1
|
Best S, Thursky K, Buzza M, Klaic M, Peters S, Guccione L, Trainer A, Francis J. Aligning organisational priorities and implementation science for cancer research. BMC Health Serv Res 2024; 24:338. [PMID: 38486219 PMCID: PMC10938739 DOI: 10.1186/s12913-024-10801-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/28/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The challenge of implementing evidence into routine clinical practice is well recognised and implementation science offers theories, models and frameworks to promote investigation into delivery of evidence-based care. Embedding implementation researchers into health systems is a novel approach to ensuring research is situated in day-to-day practice dilemmas. To optimise the value of embedded implementation researchers and resources, the aim of this study was to investigate stakeholders' views on opportunities for implementation science research in a cancer setting that holds potential to impact on care. The research objectives were to: 1) Establish stakeholder and theory informed organisation-level implementation science priorities and 2) Identify and prioritise a test case pilot implementation research project. METHODS We undertook a qualitative study using semi-structured interviews. Participants held either a formal leadership role, were research active or a consumer advocate and affiliated with either a specialist cancer hospital or a cancer alliance of ten hospitals. Interview data were summarised and shared with participants prior to undertaking both thematic analysis, to identify priority areas for implementation research, and content analysis, to identify potential pilot implementation research projects. The selected pilot Implementation research project was prioritised using a synthesis of an organisational and implementation prioritisation framework - the organisational priority setting framework and APEASE framework. RESULTS Thirty-one people participated between August 2022 and February 2023. Four themes were identified: 1) Integration of services to address organisational priorities e.g., tackling fragmented services; 2) Application of digital health interventions e.g., identifying the potential benefits of digital health interventions; 3) Identification of potential for implementation research, including deimplementation i.e., discontinuing ineffective or low value care and; 4) Focusing on direct patient engagement e.g., wider consumer awareness of the challenges in delivering cancer care. Six potential pilot implementation research projects were identified and the EMBED project, to support clinicians to refer appropriate patients with cancer for genetic testing, was selected using the synthesised prioritisation framework. CONCLUSIONS Using a theory informed and structured approach the alignment between strategic organisational priorities and implementation research priorities can be identified. As a result, the implementation research focus can be placed on activities with the highest potential impact.
Collapse
Affiliation(s)
- Stephanie Best
- University of Melbourne; Peter MacCallum Cancer Centre; Australian Genomics, Melbourne, Australia.
| | - Karin Thursky
- Peter MacCallum Cancer Centre; Royal Melbourne Hospital; University of Melbourne, Melbourne, Australia
| | | | | | | | - Lisa Guccione
- Peter MacCallum Cancer Centre; University of Melbourne, Melbourne, Australia
| | - Alison Trainer
- Peter MacCallum Cancer Centre; University of Melbourne, Melbourne, Australia
| | - Jillian Francis
- University of Melbourne; Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
2
|
Ponzano M, Tibert N, Brien S, Funnell L, Gibbs JC, Keller H, Laprade J, Morin SN, Papaioannou A, Weston ZJ, Wideman TH, Giangregorio LM. Development, Acceptability, and Usability of a Virtual Intervention for Vertebral Fractures. Phys Ther 2023; 103:pzad098. [PMID: 37555708 DOI: 10.1093/ptj/pzad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/30/2023] [Accepted: 05/31/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE This project aimed to develop a virtual intervention for vertebral fractures (VIVA) to implement the international recommendations for the nonpharmacological management of osteoporotic vertebral fractures and to test its acceptability and usability. METHODS VIVA was developed in accordance with integrated knowledge translation principles and was informed by the Behavioral Change Wheel, the Theoretical Domains Framework, and the affordability, practicability, effectiveness and cost-effectiveness, acceptability, side effects/safety, and equity (APEASE) criteria. The development of the prototype of VIVA involved 3 steps: understanding target behaviors, identifying intervention options, and identifying content and implementation options. The VIVA prototype was delivered to 9 participants to assess its acceptability and usability. RESULTS VIVA includes 7 1-on-1 virtual sessions delivered by a physical therapist over 5 weeks. Each session lasts 45 minutes and is divided in 3 parts: education, training, and behavioral support/goal setting. Four main themes emerged from the acceptability evaluation: perceived improvements in pain, increased self-confidence, satisfaction with 1-on-1 sessions and resources, and ease of use. All of the participants believed that VIVA was very useful and were very satisfied with the 1-on-1 sessions. Four participants found the information received very easy to practice, 4 found it easy to practice, and 1 found it somewhat difficult to practice. Five participants were satisfied with the supporting resources, and 4 were very satisfied. Potential for statistically significant improvements was observed in participants' ability to make concrete plans about when, how, where, and how often to exercise. CONCLUSION VIVA was acceptable and usable to the participants, who perceived improvements in pain and self-confidence. IMPACT The virtual implementation of the recommendations for the nonpharmacological management of vertebral fractures showed high acceptability and usability. Future trials will implement the recommendations on a larger scale to evaluate their effectiveness.
