang
- Department of General Practice, Peking University First Hospital, Beijing, China
| | - Rachel E Jordan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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13
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Woolf B, Vinson AH. Cultural health capital and patient partner recruitment into healthcare improvement work. Soc Sci Med 2024; 341:116500. [PMID: 38134712 DOI: 10.1016/j.socscimed.2023.116500] [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: 07/13/2023] [Revised: 10/21/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
A rising emphasis on patient involvement in clinical research and healthcare improvement has led to the steady incorporation of patients and caregivers into this work. However, interactional factors shaping recruitment processes are not well understood. In this paper, we present a qualitative analysis of interviews with twenty-six patients, family members, engagement staff and healthcare providers who are engaged in healthcare improvement work in the United States. We focus on how stakeholders account for recruitment decisions to participate in healthcare improvement work. We find that expressions of and judgments about patients' and caregivers' cultural health capital shape providers' decisions to extend invitations to participate in healthcare improvement work. These findings extend current conceptualizations of cultural health capital beyond the clinical encounter to reveal factors shaping patient recruitment into healthcare improvement work. In theorizing how cultural health capital shapes action in this new setting, we found that healthcare providers, engagement staff, and patients/caregivers attended to different aspects of cultural health capital when accounting for why they extended or received a recruitment pitch. We further found that participating in healthcare improvement work led to a boost in cultural health capital for patients and caregivers, which they could use to develop transmissible forms of cultural health capital for less centrally involved patients and caregivers. Finally, we describe how participants in healthcare improvement collaboratives account for a lack of diversity among partners. These findings help us hypothesize the consequences of recruitment processes that rely on displays and judgments of cultural health capital and identify possibilities for change. Using the case of healthcare improvement work in Collaborative Learning Health Systems, our findings advance past work on cultural health capital in medical sociology by theorizing the role of cultural health capital in recruitment processes.
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Affiliation(s)
- Becky Woolf
- Department of Learning Health Sciences, University of Michigan, USA.
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14
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Trowman R, Migliore A, Ollendorf DA. The value and impact of health technology assessment: discussions and recommendations from the 2023 Health Technology Assessment International Global Policy Forum. Int J Technol Assess Health Care 2023; 39:e75. [PMID: 38130164 DOI: 10.1017/s0266462323002763] [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: 12/23/2023]
Abstract
Health technology assessment (HTA) programs inform decision making about the value and reimbursement of new and existing health technologies; however, they are under increasing pressure to demonstrate that they are a cost-effective use of finite healthcare resources themselves. The 2023 HTAi Global Policy Forum (GPF) discussed the value and impact of HTA, including how it is assessed and communicated, and how it could be enhanced in the future. This article summarizes the discussions held at the 2023 HTAi GPF, where the challenges and opportunities related to the value and impact of HTA were debated. Core themes and recommendations identified that defining the purpose of value and impact assessment is an essential first step prior to undertaking it, and that it can be done through the use and expansion of existing tools. Further work around aligning HTA programs with underlying societal values is needed to ensure the long-term value and impact of HTA. HTA could also have a role in assessing the efficiency of the wider health system by applying HTA methods or concepts to broader budgetary allocations and organizational aspects of health care. Stakeholders (particularly patients, industry, and clinicians but also payers, wider society, and the media) should ideally be actively engaged when undertaking the value and impact assessment of HTA. More concerted efforts in communicating the role and remit of HTA bodies would also help stakeholders to better understand the value and impact of HTA, which in turn could improve the implementation of HTA recommendations and application to future actions in the lifecycle of technologies.
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Affiliation(s)
| | - Antonio Migliore
- Health Technology Assessment International (HTAi), Edmonton, AB, Canada
| | - Daniel A Ollendorf
- Tufts Medical Center, Center for the Evaluation of Value and Risk in Health, Boston, MA, USA
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15
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Coulston F, Spittle A, McDonald C, Remedios L, Toovey R, Cheong J, Sellick K. "We are a unique breed": strategies to enhance physical activity participation for preschool-aged children born extremely preterm, a mixed-methods study. Disabil Rehabil 2023; 45:4111-4121. [PMID: 36415163 DOI: 10.1080/09638288.2022.2147226] [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: 05/27/2022] [Accepted: 11/05/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Preschool-aged children (three to five years old) born preterm participate in less physical activity (PA) than term-born children. Circus activities (a type of recreational PA) are a potential avenue to increase PA rates, but further insight into how to tailor these to address the participation gap is needed. This study investigated barriers and facilitators informing participation in recreational PA for preschool-aged children born extremely preterm and explored strategies to enhance participation in circus activities. MATERIALS AND METHODS Sequential mixed-methods study utilizing surveys (n = 217), interviews (n = 43), and a focus group (n = 6) with key stakeholder groups (parents, coaches, and clinicians). Qualitative data (Framework Method) and quantitative data (descriptive statistics) were mixed during preliminary and final analyses. RESULTS Five themes were developed from the mixed data: the crucial role of the coach and the need for specific training, the therapeutic role of PA and promoting outcomes beyond the physical, the impact of communication and class planning, consideration of convenience and cost, and finally, the role of clinicians. CONCLUSIONS Barriers, facilitators, and strategies were identified which may be used to modify or co-design circus-based PA interventions to enhance participation and improve rates of PA for preschool-aged children born extremely preterm.IMPLICATIONS FOR REHABILITATIONFamilies consider recreational physical activities to be part of the therapeutic agenda for their preschool-aged children born extremely preterm.Key stakeholders feel that recreational physical activity should target outcomes beyond the physical.Coach attributes and capability impact participation of children born preterm and their families, and may be enhanced with specific training.Clinicians should be engaged in design of recreational physical activities for children born preterm.
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Affiliation(s)
- Free Coulston
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Alicia Spittle
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Services, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Cassie McDonald
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Allied Health, Alfred Health, Melbourne, Victoria, Australia
| | - Louisa Remedios
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- School of Health, Federation University, Ballarat, Victoria, Australia
| | - Rachel Toovey
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jeanie Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Services, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
| | - Kath Sellick
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Williams VW, Finkelstein JB. Speaking and listening: The importance of stakeholder engagement in quality improvement in pediatric urology. J Pediatr Urol 2023; 19:792-799. [PMID: 37689553 DOI: 10.1016/j.jpurol.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/04/2023] [Accepted: 08/17/2023] [Indexed: 09/11/2023]
Abstract
To improve health care, we as clinicians must work to change processes that make it easier to do our job well and reliably every day. Before improving a process, we must understand it and this often requires employing the expertise of others. Indeed, quality improvement work is often done in teams. The key is identifying and engaging the right stakeholders for each improvement initiative. The goal of this review is to provide health care professionals with the basis for how to do this. We describe four essential stakeholder steps that aid in the success of a quality improvement initiative. The steps of 1.) identifying and 2.) categorizing stakeholders involve spending the time to think about who the necessary stakeholders are and how to organize them. It is essential to consider stakeholders who are balanced for expertise, skills, experience, perspective, gender, race, and ethnicity. The process then moves on to 3.) analyzing stakeholders, which supports efforts that are focused on the stakeholder relationships that will most impact project success. The final step is 4.) stakeholder engagement. This represents a critical opportunity, not only upfront, but also to maintain a high level of stakeholder engagement throughout the quality improvement project. As the improvement work evolves, it is important to return to the earlier steps and reflect on the stakeholder group; the process is iterative. Devoting sufficient energy and time to these stakeholder steps will provide ample returns. This review should assist health care professionals in establishing an improvement team for each quality improvement initiative, which is foundational to initiating change efforts that better system performance, enhance the quality of care, and ensure patient safety.
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17
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Bao H, Lee EWJ. Examining Theoretical Frameworks and Antecedents of Health Apps and Wearables Use: A Scoping Review. HEALTH COMMUNICATION 2023:1-11. [PMID: 37968803 DOI: 10.1080/10410236.2023.2283655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
The advancement of health apps and wearables has garnered substantial academic attention, particularly in examining why individuals decide to use or not use them. In response to the extensive body of research on this topic, we conducted a scoping review of 61 articles published from 2007 to 2022, aiming to examine the dominant theoretical frameworks and antecedents of health apps and wearables use. The findings demonstrated that the dominant theoretical frameworks within this domain were rooted in the human-computer interaction theories, notably the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology. Next, our review identified four levels of antecedents: technological, individual, societal, and policy. At the technological level, emphasis was placed on functionality, reliability, and technological infrastructure. Individual antecedents encompassed socio-demographics, personality traits, cognitive responses to benefits and risks, emotional and affective responses, self-efficacy, and digital literacy. Societal antecedents highlighted the role of social networks and social norms, while policy antecedents elaborated on laws, regulations, and guidelines that encouraged health technology adoption. Our discussion illuminated that the evolving trend of theoretical frameworks in health apps and wearables use research, initially rooted in human-computer interaction, is progressively moving toward more comprehensive perspectives. We further underscored the importance of delving into societal and policy antecedents, which often are overshadowed by the more commonly discussed technological and individual factors. In conclusion, we advocated for a multi-stakeholder collaborative network approach, as this would enable communication researchers to understand the use of health apps and wearables more comprehensively.
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Affiliation(s)
- Huanyu Bao
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Edmund W J Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
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18
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Gilfoyle M, Melro C, Koskinas E, Salsberg J. Recruitment of patients, carers and members of the public to advisory boards, groups and panels in public and patient involved health research: a scoping review. BMJ Open 2023; 13:e072918. [PMID: 37832980 PMCID: PMC10582988 DOI: 10.1136/bmjopen-2023-072918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES The objectives of this scoping review are to: (1) identify the distribution of and context of the recruitment strategies used, (2) explore the facilitators, benefits, barriers and ethical issues of the identified recruitment strategies, (3) distinguish the varying terminology for involvement (ie, panels, boards, individual) and (4) determine if the individual recruitment strategies used were to address issues of representation or bias. DESIGN A scoping review. SETTING This scoping review follows the framework by Peters et al. Seven electronic databases were explored including Scopus, Medline, PubMed, Web of Science, CINAHL, Cochrane Library and PsycINFO (conducted July 2021). The search strategy was codeveloped among the research team, PPI research experts and a faculty librarian. Two independent reviewers screened articles by title and abstract and then at full text based on predetermined criteria. PRIMARY AND SECONDARY OUTCOME MEASURES Explore recruitment strategies used, facilitators, benefits, barriers and ethical issues of the identified recruitment strategies. Identify terminology for involvement. Explore recruitment strategies used to address issues of representation or bias. RESULTS The final sample was from 51 sources. A large portion of the extracted empirical literature had a clinical focus (37%, n=13) but was not a randomised control trial. The most common recruitment strategies used were human networks (78%, n=40), such as word of mouth, foundation affiliation, existing networks, clinics or personal contacts. Within the reviewed literature, there was a lack of discussion pertaining to facilitators, benefits, barriers and ethical considerations of recruitment strategies was apparent. Finally, 41% (n=21) of studies employed or proposed recruitment strategies or considerations to address issues of representation or bias. CONCLUSION We conclude with four key recommendations that researchers can use to better understand appropriate routes to meaningfully involve patients, carers and members of the public to cocreate the evidence informing their care.
