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Postma L, Luchtenberg ML, Verhagen AAE, Maeckelberghe ELM. 'It's Powerful' The impact of involving children and young people in developing paediatric research agendas: A qualitative interview study. Health Expect 2024; 27:e14028. [PMID: 38613790 PMCID: PMC11015888 DOI: 10.1111/hex.14028] [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: 10/18/2023] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 04/15/2024] Open
Abstract
INTRODUCTION There is a growing consensus that children and young people (CYP) should be involved in matters that concern them. Progress is made in involving CYP in developing pediatric research agendas (PRAs), although the impact of their involvement remains unknown. We aimed to evaluate the impact of involving CYP in developing PRAs and assess the extent to which postpatient and public involvement (post-PPI) activities were planned. METHODS We conducted a qualitative study using in-depth interviews to identify and gain an in-depth understanding of the impact of involving CYP in developing PRAs. The transcripts were uploaded to Atlas.ti to be coded and organised. Dutch-language interviews were analysed and interpreted together with vocational education and training (VET) students. These students were aged between 14 and 18 years and were training to become nurses. RESULTS Three CYP and 15 researchers decided to participate. We focused on three categories of impact: agenda-setting impact, individual impact and academic impact. Involving CYP creates a more enriched and clarified agenda. It ensured that both CYP and researchers underwent personal or professional growth and development, it created a connection between the people involved, awareness about the importance of involving CYP and it ensured that the people involved had a positive experience. The participants were unable to indicate the academic impact of their PRAs, but they did understand the key factors for creating it. In addition, the need to measure impact was highlighted, with a particular focus on assessing individual impact. DISCUSSION Our study outlines the diverse subthemes of impact that arise from involving CYP in developing PRAs. Despite the potential of research agendas to amplify CYP voices, only a minority of researchers strategized post-PPI activities ensuring impactful outcomes, prompting the need for thorough evaluation of various impact forms and consistent alignment with the overarching goal of transforming the research field. PATIENT OR PUBLIC CONTRIBUTION We involved VET students in the data analysis and interpretation phase by forming a young person advisory group. The data analysis of the interviews analysed by the VET students revealed four distinct themes: 1. Learnt new knowledge. 2. Learnt to collaborate. 3. Learnt to listen. 4. Assessment of the individual impact.
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Affiliation(s)
- Laura Postma
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Malou L. Luchtenberg
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - A. A. Eduard Verhagen
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Els L. M. Maeckelberghe
- Beatrix Children's Hospital, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Waterland JL, Beer C, Forbes Shepherd R, Forrest LE. Exploring Consumers' Motivations and Experiences of Engaging as Partners in Cancer Research. THE PATIENT 2024:10.1007/s40271-023-00667-2. [PMID: 38401039 DOI: 10.1007/s40271-023-00667-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Consumer engagement improves research quality and relevance but can be difficult to implement. This study aimed to explore the motivations and understand the barriers, if any, experienced by consumers before and when partnering with cancer research teams. METHODS Semi-structured interviews were conducted with consumers and the results analysed thematically. Two groups were recruited: consumers who were members of the consumer registry and patients who did not have previous experience of being a consumer in a researcher partnership. RESULTS Twenty-one interviews were conducted with a total of 22 participants aged between 26 and 74 years. Consumers motivation was driven by altruism to help others and personal benefits. Barriers to beginning and maintaining consumer engagement included consumers' perceptions of being appreciated by researchers and meaningful communication between researchers and consumers. CONCLUSIONS Australian policy has made important steps towards consumer engagement in research. This study showed that demonstrating an appreciation for consumers and effective communication are key areas to consider when designing implementation strategies of these policies in the cancer research space in the future.