Collapse
Affiliation(s)
- Matteo Ponzano
- School of Health and Exercise Sciences, University of British Columbia, Kelowna BC, Canada
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre (BSCC), University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Tibert
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sheila Brien
- Canadian Osteoporosis Patient Network, Osteoporosis, Toronto, ON, Canada
| | - Larry Funnell
- Canadian Osteoporosis Patient Network, Osteoporosis, Toronto, ON, Canada
| | - Jenna C Gibbs
- Department of Kinesiology and Physical Activity, McGill University, Montreal, QC, Canada
| | - Heather Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Judi Laprade
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Alexandra Papaioannou
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Zachary J Weston
- Canadian Society for Exercise Physiology (CSEP), Ottawa Ontario, Canada
- Faculty of Human and Social Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Timothy H Wideman
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Lora M Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| |
Collapse
|
3
|
Hammack-Aviran C, Fair AM, Aldrich M, Richmond J, Carpenter SM, Watson KS, Cohn EG, Wilkins CH. Integrating participants as partners in research governance and operations: an approach from the All of Us Research Program Engagement Core. BMJ Open 2023; 13:e068100. [PMID: 38011981 PMCID: PMC10685928 DOI: 10.1136/bmjopen-2022-068100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVES During the last two decades, researchers and funders increasingly recognised the value of engaging patients and communities in research. Despite progress, community engagement remains challenging. There are few examples of successful participant engagement in governance of large-scale research programmes. Here we describe efforts to engage participants as partners in new governance roles in the All of Us Research Program, a precision medicine research initiative which intends to enrol at least one million participants. Using intentional, participant-centric engagement strategies, the All of Us Engagement Core recruited and integrated a diverse group of participants into governance roles including Steering and Executive Committees. Evaluation measures included a survey to assess Consortium Members' readiness for participant engagement. RESULTS Over a 3-year period, all items on the survey increased (higher readiness). Of the 291 respondents to the 2021 survey, respondents most frequently agreed that participant perspectives are essential (100%), participants understand enough to contribute meaningfully (94%) and participants should be involved in setting goals (96%). Respondents least frequently agreed that participants should have an equal voice in Working Groups (75%), Steering Committee (69%) and Executive Committee (63%). CONCLUSION In conclusion, participants can be effectively integrated into large-scale research governance, which is associated with increased researcher readiness for engagement.
Collapse
Affiliation(s)
- Catherine Hammack-Aviran
- Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Ethics, Education, Policy, and Society, Research Immersion Program at Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alecia Malin Fair
- Department of Medicine; Division of Geriatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melinda Aldrich
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer Richmond
- Department of Social Sciences and Health Policy and Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Selena McCoy Carpenter
- Office of Health Equity, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Karriem S Watson
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth G Cohn
- Zucker School of Medicine, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Consuelo Hopkins Wilkins
- Department of Medicine; Division of Geriatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Office of Health Equity, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
4
|
Sprague Martinez L, Howard RC, Schotland M, Lobb R, Battaglia T, Stone S, Auerswald C, Ozer E. Community engagement and financial arrangements: Navigating institutional change. J Clin Transl Sci 2023; 7:e261. [PMID: 38229900 PMCID: PMC10790102 DOI: 10.1017/cts.2023.683] [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: 03/18/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 01/18/2024] Open
Abstract
Despite their documented benefits, the widespread adoption of community-engaged and participatory approaches among health researchers remains limited. Institutional practices and policies influence the uptake of community engagement and participatory approaches. We examine the role of financial arrangements between university researchers and community partners, by exploring efforts to bridge the gap between research administration and researchers at two research-intensive institutions. The type of financial arrangement a researcher has with a community partner plays an important role in setting the stage for the structure of the partnership as it relates to shared decision-making and ownership of the research. Continued efforts to clarify and streamline subcontracting processes are needed as is infrastructure to support community partners and researchers as they navigate financial arrangements if progress is to be made.