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Affiliation(s)
- Meghan Gilfoyle
- School of Medicine, University of Limerick, Limerick, Ireland
- McMaster University, Hamilton, Ontario, Canada
| | | | - Elena Koskinas
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- School of Medicine, University of Limerick, Limerick, Ireland
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Brasier N, Ates HC, Sempionatto JR, Cotta MO, Widmer AF, Eckstein J, Goldhahn J, Roberts JA, Gao W, Dincer C. A three-level model for therapeutic drug monitoring of antimicrobials at the site of infection. THE LANCET. INFECTIOUS DISEASES 2023; 23:e445-e453. [PMID: 37348517 DOI: 10.1016/s1473-3099(23)00215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 06/24/2023]
Abstract
The silent pandemic of bacterial antimicrobial resistance is a leading cause of death worldwide, prolonging hospital stays and raising health-care costs. Poor incentives to develop novel pharmacological compounds and the misuse of antibiotics contribute to the bacterial antimicrobial resistance crisis. Therapeutic drug monitoring (TDM) based on blood analysis can help alleviate the emergence of bacterial antimicrobial resistance and effectively decreases the risk of toxic drug concentrations in patients' blood. Antibiotic tissue penetration can vary in patients who are critically or chronically ill and can potentially lead to treatment failure. Antibiotics such as β-lactams and glycopeptides are detectable in non-invasively collectable biofluids, such as sweat and exhaled breath. The emergence of wearable sensors enables easy access to these non-invasive biofluids, and thus a laboratory-independent analysis of various disease-associated biomarkers and drugs. In this Personal View, we introduce a three-level model for TDM of antibiotics to describe concentrations at the site of infection (SOI) by use of wearable sensors. Our model links blood-based drug measurement with the analysis of drug concentrations in non-invasively collectable biofluids stemming from the SOI to characterise drug concentrations at the SOI. Finally, we outline the necessary clinical and technical steps for the development of wearable sensing platforms for SOI applications.
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Affiliation(s)
- Noé Brasier
- Institute for Translational Medicine, ETH Zurich, Zurich, Switzerland; Department of Digitalization & ICT, University Hospital Basel, Basel, Switzerland.
| | - H Ceren Ates
- FIT Freiburg Centre for Interactive Materials and Bioinspired Technology, University of Freiburg, Freiburg, Germany; Department of Microsystems Engineering, IMTEK, University of Freiburg, Freiburg, Germany
| | - Juliane R Sempionatto
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Menino O Cotta
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Andreas F Widmer
- Department of Infectious Disease and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Jens Eckstein
- Department of Digitalization & ICT, University Hospital Basel, Basel, Switzerland; Division for Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Jörg Goldhahn
- Institute for Translational Medicine, ETH Zurich, Zurich, Switzerland
| | - Jason A Roberts
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia; Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, QLD, Australia; Department of Pharmacy and Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Division of Anaesthesiology, Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Wei Gao
- Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Can Dincer
- FIT Freiburg Centre for Interactive Materials and Bioinspired Technology, University of Freiburg, Freiburg, Germany; Department of Microsystems Engineering, IMTEK, University of Freiburg, Freiburg, Germany.
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20
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Vanderhout S, Nevins P, Nicholls SG, Macarthur C, Brehaut JC, Potter BK, Gillies K, Goulao B, Smith M, Hilderley A, Carroll K, Spinewine A, Weijer C, Fergusson DA, Taljaard M. Patient and public involvement in pragmatic trials: online survey of corresponding authors of published trials. CMAJ Open 2023; 11:E826-E837. [PMID: 37726115 PMCID: PMC10516685 DOI: 10.9778/cmajo.20220198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND There are few data on patient and public involvement (PPI) in pragmatic trials. We aimed to describe the prevalence and nature of PPI within pragmatic trials, describe variation in prevalence of PPI by trial characteristics and compare prevalence of PPI reported by trial authors to that reported in trial publications. METHODS We applied a search filter to identify pragmatic trials published from 2014 to 2019 in MEDLINE. We invited the corresponding authors of pragmatic trials to participate in an online survey about their specific trial. RESULTS Of 3163 authors invited, 2585 invitations were delivered, 710 (27.5%) reported on 710 unique trials and completed the survey; 334 (47.0%) conducted PPI. Among those who conducted PPI, for many the aim was to increase the research relevance (86.3%) or quality (76.5%). Most PPI partners were engaged at protocol development stages (79.1%) and contributed to the co-design of interventions (70.9%) or recruitment or retention strategies (60.5%). Patient and public involvement was more common among trials involving children, trials conducted in the United Kingdom, cluster randomized trials, those explicitly labelled as "pragmatic" in the study manuscript, and more recent trials. Less than one-quarter of trials (22.8%) that reported PPI in the survey also reported PPI in the trial manuscript. INTERPRETATION Nearly half of trialists in this survey reported conducting PPI and listed several benefits of doing so, but researchers who did not conduct PPI often cited a lack of requirement for it. Patient and public involvement appears to be significantly underreported in trial publications. Consistent and standardized reporting is needed to promote transparency about PPI methods, outcomes, challenges and benefits.
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Affiliation(s)
- Shelley Vanderhout
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont.
| | - Pascale Nevins
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Stuart G Nicholls
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Colin Macarthur
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Jamie C Brehaut
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Beth K Potter
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Kate Gillies
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Beatriz Goulao
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Maureen Smith
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Alicia Hilderley
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Kelly Carroll
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Anne Spinewine
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Charles Weijer
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Dean A Fergusson
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
| | - Monica Taljaard
- Clinical Epidemiology Program (Vanderhout, Nevins, Nicholls, Brehaut, Carroll, Fergusson, Taljaard), Ottawa Hospital Research Institute; School of Epidemiology and Public Health (Vanderhout, Potter, Fergusson, Taljaard), University of Ottawa, Ottawa, Ont.; Child Health Evaluative Sciences (Macarthur), Hospital for Sick Children Research Institute, Toronto, Ont.; Health Services Research Unit (Gillies, Goulao), University of Aberdeen, Aberdeen, UK; Patient Partner (Smith), INFORM RARE Research Network, Ottawa, Ont.; Patient Partner (Hilderley); Louvain Drug Research Institute (Spinewine), Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium; CHU UCL Namur (Spinewine), Godinne, Pharmacy Department, Yvoir, Belgium; Departments of Medicine, Epidemiology & Biostatistics, and Philosophy (Weijer), University of Western Ontario, London, Ont
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21
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Cazzolli R, Sluiter A, Guha C, Huuskes B, Wong G, Craig JC, Jaure A, Scholes-Robertson N. Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies. Clin Kidney J 2023; 16:i57-i68. [PMID: 37711636 PMCID: PMC10497378 DOI: 10.1093/ckj/sfad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 09/16/2023] Open
Abstract
Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.
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Affiliation(s)
- Rosanna Cazzolli
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Sluiter
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Chandana Guha
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Brooke Huuskes
- Centre for Cardiovascular Biology and Disease Research, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, VIC, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Allison Jaure
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
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22
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Etchegary H, Linklater S, Duquette D, Wilkinson G, Francis V, Gionet E, Patey AM, Grimshaw JM. "I think there has to be a mutual respect for there to be value": Evaluating patient engagement in a national clinical trial on de-implementation of low value care. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:70. [PMID: 37633983 PMCID: PMC10463407 DOI: 10.1186/s40900-023-00483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The evaluation of patient engagement in research is understudied and under-reported, making it difficult to know what engagement strategies work best and when. We provide the results of an evaluation of patient engagement in a large Canadian research program focused on the de-implementation of low-value care. We aimed to evaluate the experience and impact of patient engagement in the study. METHODS An online cross-sectional survey was administered using Microsoft Forms to (1) researchers and study staff and (2) patient partners. The survey was developed following iterative reviews by the project's patient partnership council and evaluation committee. Survey content areas included opinions on patient engagement to date, including challenges to engagement and suggestions for improvement. Patient partners also evaluated the partnership council. Descriptive statistics including counts and percentages described Likert scale survey items, while open comments were analyzed using descriptive content analysis. RESULTS The survey response rate was 46% (17/37). There were positive attitudes about the value of patient engagement in this project. There was also a high degree of willingness to be involved with patient engagement in future projects, whether as a patient partner or as a researcher including patients on the research team. Most patient partners felt their contributions to the project were valued by researchers and study research staff. Open comments revealed that a co-design approach and full inclusion on the research team were integral to demonstrating the value of patient partner input. Areas for improvement included more frequent and ongoing communication among all team members, as well as earlier training about patient engagement, particularly addressing role expectations and role clarity. CONCLUSIONS Our data revealed that despite some challenges, team members recognized the value of patient engagement in research and agreed project decisions had been impacted by patient partner input. Ongoing communication was highlighted as an area for improvement, as well as earlier training and ongoing support for all team members, but particularly researchers and study staff. In response to evaluation data, the team has reinstated a quarterly newsletter and plans to use specific patient engagement planning templates across study sites for all project activities. These tools should help make expectations clear for all team members and contribute to a positive patient engagement experience. Findings can inform patient engagement planning and evaluation for other health research projects.
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Affiliation(s)
- Holly Etchegary
- Clinical Epidemiology Program, Faculty of Medicine, Patient Engagement Lead, NL SUPPORT, CIHR-SPOR, Craig L. Dobbin Centre for Genetics, Memorial University, 300 Price Phillip Parkway, Rm 4M210, St. John’s, NL A1B 3V6 Canada
| | - Stefanie Linklater
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - D.’Arcy Duquette
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Gloria Wilkinson
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Vanessa Francis
- Patient Partnership Council of the De-Implementing Wisely Research Group, Calgary, Canada
| | - Erin Gionet
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Andrea M. Patey
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Jeremy M. Grimshaw
- Department of Medicine, Centre for Implementation Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
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23
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Tugwell P, Welch V, Magwood O, Todhunter-Brown A, Akl EA, Concannon TW, Khabsa J, Morley R, Schunemann H, Lytvyn L, Agarwal A, Antequera A, Avey MT, Campbell P, Chang C, Chang S, Dans L, Dewidar O, Ghersi D, Graham ID, Hazlewood G, Hilgart J, Horsley T, John D, Jull J, Maxwell LJ, McCutcheon C, Munn Z, Nonino F, Pardo Pardo J, Parker R, Pottie K, Rada G, Riddle A, Synnot A, Ghogomu ET, Tomlinson E, Toupin-April K, Petkovic J. Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses. Syst Rev 2023; 12:134. [PMID: 37533051 PMCID: PMC10394942 DOI: 10.1186/s13643-023-02279-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/18/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Involving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes. Our objectives are to: A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence syntheses B. Explore how engagement in evidence synthesis promotes health equity C. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence syntheses METHODS: Our diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach: 1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis. 2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey. 3. CONSENSUS The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners. 4. DISSEMINATION We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations. CONCLUSION Our international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
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Affiliation(s)
- Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Canada
| | - Vivian Welch
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Bruyere Research Institute, Ottawa, Canada
| | - Olivia Magwood
- Bruyere Research Institute, Ottawa, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Thomas W Concannon
- The RAND Corporation and Tufts University School of Medicine, Boston, MA, USA
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Holger Schunemann
- Department of Health Research Methods, Evidence, and Impact, Michael G DeGroote Cochrane Canada Centre, Cochrane Canada and McMaster GRADE Centre, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Cochrane Canada, Hamilton, ON, Canada
| | | | - Arnav Agarwal
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- Division of General Internal Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Alba Antequera
- International Health Department, ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Marc T Avey
- Canadian Council On Animal Care, Ottawa, Canada
| | - Pauline Campbell
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Christine Chang
- Agency for Healthcare Research and Quality, Rockville, MD, USA
| | | | - Leonila Dans
- Department of Clinical Epidemiology, University of the Philippines-Manila, Manila, Philippines
| | | | - Davina Ghersi
- Research Translation, National Health and Medical Research Council, Canberra, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Ian D Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Glen Hazlewood
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Tanya Horsley
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Denny John
- PharmaQuant, Kolkata, India
- Center for Public Health Research (CPHR), Kolkata, India
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Chris McCutcheon
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Zachary Munn
- Faculty of Health and Medical Sciences, JBI, University of Adelaide, Adelaide, South Australia, Australia
| | - Francesco Nonino
- Unit of Epidemiology and Statistics, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Jordi Pardo Pardo
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa Methods Centre, Ottawa, Canada
| | - Roses Parker
- Cochrane Pain Palliative and Supportive Care, Oxford University Hospitals Trust, Oxford, England
| | - Kevin Pottie
- Departments of Family Medicine and Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Gabriel Rada
- Epistemonikos Foundation, Santiago, Chile
- UC Evidence Centre and Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alison Riddle
- Bruyere Research Institute, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Anneliese Synnot
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne Victoria, 3004, Australia
- Centre for Health Communication and Participation, School of Public Health and Psychological Sciences, La Trobe University, Plenty Rd, Bundoora, VIC, 3086, Australia
| | - Elizabeth Tanjong Ghogomu
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Bruyere Research Institute, Ottawa, Canada
| | - Eve Tomlinson
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Karine Toupin-April
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Institut du Savoir Montfort, Ottawa, Canada
| | - Jennifer Petkovic
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
- Bruyere Research Institute, Ottawa, Canada.
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Budin‐Ljøsne I, Friedman BB, Baaré WFC, Bartrés‐Faz D, Carver RB, Drevon CA, Ebmeier KP, Fjell AM, Ghisletta P, Henson RN, Kievit R, Madsen KS, Nawijn L, Suri S, Solé‐Padullés C, Walhovd KB, Zsoldos E. Stakeholder engagement in European brain research: Experiences of the Lifebrain consortium. Health Expect 2023; 26:1318-1326. [PMID: 36989126 PMCID: PMC10154816 DOI: 10.1111/hex.13747] [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: 09/02/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Stakeholder engagement remains scarce in basic brain research. However, it can greatly improve the relevance of investigations and accelerate the translation of study findings to policy. The Lifebrain consortium investigated risk and protective factors influencing brain health using cognition, lifestyle and imaging data from European cohorts. Stakeholder activities of Lifebrain-organized in a separate work package-included organizing stakeholder events, investigating public perceptions of brain health and dissemination. Here, we describe the experiences of researchers and stakeholders regarding stakeholder engagement in the Lifebrain project. METHODS Stakeholder engagement in Lifebrain was evaluated through surveys among researchers and stakeholders and stakeholders' feedback at stakeholder events through evaluation forms. Survey data were analysed using a simple content analysis approach, and results from evaluation forms were summarized after reviewing the frequency of responses. RESULTS Consortium researchers and stakeholders experienced the engagement activities as meaningful and relevant. Researchers highlighted that it made the research and research processes more visible and contributed to new networks, optimized data collection on brain health perceptions and the production of papers and provided insights into stakeholder views. Stakeholders found research activities conducted in the stakeholder engagement work package to be within their field of interest and research results relevant to their work. Researchers identified barriers to stakeholder engagement, including lack of time, difficulties in identifying relevant stakeholders, and challenges in communicating complex scientific issues in lay language and maintaining relationships with stakeholders over time. Stakeholders identified barriers such as lack of budget, limited resources in their organization, time constraints and insufficient communication between researchers and stakeholders. CONCLUSION Stakeholder engagement in basic brain research can greatly benefit researchers and stakeholders alike. Its success is conditional on dedicated human and financial resources, clear communication, transparent mutual expectations and clear roles and responsibilities. PUBLIC CONTRIBUTION Patient organizations, research networks, policymakers and members of the general public were involved in engagement and research activities throughout the project duration.
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Affiliation(s)
| | - Barbara B. Friedman
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - William F. C. Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital—Amager and HvidovreCopenhagenDenmark
| | - David Bartrés‐Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Rebecca B. Carver
- Department of CommunicationsNorwegian Institute of Public HealthOsloNorway
| | - Christian A. Drevon
- Vitas ASOsloNorway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Klaus P. Ebmeier
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
| | - Anders M. Fjell
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - Paolo Ghisletta
- Methodology and Data Analysis Group, Faculty of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
- Faculty Council of the Faculty of PsychologyUniDistance SuisseBrigSwitzerland
- Swiss National Centre of Competence in Research LIVESUniversity of GenevaGenevaSwitzerland
| | - Richard N. Henson
- MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
- Cognitive Neuroscience DepartmentDonders Institute for Brain, Cognition and Behavior, Radboud University Medical CenterNijmegenThe Netherlands
| | - Kathrine S. Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital—Amager and HvidovreCopenhagenDenmark
- Radiography, Department of TechnologyUniversity College CopenhagenCopenhagenDenmark
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Sana Suri
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
| | - Cristina Solé‐Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Kristine B. Walhovd
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - Enikő Zsoldos
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
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Petkovic J, Magwood O, Lytvyn L, Khabsa J, Concannon TW, Welch V, Todhunter-Brown A, Palm ME, Akl EA, Mbuagbaw L, Arayssi T, Avey MT, Marusic A, Morley R, Saginur M, Slingers N, Texeira L, Ben Brahem A, Bhaumik S, Bou Akl I, Crowe S, Dormer L, Ekanem C, Lang E, Kianzad B, Kuchenmüller T, Moja L, Pottie K, Schünemann H, Tugwell P. Key issues for stakeholder engagement in the development of health and healthcare guidelines. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:27. [PMID: 37118762 PMCID: PMC10142244 DOI: 10.1186/s40900-023-00433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
Established in 2015, the Multi-Stakeholder Engagement (MuSE) Consortium is an international network of over 120 individuals interested in stakeholder engagement in research and guidelines. The MuSE group is developing guidance for stakeholder engagement in the development of health and healthcare guideline development. The development of this guidance has included multiple meetings with stakeholders, including patients, payers/purchasers of health services, peer review editors, policymakers, program managers, providers, principal investigators, product makers, the public, and purchasers of health services and has identified a number of key issues. These include: (1) Definitions, roles, and settings (2) Stakeholder identification and selection (3) Levels of engagement, (4) Evaluation of engagement, (5) Documentation and transparency, and (6) Conflict of interest management. In this paper, we discuss these issues and our plan to develop guidance to facilitate stakeholder engagement in all stages of the development of health and healthcare guideline development.
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Affiliation(s)
- Jennifer Petkovic
- Bruyère Research Institute, Ottawa, Canada.
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Olivia Magwood
- Bruyère Research Institute, Ottawa, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Thomas W Concannon
- The RAND Corporation and Tufts University School of Medicine, Boston, MA, USA
| | - Vivian Welch
- Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Alex Todhunter-Brown
- Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Marisha E Palm
- Tufts Medical Center, Tufts Clinical and Translational Science Institute, Boston, MA, USA
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, USA
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Marc T Avey
- Canadian Council on Animal Care, Ottawa, Canada
| | - Ana Marusic
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | | | | | | | | | - Asma Ben Brahem
- Director Guidelines and Care Pathways, INEAS (National Authority for Assessment and Accreditation in Healthcare), Tunis, Tunisia
| | - Soumyadeep Bhaumik
- Meta-Research and Evidence Synthesis Unit, The George Institute for Global Health, New Delhi, India
| | - Imad Bou Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | | | | | | | - Eddy Lang
- Cumming School of Medicine, University of Calgary, Alberta Health Services, Calgary Zone, Canada
| | - Behrang Kianzad
- Center for Advanced Studies in Biomedical Innovation Law (CeBIL), Faculty of Law, Copenhagen University, Copenhagen, Denmark
| | | | - Lorenzo Moja
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Kevin Pottie
- Departments of Family Medicine and Epidemiology and Biostatistics, Western University, London, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Holger Schünemann
- Clinical Epidemiology and of Medicine, WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, Cochrane Canada and McMaster GRADE Centre, McMaster University, Hamilton, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Canada
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King LK, Ivers NM, Waugh EJ, MacKay C, Stanaitis I, Krystia O, Stretton J, Wong S, Weisman A, Bardai Z, Ross S, Brady S, Shloush M, Stier T, Gakhal N, Agarwal P, Parsons J, Lipscombe L, Hawker GA. Improving diagnosis and treatment of knee osteoarthritis in persons with type 2 diabetes: development of a complex intervention. Implement Sci Commun 2023; 4:20. [PMID: 36855209 PMCID: PMC9972628 DOI: 10.1186/s43058-023-00398-3] [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: 09/16/2022] [Accepted: 02/09/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Symptomatic knee osteoarthritis (OA) commonly co-occurs in people with type 2 diabetes (T2DM) and increases the risk for diabetes complications, yet uptake of evidence-based treatment is low. We combined theory, stakeholder involvement and existing evidence to develop a multifaceted intervention to improve OA care in persons with T2DM. This was done in partnership with Arthritis Society Canada to leverage the existing infrastructure and provincial funding for community arthritis care. METHODS Each step was informed by a User Advisory Panel of stakeholder representatives, including persons with lived experience. First, we identified the target groups and behaviours through consulting stakeholders and current literature. Second, we interviewed persons living with T2DM and knee OA (n = 18), health professionals (HPs) who treat people with T2DM (n = 18) and arthritis therapists (ATs, n = 18) to identify the determinants of seeking and engaging in OA care (patients), assessing and treating OA (HPs) and considering T2DM in OA treatment (ATs), using the Theoretical Domains Framework (TDF). We mapped the content to behavioural change techniques (BCTs) to identify the potential intervention components. Third, we conducted stakeholder meetings to ascertain the acceptability and feasibility of intervention components, including content and modes of delivery. Fourth, we selected intervention components informed by prior steps and constructed a programme theory to inform the implementation of the intervention and its evaluation. RESULTS We identified the barriers and enablers to target behaviours across a number of TDF domains. All stakeholders identified insufficient access to resources to support OA care in people with T2DM. Core intervention components, incorporating a range of BCTs at the patient, HP and AT level, sought to identify persons with knee OA within T2DM care and refer to Arthritis Society Canada for delivery of evidence-based longitudinal OA management. Diverse stakeholder input throughout development allowed the co-creation of an intervention that appears feasible and acceptable to target users. CONCLUSIONS We integrated theory, evidence and stakeholder involvement to develop a multifaceted intervention to increase the identification of knee OA in persons with T2DM within diabetes care and improve the uptake and engagement in evidence-based OA management. Our partnership with Arthritis Society Canada supports future spread, scalability and sustainability. We will formally assess the intervention feasibility in a randomized pilot trial.