Collapse
Affiliation(s)
- Linda Sprague Martinez
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Riana C. Howard
- Boston University School of Social Work, Boston, MA, USA
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Marieka Schotland
- University of California Berkeley, School of Public Health, Berkely, CA, USA
| | - Rebecca Lobb
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
| | - Tracy Battaglia
- Boston University Clinical Translational Science Institute, Community Engagement Program, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | - Susan Stone
- University of California Berkeley, School of Social Welfare, Berkely, CA, USA
| | - Coco Auerswald
- University of California Berkeley, School of Public Health, Berkely, CA, USA
| | - Emily Ozer
- University of California Berkeley, School of Public Health, Berkely, CA, USA
| |
Collapse
|
5
|
Burrow AL. Beyond Finding Purpose: Motivating a Translational Science of Purpose Acquisition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6091. [PMID: 37372678 DOI: 10.3390/ijerph20126091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
A broad interest in finding purpose is understandable, as having purpose is situated in notions of "the good life" and is linked in studies to greater health and wellbeing. Yet, the empirical basis for whether purpose is truly findable is inadequate, lacking guidance from theories predicting behavioral capacities that drive its acquisition. If feeling purposeful is as favorable as studies suggest, then more transparent and precise explanations of how it is derived are needed; otherwise, the field risks illuminating this resource while leaving the pathways to it unlit. Here, I call for a translational science of purpose acquisition directed at gathering and disseminating evidence of the processes by which this sense can be cultivated. I introduce a minimal viable framework for integrating basic and applied investigations into purpose by bridging laboratory research, intervention and implementation efforts, community-engaged practices, and policies to accelerate testing and strategies for enhancing this salubrious sense in people's lives.
Collapse
Affiliation(s)
- Anthony L Burrow
- Department of Psychology, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY 14853, USA
| |
Collapse
|
6
|
Slaghmuylder Y, Pype P, Van Hecke A, Lauwerier E. Development of an intervention aimed at the prevention and treatment of chronic pain in breast cancer survivors: An intervention mapping approach. PATIENT EDUCATION AND COUNSELING 2023; 108:107618. [PMID: 36586350 DOI: 10.1016/j.pec.2022.107618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Pain is prevalent among breast cancer survivors and can persist for years, impeding quality of life. Both prevention and pain treatment are important. However, this requires an interdisciplinary approach and complex models of care. We report on the design and implementation of an intervention that follows a step-wise care model, aimed at timely and adequate pain follow-up among breast cancer survivors. METHODS We used intervention mapping to guide our planning process. The intervention was developed in co-design with relevant stakeholders, such as breast cancer survivors and healthcare providers. RESULTS An e-learning training was developed aimed at changing healthcare providers' knowledge, beliefs, and interprofessional behaviour regarding pain follow-up. Second, guides were produced to empower patients in talking about pain and stimulate referral to other disciplines. CONCLUSION To achieve change in pain follow-up, multiple levels should be addressed. Additionally, the implementation and adoption of an intervention opposes challenges. Intervention mapping can serve as a theory-based and data-driven approach for decision-making during planning. PRACTICE IMPLICATIONS This study can inform others about how to prepare for the development and implementation of an intervention. The developed intervention can also be adapted according to the target population and context, and used for other cancer populations.