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Affiliation(s)
- Lauren K. King
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada
| | - Noah M. Ivers
- grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Community and Family Medicine, University of Toronto, Toronto, ON Canada
| | - Esther J. Waugh
- grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Physical Therapy, University of Toronto, Toronto, ON Canada
| | - Crystal MacKay
- grid.17063.330000 0001 2157 2938Department of Physical Therapy, University of Toronto, Toronto, ON Canada
| | - Ian Stanaitis
- grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada
| | - Owen Krystia
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada
| | | | - Sim Wong
- Patient Research Partner, Toronto, ON Canada
| | - Alanna Weisman
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON Canada
| | - Zahra Bardai
- grid.17063.330000 0001 2157 2938Department of Community and Family Medicine, University of Toronto, Toronto, ON Canada
| | - Susan Ross
- grid.469795.0Arthritis Rehabilitation and Education Program, Arthritis Society Canada, Toronto, ON Canada
| | - Shawn Brady
- grid.469795.0Arthritis Rehabilitation and Education Program, Arthritis Society Canada, Toronto, ON Canada
| | - Marlee Shloush
- grid.469795.0Arthritis Rehabilitation and Education Program, Arthritis Society Canada, Toronto, ON Canada
| | - Tara Stier
- grid.469795.0Arthritis Rehabilitation and Education Program, Arthritis Society Canada, Toronto, ON Canada
| | - Natasha Gakhal
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada
| | - Payal Agarwal
- grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Community and Family Medicine, University of Toronto, Toronto, ON Canada
| | - Janet Parsons
- grid.17063.330000 0001 2157 2938Department of Physical Therapy, University of Toronto, Toronto, ON Canada ,grid.415502.7Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Lorraine Lipscombe
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada
| | - Gillian A. Hawker
- grid.17063.330000 0001 2157 2938Department of Medicine, University of Toronto, Toronto, ON Canada ,grid.417199.30000 0004 0474 0188Women’s College Research Institute, Women’s College Hospital, Toronto, ON Canada
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Aravind G, Graham ID, Cameron JI, Ploughman M, Salbach NM. Conditions and strategies influencing sustainability of a community-based exercise program incorporating a healthcare-community partnership for people with balance and mobility limitations in Canada: A collective case study of the Together in Movement and Exercise (TIME™) program. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1064266. [PMID: 36923967 PMCID: PMC10009252 DOI: 10.3389/fresc.2023.1064266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/25/2023] [Indexed: 03/02/2023]
Abstract
Background Community-based exercise programs delivered through healthcare-community partnerships (CBEP-HCPs) are beneficial to individuals with balance and mobility limitations. For the community to benefit, however, these programs must be sustained over time. Purpose To identify conditions influencing the sustainability of CBEP-HCPs for people with balance and mobility limitations and strategies used to promote sustainability based on experiences of program providers, exercise participants, and caregivers. Methods Using a qualitative collective case study design, we invited stakeholders (program providers, exercise participants, and caregivers) from sites that had been running a CBEP-HCP for people with balance and mobility limitations for ≥4 years; and sites where the CBEP-HCP had been discontinued, to participate. We used two sustainability models to inform development of interview guides and data analysis. Qualitative data from each site were integrated using a narrative approach to foster deeper understanding of within-organization experiences. Results Twenty-nine individuals from 4 sustained and 4 discontinued sites in Ontario (n = 6) and British Columbia (n = 2), Canada, participated. Sites with sustained programs were characterized by conditions such as need for the program in the community, presence of secure funding or cost recovery mechanisms, presence of community partners, availability of experienced and motivated instructors, and the capacity to allocate resources towards program marketing and participant recruitment. For sites where programs discontinued, diminished participation and/or enrollment and an inability to allocate sufficient financial, human, and logistical resources towards the program affected program continuity. Participants from discontinued sites also identified issues such as staff with low motivation and limited experience, and presence of competing programs within the organization or the community. Staff associated the absence of referral pathways, insufficient community awareness of the program, and the inability to recover program cost due to poor participation, with program discontinuation. Conclusion Sustainability of CBEP-HCPs for people with balance and mobility limitations is influenced by conditions that exist during program implementation and delivery, including the need for the program in the community, and organization and community capacity to bear the program's financial and resource requirements. Complex interactions among these factors, in addition to strategies employed by program staff to promote sustainability, influence program sustainability.
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Affiliation(s)
- Gayatri Aravind
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, Toronto, ON, Canada
| | - Ian D. Graham
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jill I. Cameron
- Department of Occupational Science and Occupational Therapy, Centre for Practice Changing Research, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Michelle Ploughman
- BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Nancy M. Salbach
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
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Nicholls SG, Taylor HA, James R, Anderson EE, Friesen P, Schonfeld T, Summers EI. A Cross Sectional Survey of Recruitment Practices, Supports, and Perceived Roles for Unaffiliated and Non-scientist Members of IRBs. AJOB Empir Bioeth 2023; 14:174-184. [PMID: 36821084 PMCID: PMC10444906 DOI: 10.1080/23294515.2023.2180107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND Institutional Review Boards (IRBs) are federally mandated to include both nonscientific and unaffiliated representatives in their membership. Despite this, there is no guidance or policy on the selection of unaffiliated or non-scientist members and reports indicate a lack of clarity regarding members' roles. In the present study we sought to explore processes of recruitment, training, and the perceived roles for unaffiliated and non-scientist members of IRBs. METHODS We distributed a self-administered REDCap survey of members of the Association for the Accreditation of Human Research Protection Programs familiar with IRB member recruitment. The survey included closed and open-ended questions regarding: the operation of the HRPP/IRB(s), how unaffiliated and non-scientist members are recruited, whether they had faced challenges recruiting for these roles, and training and mentorship offered. The survey also collected information regarding the perceived value and roles of unaffiliated and non-scientist members. RESULTS 76 responses were included in the analysis (38% completion rate). The most common approach for recruitment was referral from current IRB members, with almost half of respondents indicating challenges recruiting unaffiliated members. Over 75% indicated no additional training was provided to unaffiliated or non-scientist members compared to affiliated or scientist members. Most common supports provided were travel/parking expenses and honoraria. Commonly perceived roles were to provide an independent voice from the participant perspective, notably regarding consent processes and materials. CONCLUSIONS Respondents indicated challenges in defining unaffiliated and non-scientist members and limited practices toward recruitment and support. Future work should more closely examine the challenges in defining these roles and applying the definitions in practice, as well as strategies that may improve recruitment and retention of unaffiliated and non-scientist members.
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Affiliation(s)
- Stuart G. Nicholls
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - Holly A. Taylor
- Department of Bioethics Clinical Center, NIH, Bethesda, MD, USA
| | | | - Emily E. Anderson
- Loyola University of Chicago, Neiswanger Institute for Bioethics, Maywood, IL,USA
| | | | - Toby Schonfeld
- VA National Center for Ethics in Health Care, Washington, DC, USA
| | - Elyse I. Summers
- Association for the Accreditation of Human Research Protection Programs (AAHRPP), Washington, DC, USA
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Gould DJ, Glanville-Hearst M, Bunzli S, Choong PFM, Dowsey MM. Research Buddy partnership in a MD-PhD program: lessons learned. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:4. [PMID: 36803954 PMCID: PMC9938357 DOI: 10.1186/s40900-023-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND AIMS There is increasing recognition of the importance of patient involvement in research. In recent years, there has also been growing interest in patient partnerships with doctoral studies students. However, it can be difficult to know where to start and how to go about such involvement activities. The purpose of this perspective piece was to share experiential insight of the experience of a patient involvement program such that others can learn from this experience. BODY: This is a co-authored perspective piece centred on the experience of MGH, a patient who has had hip replacement surgery, and DG, a medical student completing a PhD, participating in a Research Buddy partnership over the course of over 3 years. The context in which this partnership took place was also described to facilitate comparison with readers' own circumstances and contexts. DG and MGH met regularly to discuss, and work together on, various aspects of DG's PhD research project. Reflexive thematic analysis was conducted on reflections from DG and MGH regarding their experience in the Research Buddy program to synthesise nine lessons which were then corroborated with reference to published literature on patient involvement in research. These lessons were: learn from experience; tailor the program; get involved early; embrace uniqueness; meet regularly; build rapport; ensure mutual benefit; broad involvement; regularly reflect and review. CONCLUSIONS In this perspective piece, a patient and a medical student completing a PhD reflected upon their experience co-designing a Research Buddy partnership within a patient involvement program. A series of nine lessons was identified and presented to inform readers seeking to develop or enhance their own patient involvement programs. Researcher-patient rapport is foundational to all other aspects of the patient's involvement.
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Affiliation(s)
- Daniel J Gould
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia.
| | - Marion Glanville-Hearst
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Samantha Bunzli
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, QLD, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Peter F M Choong
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Michelle M Dowsey
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
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Riester MR, Zullo AR. Prediction tool Development and Implementation in pharmacy praCTice (PreDICT) proposed guidance. Am J Health Syst Pharm 2023; 80:111-123. [PMID: 36242567 DOI: 10.1093/ajhp/zxac298] [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: 10/13/2022] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Proposed guidance is presented for Prediction tool Development and Implementation in pharmacy praCTice (PreDICT). This guidance aims to assist pharmacists and their collaborators with planning, developing, and implementing custom risk prediction tools for use by pharmacists in their own health systems or practice settings. We aimed to describe general considerations that would be relevant to most prediction tools designed for use in health systems or other pharmacy practice settings. SUMMARY The PreDICT proposed guidance is organized into 3 sequential phases: (1) planning, (2) development and validation, and (3) testing and refining prediction tools for real-world use. Each phase is accompanied by a checklist of considerations designed to be used by pharmacists or their trainees (eg, residents) during the planning or conduct of a prediction tool project. Commentary and a worked example are also provided to highlight some of the most relevant and impactful considerations for each phase. CONCLUSION The proposed guidance for PreDICT is a pharmacist-focused set of checklists for planning, developing, and implementing prediction tools in pharmacy practice. The list of considerations and accompanying commentary can be used as a reference by pharmacists or their trainees before or during the completion of a prediction tool project.