Collapse
Affiliation(s)
- Yaël Slaghmuylder
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Peter Pype
- InterProfessional Collaboration in Education, Research and Practice (IPC-ERP), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| |
Collapse
|
7
|
Headrick K, Thornton M, Hogan A, Deramore Denver B, Drake G, Wallen M. Consumer involvement in research - parent perceptions of partnership in cerebral palsy research: a qualitative study. Disabil Rehabil 2023; 45:483-493. [PMID: 35133223 DOI: 10.1080/09638288.2022.2034992] [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: 01/19/2023]
Abstract
PURPOSE Identify perceptions of parents and caregivers of children with cerebral palsy about being consumer research partners and identify strategies to inform involvement of parents in cerebral palsy research. MATERIALS AND METHODS Twenty-two parents in New South Wales and Victoria (Australia) participated in this qualitative study. Seven interviews and three focus groups were completed. Interpretive description guided data analysis. Methodological rigor was enhanced through involving two consumer investigators in the research team, member checking, and multiple researchers completing data analysis and theme generation. RESULTS Participants identified a range of factors that may influence their involvement in research partner roles. Main topics emerging from the data included "Research Is Better with Parents" and "Parents Benefit from Being Research Partners." A third, "Parents as Research Partners," contained the themes "Flexible Involvement," "Starting Partnerships," and "Building and Sustaining Partnerships." CONCLUSION This study has provided a rich insight into how parents perceive and describe engaging as research partners. Parent-identified guidance will inform future partnerships aiming to enhance the quality of cerebral palsy research and outcomes for people with cerebral palsy and their families. The involvement of consumer investigators in this study was considered valuable for enhancing the quality and applicability of the research.IMPLICATIONS FOR REHABILITATIONParents believed that parent partnership in research has benefits for the research and for the consumers involved.Parents provided guidance about the importance of starting, building and sustaining relationships in involving parents as research partners.Understanding the parent context, investing in relationships and acknowledgement of, and recognition for, contributions were considered important for building and sustaining effective partnerships.Flexible approaches to supporting parents as research partners was considered necessary for effective partnership.
Collapse
Affiliation(s)
- Katie Headrick
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| | | | - Amy Hogan
- Consumer Research Partner, Sydney, Australia
- Cerebral Palsy Society, Auckland, New Zealand
| | | | - Gabrielle Drake
- School of Allied Health, Australian Catholic University, Strathfield, Australia
| | - Margaret Wallen
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| |
Collapse
|
8
|
Taffere GR, Abebe HT, Zerihun Z, Mallen C, Price HP, Mulugeta A. Systematic review of community engagement approach in research: describing partnership approaches, challenges and benefits. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
9
|
Fidler DJ, Riggs N, Esbensen AJ, Jackson-Cook C, Rosser T, Cohen A. Outreach and Engagement Efforts in Research on Down Syndrome: An NIH INCLUDE Working Group Consensus Statement. INTERNATIONAL REVIEW OF RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 63:247-267. [PMID: 36545326 PMCID: PMC9762205 DOI: 10.1016/bs.irrdd.2022.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The National Institutes of Health formulated the Outreach and Engagement Working Group in Fall of 2019 to support the objectives of the INCLUDE Project (INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE). This Working Group consisted of a multi-disciplinary team of stakeholders in research on Down syndrome that met to discuss best practices for outreach and engagement to Down syndrome communities, with an emphasis on representation and diversity. This review and consensus paper describes the importance of increasing representation in DS research for future cohort building and summarizes the priority issues identified by the Working Group members. An overview of Working Group activities is then presented, followed by consensus recommendations and a discussion of future opportunities and challenges.
Collapse
Affiliation(s)
| | | | - Anna J Esbensen
- Cincinnati Children's Hospital Medical Campus, Cincinnati, OH, USA
| | | | | | - Annie Cohen
- University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
10
|
"It has to be designed in a way that really challenges people's assumptions": preparing scholars to build equitable community research partnerships. J Clin Transl Sci 2021; 5:e182. [PMID: 34849257 PMCID: PMC8596064 DOI: 10.1017/cts.2021.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction: Clinical and Translational Award (CTSA) programs are developing relevant training for researchers and community stakeholders participating in community-engaged research (CEnR). However, there is limited research exploring the ways community stakeholders and partners with key CEnR experiences can inform and shape training priorities for prospective CEnR scholars to build meaningful and equitable partnerships. Methods: This study conducted and analyzed online individual semi-structured in-depth interviews with community stakeholders (n = 13) engaged in CEnR to identify training priorities for graduate students and emerging scholars. Findings: Thematic analysis of 13 interview transcripts revealed four major training priorities for prospective scholars interested in engaging in CEnR: 1) researcher’s positionality, 2) equitable power sharing, 3) funding, and 4) ethics. Conclusion: Building equitable research partnerships was a central theme woven across all four training priorities. Further research should focus on examining the development, implementation, and evaluation of CEnR training in partnership with community stakeholders and partners with relevant CEnR experience. Adopting a collaborative approach to incorporate both community stakeholders and researchers’ priorities can align training competencies to better prepare scholars to engage in building research partnerships.