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Affiliation(s)
- Melissa R Riester
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Andrew R Zullo
- Departments of Health Services, Policy, and Practice and Epidemiology, Brown University School of Public Health, Providence, RI.,Department of Pharmacy, Rhode Island Hospital, Providence, RI, USA
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Alarie C, Gagnon I, Thao Huynh LT, Doucet K, Pichette-Auray A, Hinse-Joly C, Swaine B. SWOT analysis of a physical activity intervention delivered to outpatient adults with a mild traumatic brain injury. SAGE Open Med 2023; 11:20503121231166638. [PMID: 37101817 PMCID: PMC10123884 DOI: 10.1177/20503121231166638] [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: 09/10/2022] [Accepted: 03/13/2023] [Indexed: 04/28/2023] Open
Abstract
Objectives Physical activity interventions are effective to reduce the symptoms and recovery time after a mild traumatic brain injury; such interventions are not always embedded in all interdisciplinary outpatient settings. Service providers of a specialized rehabilitation program recognized the need to implement emerging evidence-based approaches to improve physical activity delivery. Understanding the perceptions of managers, clinicians, and users regarding the strengths, weaknesses, opportunities, and threats of the current physical activity intervention delivered to outpatient adults with a mild traumatic brain injury could inform local and widespread intervention development, enhancement, and implementation of evidence-based physical activity interventions. Methods This study used a descriptive qualitative design using a strength, weakness, opportunity, and threat analysis framework. Managerial staff (n = 3), clinicians (n = 6), and program users (n = 5) with persisting symptoms following a mild traumatic brain injury from an outpatient specialized public rehabilitation program in Québec (Canada) participated. Individual semi-structured interviews were performed, recorded, transcribed verbatim, and analyzed using a qualitative content analysis approach. Results Participants were generally positive about the intervention but expressed that improvement was required. Strengths (n = 15), weaknesses (n = 17), opportunities (n = 12), and threats (n = 6) related to eight overarching categories: physical activity intervention, health-related outcomes, clinical expertise, knowledge translation, communication, user engagement, resources, and accessibility. Category descriptions, convergent and divergent perspectives, and salient quotes of participants are provided. Conclusions Participants were generally positive about the intervention (e.g., format) but identified weaknesses (e.g., need for service providers to better describe the physical activity intervention using theoretically driven approaches). Consultations of stakeholders will inform future intervention enhancement efforts and assist in ensuring interventions meet user needs.
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Affiliation(s)
- Christophe Alarie
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, QC, Canada
- Trauma Center and Pediatric Emergency Medicine, Montreal Children’s Hospital, McGill University Health Center and Research Institute of the McGill University Health Center, Montréal, QC, Canada
| | - Lily Trang Thao Huynh
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
| | - Karine Doucet
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
| | - Adèle Pichette-Auray
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
| | - Cassandre Hinse-Joly
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
| | - Bonnie Swaine
- École de Réadaptation, Faculté de Médecine, Université de Montréal Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montréal, QC, Canada
- Bonnie Swaine, École de réadaptation, Faculté de médecine, Université de Montréal, C. P. 6128, Succursale Centre-ville, Montréal, QC H3C 3J7, Canada.
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Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership. J Gen Intern Med 2022; 37:4047-4053. [PMID: 35132560 PMCID: PMC9708980 DOI: 10.1007/s11606-022-07411-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/07/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification. OBJECTIVE We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams. DESIGN Consensus development. PARTICIPANTS We involved 16 stakeholders from the international Multi-Stakeholder Engagement (MuSE) Consortium, including patients and the public, providers, payers of health services/purchasers, policy makers, programme managers, peer review editors, and principal investigators. APPROACH We engaged stakeholders in factor development and as co-authors of this manuscript. Using a modified Delphi approach, we gathered stakeholder views concerning a preliminary list of 18 factors. Over two feedback rounds, using qualitative and quantitative analysis, we concentrated these into ten factors. KEY RESULTS We present seven highly desirable factors: 'expertise or experience', 'ability and willingness to represent the stakeholder group', 'inclusivity (equity, diversity and intersectionality)', 'communication skills', 'commitment and time capacity', 'financial and non-financial relationships and activities, and conflict of interest', 'training support and funding needs'. Additionally, three factors are desirable: 'influence', 'research relevant values', 'previous stakeholder engagement'. CONCLUSIONS We present factors for research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership. Policy makers and guideline developers may benefit from considering the factors in stakeholder identification and invitation. Research funders may consider stipulating consideration of the factors in funding applications. We outline how these factors can be implemented and exemplify how their use has the potential to improve the quality and relevancy of health research.
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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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Wurcel AG, Kraus C, Johnson O, Zaller ND, Ray B, Spaulding AC, Flynn T, Quinn C, Day R, Akiyama MJ, Del Pozo B, Meyer F, Glenn JE. Stakeholder-engaged research is necessary across the criminal-legal spectrum. J Clin Transl Sci 2022; 7:e5. [PMID: 36755540 PMCID: PMC9879908 DOI: 10.1017/cts.2022.501] [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: 03/01/2022] [Revised: 09/23/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
People with lived experience of incarceration have higher rates of morbidity and mortality compared to people without history of incarceration. Research conducted unethically in prisons and jails led to increased scrutiny of research to ensure the needs of those studied are protected. One consequence of increased restrictions on research with criminal-legal involved populations is reluctance to engage in research evaluations of healthcare for people who are incarcerated and people who have lived experience of incarceration. Ethical research can be done in partnership with people with lived experience of incarceration and other key stakeholders and should be encouraged. In this article, we describe how stakeholder engagement can be accomplished in this setting, and further, how such engagement leads to impactful research that can be disseminated and implemented across disciplines and communities. The goal is to build trust across the spectrum of people who work, live in, or are impacted by the criminal-legal system, with the purpose of moving toward health equity.
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Affiliation(s)
- Alysse G. Wurcel
- Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
| | - Christina Kraus
- Tufts University Medical Student, JCOIN LEAP Scholar, Boston, MA, USA
| | - O’Dell Johnson
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Bradley Ray
- RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC27709, USA
| | - Anne C. Spaulding
- Associate Professor of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tara Flynn
- Assistant Deputy Superintendent Health Services, Norfolk County Sheriff’s Office, Dedham, MA, USA
| | | | - Ronald Day
- The Fortune Society, Vice President of Programs and Research, Long Island City, New York, USA
| | - Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Fred Meyer
- Deputy Chief (Retired), Las Vegas Metropolitan Police Department, Las Vegas, NV, USA
| | - Jason E. Glenn
- Department of History and Philosophy of Medicine, University of Kansas Medical Center, Kansas, USA
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Quanbeck A, Hennessy RG, Park L. Applying concepts from "rapid" and "agile" implementation to advance implementation research. Implement Sci Commun 2022; 3:118. [PMID: 36335373 PMCID: PMC9636827 DOI: 10.1186/s43058-022-00366-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/08/2022] Open
Abstract
Background The translation of research findings into practice can be improved to maximize benefits more quickly and with greater flexibility. To expedite translation, researchers have developed innovative approaches to implementation branded as “rapid” and “agile” implementation. Rapid implementation has roots in precision medicine and agile implementation has roots in systems engineering and software design. Research has shown that innovation often derives from learning and applying ideas that have impacted other fields. Implications for implementation researchers This commentary examines “rapid” and “agile” approaches to implementation and provides recommendations to implementation researchers stemming from these approaches. Four key ideas are synthesized that may be broadly applicable to implementation research, including (1) adopting a problem orientation, (2) applying lessons from behavioral economics, (3) using adaptive study designs and adaptive interventions, and (4) using multi-level models to guide implementation. Examples are highlighted from the field where researchers are applying these key ideas to illustrate their potential impact. Conclusions “Rapid” and “agile” implementation approaches to implementation stem from diverse fields. Elements of these approaches show potential for advancing implementation research, although adopting them may entail shifting scientific norms in the field.
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Affiliation(s)
- Andrew Quanbeck
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, 800 University Bay Drive, Madison, WI, 53705, USA.
| | - Rose Garza Hennessy
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI, 53205, USA
| | - Linda Park
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, 800 University Bay Drive, Madison, WI, 53705, USA
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Holcomb J, Ferguson GM, Sun J, Walton GH, Highfield L. Stakeholder Engagement in Adoption, Implementation, and Sustainment of an Evidence-Based Intervention to Increase Mammography Adherence Among Low-Income Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1486-1495. [PMID: 33754327 PMCID: PMC9550737 DOI: 10.1007/s13187-021-01988-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 05/05/2023]
Abstract
Multi-level organizational stakeholder engagement plays an important role across the research process in a clinical setting. Stakeholders provide organizational specific adaptions in evidence-based interventions to ensure effective adoption, implementation, and sustainability. Stakeholder engagement strategies involve building mutual trust, providing clear communication, and seeking feedback. Using constructs from the Consolidated Framework for Implementation Research and The International Association for Public Participation spectrum, a conceptual framework was created to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. A document review was used to explore the alignment of the conceptual framework with intervention activities and stakeholder engagement strategies. The results indicate an alignment with the conceptual framework constructs and a real-world application of stakeholder engagement in a mammography evidence-based intervention. The conceptual framework and stakeholder engagement strategies can be applied across a range of community-based cancer programs and interventions, organizations, and clinical settings.
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Affiliation(s)
- Jennifer Holcomb
- Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA.
| | - Gayla M Ferguson
- Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Jiali Sun
- Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Gretchen H Walton
- Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Linda Highfield
- Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
- Department of Internal Medicine, The University of Texas Health Science Center at Houston (UTHealth) John P and Katherine G McGovern Medical School, Houston, TX, USA
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Finderup J, Buur LE, Tscherning SC, Jensen AL, Kristensen AW, Petersen AP, Toft BS, Rasmussen GS, Skovlund P, Vedelø TW, Rodkjær LØ. Developing and testing guidance to support researchers engaging patient partners in health-related research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:43. [PMID: 36028911 PMCID: PMC9413931 DOI: 10.1186/s40900-022-00378-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/18/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Although interest in Patient and Public Involvement in health-related research is growing, there seems to be a lack of guidance supporting researchers in deciding on methods and levels for Patient and Public Involvement in health-related research throughout the research process. Furthermore, the numerous definitions, methods, and frameworks make it challenging for researchers new to this field to decide on the most appropriate approach for their project. METHODS This study aimed to develop and test guidance for researchers deciding on approaches, levels, and methods for engaging patient partners in health-related research. A group of 11 researchers in Patient and Public Involvement in health-related research participated in six workshops to develop the guidance. The feasibility and acceptability of the guidance were tested in a survey of 14 researchers using the System Usability Scale plus two elaborative questions. The guidance was also tested by five PhD students engaging patient partners in their projects. RESULTS The guidance developed consisted of two resources: Resource I outlined five international approaches to Patient and Public Involvement in health-related research, and Resource II described the different levels and methods for engaging patient partners in research. The System Usability Scale score (at the 50th percentile) was 80, indicating excellent usability. Qualitative data showed that the two resources supported reflections regarding different approaches, levels, and methods. CONCLUSION The researchers found the guidance to be supportive of their reflective thinking about engaging patient partners in their research. The testing provided knowledge about when and how to use the guidance but also raised questions about the usefulness of the guidance in communications with patients.
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Affiliation(s)
- Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, 8200, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark.
| | - Louise Engelbrecht Buur
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, 8200, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sarah Cecilie Tscherning
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Wilhøft Kristensen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Poder Petersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Skovsby Toft
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
| | - Gitte Susanne Rasmussen
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Dermatology and Venerology, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Skovlund
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Tina Wang Vedelø
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Ørneborg Rodkjær
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Centre for Patient Involvement, Aarhus University and Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Dewidar O, Kawala BA, Antequera A, Tricco AC, Tovey D, Straus S, Glover R, Tufte J, Magwood O, Smith M, Ooi CP, Dion A, Goetghebeur M, Reveiz L, Negrini S, Tugwell P, Petkovic J, Welch V. Methodological Guidance For Incorporating Equity When Informing Rapid-Policy And Guideline Development. J Clin Epidemiol 2022; 150:142-153. [PMID: 35863618 PMCID: PMC9359903 DOI: 10.1016/j.jclinepi.2022.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/30/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
Objectives We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews. Study Design and Setting This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for equity-focused systematic reviews (PRISMA-Equity) guideline. We identified Exemplar rapid reviews by searching COVID-19 databases and requesting examples from our team. Results We proposed the following key steps: 1. involve relevant stakeholders with lived experience in the conduct and design of the review; 2. reflect on equity, inclusion and privilege in team values and composition; 3. develop research question to assess health inequities; 4. conduct searches in relevant disciplinary databases; 5. collect data and critically appraise recruitment, retention and attrition for populations experiencing inequities; 6. analyse evidence on equity; 7. evaluate the applicability of findings to populations experiencing inequities; and 8. adhere to reporting guidelines for communicating review findings. We illustrated these methods through rapid review examples. Conclusion Implementing this guidance could contribute to improving equity considerations in rapid reviews produced in public health emergencies, and help policymakers better understand the distributional impact of diseases on the population.
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Affiliation(s)
- Omar Dewidar
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada.
| | - Brenda Allen Kawala
- Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine-Master in Global Health, The Sahlgrenska Academy at University of Gothenburg, Box 414, SE-405 Gothenburg, Sweden
| | - Alba Antequera
- Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada; Epidemiology Division, Dalla Lana School of Public Health & Institute of Health, Management, and Policy Evaluation, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada; Queen's Collaboration for Health Care Quality, Joanna Briggs Institute Centre of Excellence, Queen's University, 92 Barrie Street, Room 214, Kingston, Ontario K7L 3N6, Canada
| | | | - Sharon Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada
| | - Rebecca Glover
- Department of Health Services Research and Policy, Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - Olivia Magwood
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Thompson Hall, 25 University Private, Ottawa, ON, Canada K1N 7K4
| | - Maureen Smith
- Cochrane Consumer Executive, Ottawa, Ontario, Canada
| | - Cheow Peng Ooi
- Endocrine Unit, Department of Medicine, Universiti Putra Malaysia Faculty of Medicine and Health Sciences, 43400 Serdang, Selangor, Malaysia
| | - Anna Dion
- Centre for Implementation Research, Ottawa Hospital Research Institute, The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada
| | - Mireille Goetghebeur
- Unit Methods, Ethics and Participation, INESSS, National Institute for Excellence in Health and Social Services, Montréal, Québec, Canada
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health Department, Incident Management System for the Covid-19 Response. Pan American Health Organization, 525 23rd St, Northwest, WA 20037-2895, USA
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Peter Tugwell
- Department of Medicine, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jennifer Petkovic
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
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Naef R, Filipovic M, Jeitziner MM, von Felten S, Safford J, Riguzzi M, Rufer M. A multicomponent family support intervention in intensive care units: study protocol for a multicenter cluster-randomized trial (FICUS Trial). Trials 2022; 23:533. [PMID: 35761343 PMCID: PMC9235279 DOI: 10.1186/s13063-022-06454-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/08/2022] [Indexed: 02/25/2023] Open
Abstract
Background Family members of critically ill patients face considerable uncertainty and distress during their close others’ intensive care unit (ICU) stay. About 20–60% of family members experience adverse mental health outcomes post-ICU, such as symptoms of anxiety, depression, and posttraumatic stress. Guidelines recommend structured family inclusion, communication, and support, but the existing evidence base around protocolized family support interventions is modest and requires substantiation. Methods To test the clinical effectiveness and explore the implementation of a multicomponent, nurse-led family support intervention in ICUs, we will undertake a parallel, cluster-randomized, controlled, multicenter superiority hybrid-type 1 trial. It will include eight clusters (ICUs) per study arm, with a projected total sample size of 896 family members of adult, critically ill patients treated in the German-speaking part of Switzerland. The trial targets family members of critically ill patients with an expected ICU stay of 48 h or longer. Families in the intervention arm will receive a family support intervention in addition to usual care. The intervention consists of specialist nurse support that is mapped to the patient pathway with follow-up care and includes psycho-educational and relationship-focused family interventions, and structured, interprofessional communication, and shared decision-making with families. Families in the control arm will receive usual care. The primary study endpoint is quality of family care, operationalized as family members’ satisfaction with ICU care at discharge. Secondary endpoints include quality of communication and nurse support, family management of critical illness (functioning, resilience), and family members’ mental health (well-being, psychological distress) measured at admission, discharge, and after 3, 6, and 12 months. Data of all participants, regardless of protocol adherence, will be analyzed using linear mixed-effects models, with the individual participant as the unit of inference. Discussion This trial will examine the effectiveness of the family support intervention and generate knowledge of its implementability. Both types of evidence are necessary to determine whether the intervention works as intended in clinical practice and could be scaled up to other ICUs. The study findings will make a significant contribution to the current body of knowledge on effective ICU care that promotes family participation and well-being. Trial registration ClinicalTrials.gov NCT05280691. Prospectively registered on 20 February 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06454-y.
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Affiliation(s)
- Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitätsstrasse 84, 8006, Zurich, Switzerland. .,Centre of Clinical Nursing Science, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Miodrag Filipovic
- Surgical Intensive Care Unit, Division of Anesthesiology, Intensive Care, Rescue and Pain Medicine, Cantonal Hospital of St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland
| | - Marie-Madlen Jeitziner
- Department of Intensive Care Medicine, University Hospital Bern, Inselspital, University of Bern, Freiburgstrasse 16, CH10, Bern, Switzerland
| | - Stefanie von Felten
- Department of Biostatistics, Epidemiology, Biostatistics, and Prevention Institute, Faculty of Medicine, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | | | - Marco Riguzzi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitätsstrasse 84, 8006, Zurich, Switzerland.,Centre of Clinical Nursing Science, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Michael Rufer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center for Psychiatry and Psychotherapy, Clinic Zugersee, Triaplus AG, Widenstrasse 55, 6317, Oberwil-Zug, Switzerland
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Di Bidino R, Rogliani P, Sebastiani A, Ricci A, Varone F, Sgalla G, Iovene B, Bruni T, Flore MC, D'Ascanio M, Cavalli F, Savi D, Di Michele L, Cicchetti A, Richeldi L. Road Toward a New Model of Care for Idiopathic Pulmonary Fibrosis in the Lazio Region. Front Med (Lausanne) 2022; 9:861076. [PMID: 35755040 PMCID: PMC9228027 DOI: 10.3389/fmed.2022.861076] [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: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 12/02/2022] Open
Abstract
A timely, confirmed diagnosis of Idiopathic Pulmonary Fibrosis (IPF) has a significant impact on the evolution of the disease. The current model of care in the Lazio region (in Italy) was assessed on the basis of real-world data provided by the four reference centers responsible for diagnosing and treating IPF. The 5-year, population-based, retrospective longitudinal study provided the data that is at the basis of the current proposal for a new clinical and therapeutic pathway (DTCP) and has been shared with regional decision makers. A DTCP must be defined and based on four pillars: GPs, pulmonologists, IPF centers, and telemedicine. Each must play a role within a sort of hub-and-spoke model. IPF centers remain the hubs, while spokes are identified in trained GPs and pulmonologists.
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Affiliation(s)
- Rossella Di Bidino
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore (ALTEMS), Rome, Italy
- *Correspondence: Rossella Di Bidino
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, Università di Roma “Tor Vergata, ”Rome, Italy
| | - Alfredo Sebastiani
- Department of Respiratory Diseases, San Camillo-Forlanini Hospital, Rome, Italy
| | - Alberto Ricci
- Respiratory Unit, Sant'Andrea Hospital, Università di Roma Sapienza, Rome, Italy
| | - Francesco Varone
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giacomo Sgalla
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Bruno Iovene
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Teresa Bruni
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Chiara Flore
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Michela D'Ascanio
- Respiratory Unit, Sant'Andrea Hospital, Università di Roma Sapienza, Rome, Italy
| | - Francesco Cavalli
- Unit of Respiratory Medicine, Department of Experimental Medicine, Università di Roma “Tor Vergata, ”Rome, Italy
| | - Daniela Savi
- Department of Public Health and Infectious Diseases, Università di Roma Sapienza, Rome, Italy
| | - Loreta Di Michele
- Department of Respiratory Diseases, San Camillo-Forlanini Hospital, Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore (ALTEMS), Rome, Italy
| | - Luca Richeldi
- Department of Pulmonary Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Magwood O, Riddle A, Petkovic J, Lytvyn L, Khabsa J, Atwere P, Akl EA, Campbell P, Welch V, Smith M, Mustafa RA, Limburg H, Dans LF, Skoetz N, Grant S, Concannon T, Tugwell P. PROTOCOL: Barriers and facilitators to stakeholder engagement in health guideline development: A qualitative evidence synthesis. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1237. [PMID: 36911345 PMCID: PMC9038083 DOI: 10.1002/cl2.1237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND There is a need for the development of comprehensive, global, evidence-based guidance for stakeholder engagement in guideline development. Stakeholders are any individual or group who is responsible for or affected by health- and healthcare-related decisions. This includes patients, the public, providers of health care and policymakers for example. As part of the guidance development process, Multi-Stakeholder Engagement (MuSE) Consortium set out to conduct four concurrent systematic reviews to summarise the evidence on: (1) existing guidance for stakeholder engagement in guideline development, (2) barriers and facilitators to stakeholder engagement in guideline development, (3) managing conflicts of interest in stakeholder engagement in guideline development and (4) measuring the impact of stakeholder engagement in guideline development. This protocol addresses the second systematic review in the series. OBJECTIVES The objective of this review is to identify and synthesise the existing evidence on barriers and facilitators to stakeholder engagement in health guideline development. We will address this objective through two research questions: (1) What are the barriers to multi-stakeholder engagement in health guideline development across any of the 18 steps of the GIN-McMaster checklist? (2) What are the facilitators to multi-stakeholder engagement in health guideline development across any of the 18 steps of the GIN-McMaster checklist? SEARCH METHODS A comprehensive search strategy will be developed and peer-reviewed in consultation with a medical librarian. We will search the following databases: MEDLINE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EMBASE, PsycInfo, Scopus, and Sociological Abstracts. To identify grey literature, we will search the websites of agencies who actively engage stakeholder groups such as the AHRQ, Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research (SPOR), INVOLVE, the National Institute for Health and Care Excellence (NICE) and the PCORI. We will also search the websites of guideline-producing agencies, such as the American Academy of Pediatrics, Australia's National Health Medical Research Council (NHMRC) and the WHO. We will invite members of the team to suggest grey literature sources and we plan to broaden the search by soliciting suggestions via social media, such as Twitter. SELECTION CRITERIA We will include empirical qualitative and mixed-method primary research studies which qualitatively report on the barriers or facilitators to stakeholder engagement in health guideline development. The population of interest is stakeholders in health guideline development. Building on previous work, we have identified 13 types of stakeholders whose input can enhance the relevance and uptake of guidelines: Patients, caregivers and patient advocates; Public; Providers of health care; Payers of health services; Payers of research; Policy makers; Program managers; Product makers; Purchasers; Principal investigators and their research teams; and Peer-review editors/publishers. Eligible studies must describe stakeholder engagement at any of the following steps of the GIN-McMaster Checklist for Guideline Development. DATA COLLECTION AND ANALYSIS All identified citations from electronic databases will be imported into Covidence software for screening and selection. Documents identified through our grey literature search will be managed and screened using an Excel spreadsheet. A two-part study selection process will be used for all identified citations: (1) a title and abstract review and (2) full-text review. At each stage, teams of two review authors will independently assess all potential studies in duplicate using a priori inclusion and exclusion criteria. Data will be extracted by two review authors independently and in duplicate according to a standardised data extraction form. MAIN RESULTS The results of this review will be used to inform the development of guidance for multi-stakeholder engagement in guideline development and implementation. This guidance will be official GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group guidance. The GRADE system is internationally recognised as a standard for guideline development. The findings of this review will assist organisations who develop healthcare, public health and health policy guidelines, such as the World Health Organization, to involve multiple stakeholders in the guideline development process to ensure the development of relevant, high quality and transparent guidelines.