Collapse
|
11
|
Wale JL, Di Pietro L, Renton H, Sahhar M, Walker C, Williams P, Meehan K, Lynch E, Martyn M, Bell J, Winship I, Gaff CL. Making community voices heard in a research-health service alliance, the evolving role of the Community Advisory Group: a case study from the members' perspective. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:84. [PMID: 34838131 PMCID: PMC8627002 DOI: 10.1186/s40900-021-00326-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Melbourne Genomics Health Alliance (the Alliance) is a collaboration of leading hospitals, research and academic organisations, supported by its member organisations and the Victorian Government. The Alliance was set up by its members in 2013 to steer the translation of genomics, making it an integral part of health care in Victoria, Australia. The Community Advisory Group (CAG) was formed soon after, to give input and advice across the program. This was to ensure consideration of community values, perspectives and priorities, and knowledge translation for patient care. The CAG was charged with providing a strong community voice for the duration of the program. Appointed members were experienced consumer advocates with developed connections to the community. MAIN BODY The Alliance progressed from an initial Demonstration Project (2013-2015) to a multifaceted program (2016-2020). The CAG worked strategically to help address complex issues, for example, communication, privacy, informed consent, ethics, patient experience, measurement and evaluation standards and policies, data storage and re-use of genomic data. Many aspects of translating genomics into routine care have been tackled, such as communicating with patients invited to have genomic testing, or their caregivers, and obtaining informed consent, clinical questions across 16 areas of health care, training and education of health and laboratory professionals, genomic data management and data-sharing. Evidence generated around clinical utility and cost-effectiveness led to government funding of testing for complex genetic conditions in children. CONCLUSION The CAG activities, recorded in a CAG-inspired Activity register, span the full spectrum of information sharing and consultation to co-design and partnership. The CAG were involved at multiple levels of participation and in all tiers of activity including governance, development of policies and procedures, program planning and evaluation. Working relationships were built up and a level of trust instilled to advance the Alliance work program in ensuring an effective patient-care model of delivery of genomics. CAG input into project deliverables has been tangible. Less tangible contributions included presentations at external meetings and conferences, direct interactions at meetings with Alliance members, interactions with visitors and external experts, taking part in consultations with experts, state and federal government.
Collapse
Affiliation(s)
| | - Louisa Di Pietro
- Genetic Support Network of Victoria, 50 Flemington Road, Parkville, VIC 3052 Australia
| | - Heather Renton
- Syndromes Without A Name (SWAN) – Australia, PO Box 390, Fairfield, VIC 3078 Australia
| | | | | | | | - Karen Meehan
- Melbourne Genomics Health Alliance, 1G Royal Parade, Parkville, VIC 3052 Australia
| | - Elly Lynch
- Melbourne Genomics Health Alliance, 1G Royal Parade, Parkville, VIC 3052 Australia
| | - Melissa Martyn
- Melbourne Genomics Health Alliance, 1G Royal Parade, Parkville, VIC 3052 Australia
- Department of Paediatrics (Royal Children’s Hospital), Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | | | - Ingrid Winship
- The Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3052 Australia
| | - Clara L. Gaff
- Melbourne Genomics Health Alliance, 1G Royal Parade, Parkville, VIC 3052 Australia
- Department of Paediatrics (Royal Children’s Hospital), Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| |
Collapse
|
12
|