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Affiliation(s)
- Olivia Magwood
- C.T. Lamont Primary Health Care Research CentreBruyere Research InstituteOttawaCanada
| | - Alison Riddle
- School of Epidemiology and Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
| | | | - Lyubov Lytvyn
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
| | - Joanne Khabsa
- Clinical Research InstituteAmerican University of Beirut Medical CenterBeirutLebanon
| | - Pearl Atwere
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Elie A. Akl
- Department of Internal MedicineAmerican University of Beirut Medical CenterBeirutLebanon
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research UnitGlasgow Caledonian UniversityGlasgowUK
| | - Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | - Maureen Smith
- Cochrane Consumer Network ExecutiveCochraneOttawaCanada
| | - Reem A. Mustafa
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
| | - Heather Limburg
- Global Health and Guidelines DivisionPublic Health Agency of CanadaOttawaCanada
| | - Leonila F. Dans
- Department of Clinical EpidemiologyUniversity of the Philippines College of MedicineManillaPhilippines
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
| | - Sean Grant
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public HealthIndiana UniversityIndianapolisIndianaUSA
| | | | - Peter Tugwell
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaCanada
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Petkovic J, Riddle A, Lytvyn L, Khabsa J, Akl EA, Welch V, Magwood O, Atwere P, Graham ID, Grant S, John D, Katikireddi SV, Langlois E, Mustafa RA, Todhunter‐Brown A, Schünemann H, Smith M, Stein AT, Concannon T, Tugwell P. PROTOCOL: Guidance for stakeholder engagement in guideline development: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1242. [PMID: 36911343 PMCID: PMC9096120 DOI: 10.1002/cl2.1242] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: to identify, describe, and summarize existing guidance and methods for multistakeholder engagement throughout the health guideline development process.
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Affiliation(s)
- Jennifer Petkovic
- Ottawa Centre for Health EquityBruyère Research InstituteOttawaCanada
| | - Alison Riddle
- School of Epidemiology and Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Lyubov Lytvyn
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
| | - Joanne Khabsa
- Clinical Research InstituteAmerican University of Beirut Medical CenterBeirutLebanon
| | - Elie A. Akl
- Department of Internal MedicineAmerican University of Beirut Medical CenterBeirutLebanon
| | - Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | - Olivia Magwood
- C.T. Lamont Primary Health Care Research CentreBruyère Research InstituteOttawaCanada
| | - Pearl Atwere
- Ottawa Centre for Health EquityBruyère Research InstituteOttawaCanada
| | - Ian D. Graham
- School of Epidemiology and Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Sean Grant
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public HealthIndiana UniversityIndianapolisIndianaUSA
| | | | | | - Etienne Langlois
- Alliance for Health Policy and Systems ResearchWorld Health OrganizationGenevaSwitzerland
| | - Reem A. Mustafa
- Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
| | - Alex Todhunter‐Brown
- Nursing, Midwifery and Allied Health Professions Research UnitGlasgow Caledonian UniversityGlasgowUK
| | - Holger Schünemann
- Departments of Health Research MethodsEvidence, and Impact and of Medicine, McMaster UniversityHamiltonCanada
| | - Maureen Smith
- Canadian Organization for Rare DisordersOttawaCanada
| | - Airton T. Stein
- Department of Public HealthUniversidade Federal de Ciências da SaúdePorto AlegreBrazil
| | | | - Peter Tugwell
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaCanada
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Hood AM, Booker SQ, Morais CA, Goodin BR, Letzen JE, Campbell LC, Merriwether EN, Aroke EN, Campbell CM, Mathur VA, Janevic MR. Confronting Racism in All Forms of Pain Research: A Shared Commitment for Engagement, Diversity, and Dissemination. THE JOURNAL OF PAIN 2022; 23:913-928. [PMID: 35288029 PMCID: PMC9415432 DOI: 10.1016/j.jpain.2022.01.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 01/25/2023]
Abstract
This third paper in the "Confronting Racism in All Forms of Pain Research" series discusses adopting an antiracism framework across all pain research disciplines and highlights the significant benefits of doing so. We build upon the previous call to action and the proposed reframing of study designs articulated in the other papers in the series and seek to confront and eradicate racism through a shared commitment to change current research practices. Specifically, we emphasize the systematic disadvantage created by racialization (ie, the Eurocentric social and political process of ascribing racialized identities to a relationship, social practice, or group) and discuss how engaging communities in partnership can increase the participation of racialized groups in research studies and enrich the knowledge gained. Alongside this critical work, we indicate why diversifying the research environment (ie, research teams, labs, departments, and culture) enriches our scientific discovery and promotes recruitment and retention of participants from racialized groups. Finally, we recommend changes in reporting and dissemination practices so that we do not stigmatize or reproduce oppressive forms of power for racialized groups. Although this shift may be challenging in some cases, the increase in equity, generalizability, and credibility of the data produced will expand our knowledge and reflect the pain experiences of all communities more accurately. PERSPECTIVE: In this third paper in our series, we advocate for a shared commitment toward an antiracism framework in pain research. We identify community partnerships, diversification of research environments, and changes to our dissemination practices as areas where oppressive forms of power can be reduced.
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Affiliation(s)
- Anna M Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Calia A Morais
- Department of Community Dentistry and Behavioral Sciences, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Burel R Goodin
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Janelle E Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa C Campbell
- Department of Psychology, East Carolina University, Greenville, North Carolina
| | - Ericka N Merriwether
- Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York, New York; Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York
| | - Edwin N Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, and Continuing Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Mary R Janevic
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
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Hennessy M, Linehan L, Dennehy R, Devane D, Rice R, Meaney S, O'Donoghue K. Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:18. [PMID: 35568920 PMCID: PMC9107009 DOI: 10.1186/s40900-022-00355-9] [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: 01/11/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Standardised care pathways tailored to women/couples who experience recurrent miscarriage are needed; however, clinical practice is inconsistent and poorly organised. In this paper, we outline our processes and experiences of developing guideline-based key performance indicators (KPIs) for recurrent miscarriage care with a diverse stakeholder group which will be used to evaluate national services. To date, such exercises have generally only involved clinicians, with the need for greater stakeholder involvement highlighted. METHODS Our study involved six stages: (i) identification and synthesis of recommendations for recurrent miscarriage care through a systematic review of clinical practice guidelines; (ii) a two-round modified e-Delphi survey with stakeholders to develop consensus on recommendations and outcomes; (iii) four virtual meetings to develop this consensus further; (iv) development of a list of candidate KPIs; (v) survey to achieve consensus on the final suite of KPIs and a (vi) virtual meeting to agree on the final set of KPIs. Through participatory methods, participants provided feedback on the process of KPI development. RESULTS From an initial list of 373 recommendations and 14 outcomes, 110 indicators were prioritised for inclusion in the final suite of KPIs: (i) structure of care (n = 20); (ii) counselling and supportive care (n = 7); (iii) investigations (n = 30); treatment (n = 34); outcomes (n = 19). Participants' feedback on the process comprised three main themes: accessibility, richness in diversity, streamlining the development process. CONCLUSIONS It is important and feasible to develop guideline-based KPIs with a diverse stakeholder group. One hundred and ten KPIs were prioritised for inclusion in a suite of guideline-based KPIs for recurrent miscarriage care. Insights into our experiences may help others undertaking similar projects, particularly those undertaken in the absence of a clinical guideline and/or involving a range of stakeholders.
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Affiliation(s)
- Marita Hennessy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland.
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland.
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland.
| | - Laura Linehan
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
| | - Rebecca Dennehy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
| | - Declan Devane
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, H91 E3YV, Ireland
- Evidence Synthesis Ireland, National University of Ireland, Galway, Galway, H91 E3YV, Ireland
| | - Rachel Rice
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- School of Applied Social Studies, University College Cork, Cork, T12 D726, Ireland
| | - Sarah Meaney
- National Perinatal Epidemiology Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
| | - Keelin O'Donoghue
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
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Koskinas E, Gilfoyle M, Salsberg J. Exploring how patients, carers and members of the public are recruited to advisory boards, groups and panels as partners in public and patient involved health research: a scoping review protocol. BMJ Open 2022; 12:e059048. [PMID: 35450910 PMCID: PMC9024234 DOI: 10.1136/bmjopen-2021-059048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Engaging patients, carers and members of the public in health research has become widely recognised as an important approach for bridging the gap between research, and health and social care by increasing the relevance of research for those who benefit from its findings. Specific approaches to engagement vary, but commonly include advisory boards, groups or patient panels that are active throughout all stages of research. The breadth of and optimal strategies for recruiting patients, carers and members of the public to such boards, groups or panels remains unclear. The objective of this manuscript is to identify the breadth of and optimal strategies used to recruit patients, carers and members of the public to advisory boards, groups or panels, within public and patient involvement (PPI) research. METHODS AND ANALYSIS This review follows the scoping review framework by Peters et al, an elaboration on the framework by Arksey and O'Malley. The search strategy was co-developed among the research team, PPI research experts and a faculty librarian. The review will take place between July 2021 and June 2022. In July and August 2021, eight electronic databases, MEDLINE (PubMed), MEDLINE (OVID), Embase, CINAHL, PsychINFO, Scopus, Web of Science and Cochrane Library, will be explored to capture all available literature. Two independent reviewers will screen articles by title and abstract and then at full text based on predetermined criteria. The data will be presented in a tabular format with a narrative summary discussing how the research findings relate to the overarching research question. A thematic analysis will also be completed using qualitative description, identifying key themes and gaps in the literature. ETHICS AND DISSEMINATION Ethics is not required for this review. We aim to disseminate the information gathered through presentations at academic conferences, peer-reviewed publications and consultations with lay audiences.