Carter-Edwards L, Grewe ME, Fair AM, Jenkins C, Ray NJ, Bilheimer A, Dave G, Nunez-Smith M, Richmond A, Wilkins CH. Recognizing Cross-Institutional Fiscal and Administrative Barriers and Facilitators to Conducting Community-Engaged Clinical and Translational Research. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:558-567. [PMID: 33332904 PMCID: PMC7996237 DOI: 10.1097/acm.0000000000003893] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE This qualitative study examined fiscal and administrative (i.e., pre- and post-award grants process) barriers and facilitators to community-engaged research among stakeholders across 4 Clinical and Translational Science Awards (CTSA) institutions. METHOD A purposive sample of 24 key informants from 3 stakeholder groups-community partners, academic researchers, and research administrators-from the CTSA institutions at the University of North Carolina at Chapel Hill, Medical University of South Carolina, Vanderbilt University Medical Center, and Yale University participated. Semistructured interviews were conducted in March-July 2018, including questions about perceived challenges and best practices in fiscal and administrative processes in community-engaged research. Transcribed interviews were independently reviewed and analyzed using the Rapid Assessment Process to facilitate key theme and quote identification. RESULTS Community partners were predominantly Black, academic researchers and research administrators were predominantly White, and women made up two-thirds of the overall sample. Five key themes were identified: level of partnership equity, partnership collaboration and communication, institutional policies and procedures, level of familiarity with varying fiscal and administrative processes, and financial management expectations. No stakeholders reported best practices for the institutional policies and procedures theme. Cross-cutting challenges included communication gaps between stakeholder groups; lack of or limits in supporting community partners' fiscal capacity; and lack of collective awareness of each stakeholder group's processes, procedures, and needs. Cross-cutting best practices centered on shared decision making and early and timely communication between all stakeholder groups in both pre- and post-award processes. CONCLUSIONS Findings highlight the importance of equitable processes, triangulated communication, transparency, and recognizing and respecting different financial management cultures within community-engaged research. This work can be a springboard used by CTSA institutions to build on available resources that facilitate co-learning and discussions between community partners, academic researchers, and research administrators on fiscal readiness and administrative processes for improved community-engaged research partnerships.
Collapse
Affiliation(s)
- Lori Carter-Edwards
- L. Carter-Edwards is associate professor, Public Health Leadership Program, adjunct faculty in epidemiology and health behavior, Gillings School of Global Public Health, and director, Community and Stakeholder Engagement (CaSE) Program, North Carolina Translational and Clinical Sciences Institute (NC TraCS), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-5552-136X
| | - Mary E. Grewe
- M.E. Grewe is project manager/qualitative research specialist, CaSE Program, NC TraCS, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-9979-4394
| | - Alecia M. Fair
- A.M. Fair is research assistant professor of medicine, Division of Geriatric Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; ORCID: https://orcid.org/0000-0003-0144-1425
| | - Carolyn Jenkins
- C. Jenkins is professor and Ann Darlington Edwards Endowed Chair, College of Nursing, and community engagement codirector, South Carolina Clinical & Translational Research Institute, Medical University of South Carolina, Charleston, South Carolina; ORCID: https://orcid.org/0000-0001-5506-7657
| | - Natasha J. Ray
- N.J. Ray is core services manager, New Haven Healthy Start, The Community Foundation for Greater New Haven, New Haven, Connecticut
| | - Alicia Bilheimer
- A. Bilheimer is administrative director, CaSE Program, NC TraCS, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gaurav Dave
- G. Dave is associate professor of medicine (social medicine), School of Medicine, and associate director, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0003-0825-1595
| | - Marcella Nunez-Smith
- M. Nunez-Smith is associate professor of medicine (general medicine) and epidemiology (chronic diseases), associate dean, Health Equity Research, director, Equity Research and Innovation Center, director, Center for Research Engagement, core faculty, National Clinician Scholars Program, deputy director of health equity research and workforce development, Yale Center for Clinical Investigation, and director, Yale-Commonwealth Fund Fellowship in Health Equity Leadership, Yale University, New Haven, Connecticut; ORCID: https://orcid.org/0000-0003-2797-4756
| | - Alan Richmond
- A. Richmond is executive director, Community-Campus Partnerships for Health, Raleigh, North Carolina
| | - Consuelo H. Wilkins
- C.H. Wilkins is professor of medicine, Division of Geriatric Medicine, and vice president of health equity and associate dean for health equity, Vanderbilt University Medical Center, Nashville, Tennessee; ORCID: https://orcid.org/0000-0002-8043-513X
| |
Collapse
|
13
|
Researchers' experiences working with community advisory boards: How community member feedback impacted the research. J Clin Transl Sci 2021; 5:e117. [PMID: 34221459 PMCID: PMC8223174 DOI: 10.1017/cts.2021.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction To assess researchers' experiences working with community advisory boards (CABs) and perceptions of how community member stakeholder feedback impacted the research. Methods Individual interviews were conducted with researchers (n= 34) who had presented their research to a Mayo Clinic CAB (at MN, AZ, or FL) from 2014 to 2017, with an average interview duration of 10-15 min. Researchers were asked "In what ways did the feedback you received from the CAB influence your research?" A validated, structured, 7-item interview was used to assess domains of the potential influence that CABs had on the research: (1) pre-research (e.g., generated ideas), (2) infrastructure (e.g., budget preparation), (3) research design, (4) implementation (e.g., research recruitment), (5) analysis, (6) dissemination, and (7) post-research. A total mean score was calculated with a possible range of 0-7. In addition, open-ended examples and feedback from researchers in response to each domain were summarized for themes using content analysis. Results Researchers reported that the CAB influenced research in the following domains: pre-research (24%), infrastructure (24%), study design (41%), implementation (41%), analysis (6%), dissemination (24%), and post-research activities (18%). The mean total score was = 1.8 (SD = 1.7, range: 0-6). Open-ended responses revealed major themes of CAB helpfulness in generating/refining ideas, identifying community partners, culturally tailored and targeted recruitment strategies, intervention design and delivery, and dissemination. Conclusion Findings from this preliminary evaluation indicate that despite positive experiences noted in open-ended feedback, the perceived quantitative impact of CAB feedback on the research was moderate. Bidirectional communication between researchers and community member stakeholders has the potential to make clinical and translational research more relevant and appropriate.
Collapse
|
14
|
Minton CAB, Gibbons MM, Hightower JM. Community‐Engaged Research and Evaluation in Counseling: Building Partnerships and Applying Program Evaluation. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12368] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Melinda M. Gibbons
- Department of Educational Psychology and Counseling University of Tennessee Knoxville
| | - Jennifer M. Hightower
- Department of Educational Psychology and Counseling University of Tennessee Knoxville
| |
Collapse
|
15
|
Novak LL, George S, Wallston KA, Joosten YA, Israel TL, L Simpson C, Vaughn Y, Williams NA, Stallings S, Ichimura JS, Wilkins CH. Patient Stories Can Make a Difference in Patient-Centered Research Design. J Patient Exp 2020; 7:1438-1444. [PMID: 33457599 PMCID: PMC7786662 DOI: 10.1177/2374373520958340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Amid increasing interest in improving the patient-centeredness of research, new forms of engagement are emerging that enable researchers to get input from community members on research goals, methods, and implementation. This input often includes stories, which are useful for understanding lived experiences of illness and encounters with health care organizations, and for locating these experiences within larger meta-narratives of specific communities. We analyzed the stories in transcripts of 13 Community Engagement Studios and identified 4 major functions that the stories served in the sessions. Major functions included: (1) establishing mutual understanding, (2) adding expansion and depth, (3) characterizing abstract concepts, and (4) providing context for experience, with the latter being the most frequent. We assert that stories can serve to better communicate the complex contexts of patient experiences, helping to align research priorities and research design with community interests, leading to more patient-centered innovations in clinical practice.