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Affiliation(s)
- Elena Koskinas
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Meghan Gilfoyle
- Public and Patient Involvement Research Unit, School of Medicine and Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine and Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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Rahman AE, Jabeen S, Fernandes G, Banik G, Islam J, Ameen S, Ashrafee S, Hossain AT, Alam HMS, Majid T, Saberin A, Ahmed A, A N M EK, Chisti MJ, Ahmed S, Khan M, Jackson T, Dockrell DH, Nair H, El Arifeen S, Islam MS, Campbell H. Introducing pulse oximetry in routine IMCI services in Bangladesh: A context-driven approach to influence policy and programme through stakeholder engagement. J Glob Health 2022; 12:06001. [PMID: 35441007 PMCID: PMC8994831 DOI: 10.7189/jogh.12.06001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Pneumonia is the leading cause of under-five child deaths globally and in Bangladesh. Hypoxaemia or low (<90%) oxygen concentration in the arterial blood is one of the strongest predictors of child mortality from pneumonia and other acute respiratory infections. Since 2014, the World Health Organization recommends using pulse oximetry devices in Integrated Management of Childhood Illness (IMCI) services (outpatient child health services), but it was not routinely used in most health facilities in Bangladesh until 2018. This paper describes the stakeholder engagement process embedded in an implementation research study to influence national policy and programmes to introduce pulse oximetry in routine IMCI services in Bangladesh. Methods Based on literature review and expert consultations, we developed a conceptual framework, which guided the planning and implementation of a 4-step stakeholder engagement process. Desk review, key informant interviews, consultative workshops and onsite demonstration were the key methods to involve and engage a wide range of stakeholders. In the first step, a comprehensive desk review and key informant interviews were conducted to identify stakeholder organisations and scored them based on their power and interest levels regarding IMCI implementation in Bangladesh. In the second step, two national level, two district level and five sub-district level sensitisation workshops were organised to orient all stakeholder organisations having high power or high interest regarding the importance of using pulse oximetry for pneumonia assessment and classification. In the third step, national and district level high power-high interest stakeholder organisations were involved in developing a joint action plan for introducing pulse oximetry in routine IMCI services. In the fourth step, led by a formal working group under the leadership of the Ministry of Health, we updated the national IMCI implementation package, including all guidelines, training manuals, services registers and referral forms in English and Bangla. Subsequently, we demonstrated its use in real-life settings involving various levels of (national, district and sub-district) stakeholders and worked alongside the government leaders towards carefully resuming activities despite the COVID-19 pandemic. Results Our engagement process contributed to the national decision to introduce pulse oximetry in routine child health services and update the national IMCI implementation package demonstrating country ownership, government leadership and multi-partner involvement, which are steppingstones towards scalability and sustainability. However, our experience clearly delineates that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, mercurial process that demands meticulous planning, prioritisation, inclusiveness, and adaptability. It is also influenced by the expertise, experience and positionality of the facilitating organization. Conclusions Our experience has demonstrated the value and potential of the approach that we adopted for stakeholder engagement. However, the approach needs to be conceptualised coupled with the allocation of adequate resources and time commitment to implement it effectively.
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Affiliation(s)
- Ahmed Ehsanur Rahman
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Sabrina Jabeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Genevie Fernandes
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Goutom Banik
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shafiqul Ameen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Aniqa Tasnim Hossain
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Husam Md Shah Alam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Tamanna Majid
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Ashfia Saberin
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | - Mohammod Jobayer Chisti
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | | | - Tracy Jackson
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - David H Dockrell
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Harish Nair
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Shams El Arifeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Harry Campbell
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
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Health Equity Implications of the COVID-19 Lockdown and Visitation Strategies in Long-Term Care Homes in Ontario: A Mixed Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074275. [PMID: 35409954 PMCID: PMC8998692 DOI: 10.3390/ijerph19074275] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has negatively impacted the lives and well-being of long-term care home residents. This mixed-method study examined the health equity implications of the COVID-19 lockdown and visitation strategies in long-term care homes in Ontario. We recruited long-term care home residents, their family members and designated caregivers, as well as healthcare workers from 235 homes in Ontario, Canada. We used online surveys and virtual interviews to assess the priority, feasibility, and acceptability of visitation strategies, and to explore the lived experiences of participants under the lockdown and thereafter. A total of n = 201 participants completed a survey and a purposive sample of n = 15 long-term care home residents and their family members completed an interview. The initial lockdown deteriorated residents’ physical, mental, and cognitive well-being, and disrupted family and community ties. Transitional visitation strategies, such as virtual visits, were criticised for lack of emotional value and limited feasibility. Designated caregiver programs emerged as a prioritised and highly acceptable strategy, one that residents and family members demanded continuous and unconditional access to. Our findings suggest a series of equity implications that highlight a person-centred approach to visitation strategies and promote emotional connection between residents and their loved ones.
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Pollock D, Alexander L, Munn Z, Peters MDJ, Khalil H, Godfrey CM, McInerney P, Synnot A, Tricco AC. Moving from consultation to co-creation with knowledge users in scoping reviews: guidance from the JBI Scoping Review Methodology Group. JBI Evid Synth 2022; 20:969-979. [PMID: 35477565 DOI: 10.11124/jbies-21-00416] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
ABSTRACT Knowledge user consultation is often limited or omitted in the conduct of scoping reviews. Not including knowledge users within the conduct and reporting of scoping reviews could be due to a lack of guidance or understanding about what consultation requires and the subsequent benefits. Knowledge user engagement in evidence synthesis, including consultation approaches, has many associated benefits, including improved relevance of the research and better dissemination and implementation of research findings. Scoping reviews, however, have not been specifically focused on in terms of research into knowledge user consultation and evidence syntheses. In this paper, we will present JBI's guidance for knowledge user engagement in scoping reviews based on the expert opinion of the JBI Scoping Review Methodology Group. We offer specific guidance on how this can occur and provide information regarding how to report and evaluate knowledge user engagement within scoping reviews. We believe that scoping review authors should embed knowledge user engagement into all scoping reviews and strive towards a co-creation model.
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Affiliation(s)
- Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Lyndsay Alexander
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.,The Scottish Centre for Evidence-based Multi-professional Practice: a JBI Centre of Excellence, Robert Gordon University, Aberdeen, UK
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Micah D J Peters
- University of South Australia, UniSA Clinical and Health Sciences, Rosemary Bryant AO Research Centre, Adelaide, SA, Australia.,School of Nursing, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.,The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence, The University of Adelaide, Adelaide, SA, Australia
| | - Hanan Khalil
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic, Australia.,The Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Mater Hospital, Brisbane, QLD, Australia
| | - Christina M Godfrey
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen's University Kingston, ON, Canada
| | - Patricia McInerney
- The Wits-JBI Centre for Evidence-Based Practice: A JBI Affiliated Group, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anneliese Synnot
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Vic, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia
| | - Andrea C Tricco
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, School of Nursing, Queen's University Kingston, ON, Canada.,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Epidemiology Division and Institute of Health Management, Policy, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Racine E, O Mahony L, Riordan F, Flynn G, Kearney PM, McHugh SM. What and how do different stakeholders contribute to intervention development? A mixed methods study. HRB Open Res 2022; 5:35. [PMID: 36895913 PMCID: PMC9989546 DOI: 10.12688/hrbopenres.13544.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background: UK Medical Research Council guidelines recommend end-user involvement in intervention development. There is limited evidence on the contributions of different end-users to this process. The aim of this Study Within A Trial (SWAT) was to identify and compare contributions from two groups of end-users - people with diabetes' (PWD) and healthcare professionals' (HCPs), during consensus meetings to inform an intervention to improve retinopathy screening uptake. Methods: A mixed method, explanatory sequential design comprising a survey and three semi-structured consensus meetings was used. PWD were randomly assigned to a diabetes only or combined meeting. HCPs attended a HCP only or combined meeting, based on availability. In the survey, participants rated intervention proposals on acceptability and feasibility. Survey results informed the meeting topic guide. Transcripts were analysed deductively to compare feedback on intervention proposals, suggestions for new content, and contributions to the final intervention. Results: Overall, 13 PWD and 17 HCPs completed the survey, and 16 PWD and 15 HCPs attended meetings. For 31 of the 39 intervention proposals in the survey, there were differences (≥10%) between the proportion of HCPs and PWD who rated proposals as acceptable and/or feasible. End-user groups shared and unique concerns about proposals; both were concerned about informing but not scaring people when communicating risk, while concerns about resources were mostly unique to HCPs and concerns about privacy were mostly unique to PWD. Fewer suggestions for new intervention content from the combined meeting were integrated into the final intervention as they were not feasible for implementation in general practice. Participants contributed four new behaviour change techniques not present in the original proposals: goal setting (outcome), restructuring the physical environment, material incentive (behaviour) and punishment. Conclusions: Preferences for intervention content may differ across end-user groups, with feedback varying depending on whether end-users are involved simultaneously or separately.
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Affiliation(s)
- Emmy Racine
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Lauren O Mahony
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Fiona Riordan
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Gráinne Flynn
- PPI Contributor, IDEAs Research Project, University College Cork, Cork, T12 K8AF, Ireland
| | - Patricia M Kearney
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Sheena M McHugh
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
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50
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Racine E, O Mahony L, Riordan F, Flynn G, Kearney PM, McHugh SM. What and how do different stakeholders contribute to intervention development? A mixed methods study. HRB Open Res 2022; 5:35. [PMID: 36895913 PMCID: PMC9989546 DOI: 10.12688/hrbopenres.13544.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Background: UK Medical Research Council guidelines recommend end-user involvement in intervention development. There is limited evidence on the contributions of different end-users to this process. The aim of this Study Within A Trial (SWAT) was to identify and compare contributions from two groups of end-users - people with diabetes' (PWD) and healthcare professionals' (HCPs), during consensus meetings to inform an intervention to improve retinopathy screening uptake. Methods: A mixed method, explanatory sequential design comprising a survey and three semi-structured consensus meetings was used. PWD were randomly assigned to a PWD only or combined meeting. HCPs attended a HCP only or combined meeting, based on availability. In the survey, participants rated intervention proposals on acceptability and feasibility. Survey results informed the meeting topic guide. Transcripts were analysed deductively to compare feedback on intervention proposals, suggestions for new content, and contributions to the final intervention. Results: Overall, 13 PWD and 17 HCPs completed the survey, and 16 PWD and 15 HCPs attended meetings. For 31 of the 39 intervention proposals in the survey, there were differences (≥10%) between the proportion of HCPs and PWD who rated proposals as acceptable and/or feasible. End-user groups shared and unique concerns about proposals; both were concerned about informing but not scaring people when communicating risk, while concerns about resources were mostly unique to HCPs and concerns about privacy were mostly unique to PWD. Fewer suggestions for new intervention content from the combined meeting were integrated into the final intervention as they were not feasible for implementation in general practice. Participants contributed four new behaviour change techniques not present in the original proposals: goal setting (outcome), restructuring the physical environment, material incentive (behaviour) and punishment. Conclusions: Preferences for intervention content may differ across end-user groups, with feedback varying depending on whether end-users are involved simultaneously or separately.
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Affiliation(s)
- Emmy Racine
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Lauren O Mahony
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Fiona Riordan
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Gráinne Flynn
- PPI Contributor, IDEAs Research Project, University College Cork, Cork, T12 K8AF, Ireland
| | - Patricia M Kearney
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
| | - Sheena M McHugh
- School of Public Health, University College Cork, Cork, T12 K8AF, Ireland
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