Collapse
Affiliation(s)
- Laurie Lovett Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, USA
| | - Sheba George
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Center for Biomedical Informatics and Department of Preventive and Social Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Kenneth A Wallston
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, USA
| | - Yvonne A Joosten
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, USA
| | - Tiffany L Israel
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, USA
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | | | | | - Consuelo H Wilkins
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
- Meharry-Vanderbilt Alliance, Nashville, TN, USA
| |
Collapse
|
16
|
Arterburn DE, Toh S, Williams N, Anau J, Courcoulas A, Tavakkoli A, Stilwell D, Tuzzio L, Lewis CC, Wilcox MN, McTigue KM. Translating stakeholder-driven comparative effectiveness research into practice: the PCORnet Bariatric Study. J Comp Eff Res 2020; 9:1035-1041. [PMID: 33000638 DOI: 10.2217/cer-2020-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- David E Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Jane Anau
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Anita Courcoulas
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Ali Tavakkoli
- Laboratory for Surgical and Metabolic Research, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Diana Stilwell
- Shared Decision Making Solutions Consultants, Boston, MA, USA
| | - Leah Tuzzio
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Margie N Wilcox
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kathleen M McTigue
- Departments of Medicine & Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| |
Collapse
|
17
|
Bayne AI, Dullabh P, Skillman M, Ubri P, Rotondo C, Zainulbhai S, Frosch DL, Devers KJ. Engaging patients and stakeholders in preresearch: findings from the Pipeline to Proposal Awards Initiative. J Comp Eff Res 2020; 9:721-736. [PMID: 32672474 DOI: 10.2217/cer-2019-0203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The Patient-Centered Outcomes Research Institute Pipeline to Proposal (P2P) Awards Initiative funded 177 awardees to engage patients and stakeholder partners in preresearch. Based on P2P, we described engagement strategies; outcomes; facilitators; and challenges to inform research funders and stakeholders participating in preresearch. Materials & methods: We used a qualitative approach based on content analysis of program data and interviews with P2P awardees and partners. Results: Awardees developed partnership infrastructure by recruiting patients and stakeholders, establishing clear roles, and providing training. Building trust was key to engaging patients and stakeholders in preresearch. Awardees reported partners were more likely to engage in PCOR in the future. Conclusion: P2P awardees increased capacity of patient and stakeholder partnerships to conduct PCOR.
Collapse
Affiliation(s)
- Alycia I Bayne
- NORC at The University of Chicago, Bethesda, MD 20814, USA
| | | | - Megan Skillman
- NORC at The University of Chicago, Bethesda, MD 20814, USA
| | - Petry Ubri
- NORC at The University of Chicago, Bethesda, MD 20814, USA
| | | | - Sabiha Zainulbhai
- Coalition for Nonprofit Housing & Economic Development, Washington, DC 20005, USA
| | - Dominick L Frosch
- Palo Alto Medical Foundation Research Institute and Sutter Health Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Kelly J Devers
- NORC at The University of Chicago, Bethesda, MD 20814, USA
| |
Collapse
|
18
|
Stallings SC, Boyer AP, Joosten YA, Novak LL, Richmond A, Vaughn YC, Wilkins CH. A taxonomy of impacts on clinical and translational research from community stakeholder engagement. Health Expect 2019; 22:731-742. [PMID: 31321849 PMCID: PMC6737764 DOI: 10.1111/hex.12937] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/09/2019] [Accepted: 05/31/2019] [Indexed: 01/10/2023] Open
Abstract
Background Community engagement is increasingly recognized as a valuable tool in clinical and translational research; however, the impact of engagement is not fully understood. No standard nomenclature yet exists to clearly define how research changes when community stakeholders are engaged across the research spectrum. This severely limits our ability to assess the value of community engagement in research. To address this gap, we developed a taxonomy for characterizing and classifying changes in research due to community engagement. Methods Using an iterative process, we (a) identified areas of potential impact associated with community engagement from author experience, (b) categorized these in taxonomic bins based on research stages, (c) conducted semi‐structured interviews with researchers and community stakeholders, (d) validated the codebook in a sample dataset and (e) refined the taxonomy based on the validation. Community stakeholders were involved in every step of the process including as members of the primary study team. Results The final taxonomy catalogues changes into eleven domains corresponding to research phases. Each domain includes 2‐4 dimensions depicting concepts within the domain's scope and, within each dimension, 2‐10 elements labelling activities through which community engagement could change research. Conclusions Community engagement has great potential to enhance clinical and translational research. This taxonomy provides a common vocabulary and framework for understanding the impact of community engagement and suggests metrics for assessing the value of community engagement in research.
Collapse
Affiliation(s)
- Sarah C Stallings
- Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alaina P Boyer
- National Health Care for the Homeless Council, Nashville, Tennessee
| | - Yvonne A Joosten
- Department of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laurie L Novak
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Al Richmond
- Community-Campus Partnerships for Health, Raleigh, North Carolina
| | | | - Consuelo H Wilkins
- Vice President for Health Equity, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|