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Affiliation(s)
- Jamie L Waterland
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Cassandra Beer
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Rowan Forbes Shepherd
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Laura E Forrest
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
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Ogourtsova T, Gonzalez M, Zerbo A, Gavin F, Shikako K, Weiss J, Majnemer A. Lessons learned in measuring patient engagement in a Canada-wide childhood disability network. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:18. [PMID: 38326926 PMCID: PMC10851468 DOI: 10.1186/s40900-024-00551-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND The CHILD-BRIGHT Network, a pan-Canadian childhood disability research Network, is dedicated to patient-oriented research, where numerous stakeholders, including patient-partners, researchers, and clinicians are involved at different levels. The Network is committed to continuously improving the level of engagement and partnerships' impact. Measuring patient engagement is therefore important in reflecting on our practices and enhancing our approaches. We aimed to measure patient engagement longitudinally and explore in greater depth the perceived benefits, barriers and facilitators, and overall satisfaction with patient engagement, from the perspectives of the different stakeholders. METHODS Patient engagement was measured using online surveys. In a longitudinal study design over a 3-years period (2018-2020) the Community-Based Participatory Research (CBPR) questionnaire was used. To enrich our understanding of patient engagement in Year 3, we employed the Public and Patient Engagement Evaluation Tool (PPEET) in a cross-sectional, convergent parallel mixed-method study design. Descriptive statistics and a thematic-based approach were used for data analysis. RESULTS The CBPR questionnaire was completed by n = 167 (61.4% response rate), n = 92 (30.2% response rate), and n = 62 (14.2% response rate) Network members in Years 1, 2, and 3, respectively. Ninety-five (n = 95, 21.8% response rate) members completed the PPEET in Year 3. CBPR findings demonstrate a stable and high satisfaction level with patient engagement over time, where 94%, 86%, and 94% of stakeholders indicated that the project is a "true partnership" in Years 1, 2, and 3, respectively. In Years 2 and 3, we noted an improvement in patient-partners' comfort level in sharing their views and perspectives (92% and 91% vs. 74%). An increase in critical reflective trust (i.e., allowing for discussing and resolving mistakes) from Year 1 to 3 was found, both from the perspectives of patient-partners (51-65%) and researchers (48-75%). Using the PPEET, patient engagement factors (i.e., communications and supports for participation, ability to share views and perspectives) and impact were highly rated by most (80-100%) respondents. PPEET's qualitative responses revealed several patient engagement advantages (e.g., increased projects' relevance, enhanced knowledge translation), barriers (e.g., group homogeneity), facilitators (e.g., optimal communication strategies), and solutions to further improve patient engagement (e.g., provide clarity on goals). CONCLUSION Our 3-years patient engagement evaluation journey demonstrated a consistent and high level of satisfaction with patient engagement within the Network and identified advantages, barriers, facilitators, and potential solutions. Improvements were observed in members' comfort in sharing their views and perspectives, along with an increase in critical reflective trust. These findings underscore the Network's commitment to enhancing patient engagement and provide valuable insights for continued improvement and optimization of collaborative efforts.
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Affiliation(s)
- Tatiana Ogourtsova
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
- Research Center of the Jewish Rehabilitation Hospital, Centre de Santé et de Services Sociaux de Laval, Laval, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
| | - Miriam Gonzalez
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alix Zerbo
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Frank Gavin
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Keiko Shikako
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Jonathan Weiss
- Department of Psychology, York University, Toronto, ON, Canada
| | - Annette Majnemer
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
- Montreal Children's Hospital, Research Institute of the McGill University Health Center, Montreal, QC, Canada
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Lloyd N, Hyett N, Kenny A. Barriers and Enablers to Evaluating Outcomes From Public Involvement in Health Service Design: An Interpretive Description. QUALITATIVE HEALTH RESEARCH 2023; 33:983-994. [PMID: 37548221 PMCID: PMC10494479 DOI: 10.1177/10497323231191048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
While health services are expected to have public involvement in service (re)design, there is a dearth of evaluation of outcomes to inform policy and practice. There are major gaps in understanding why outcome evaluation is under-utilised. The aims of this interpretive descriptive study were to explore researcher participants' experiences of and/or attitudes towards evaluating health service outcomes from public involvement in health service design in high-income countries. Additionally, the aims were to explore barriers and enablers of evaluation, and reasons for the use of evaluation tools or frameworks. Semi-structured interviews (n = 13) were conducted with researchers of published studies where the public was involved in designing health services. Using framework analysis, four themes were developed that captured participants' experiences: Public involvement is hard - evaluation is harder; power, a diversity of agendas, and the invisible public; practical and methodological challenges; and genuineness and authenticity matter. Evaluation is driven by stakeholder requirements, including decision-makers, funding bodies, researchers, and academics, and evaluation tools are rarely used. The public is largely absent from the outcome evaluation agenda. There is a lack of commitment and clarity of purpose of public involvement and its evaluation. Outcome evaluation must be multi-layered and localised and reflect the purpose of public involvement, what constitutes success (and to whom), and use the most appropriate methods. Multi-level supports should include increased resources, such as funding, time, and expertise. Without improved evaluation, outcomes of investment in public involvement in health service design/redesign remain unknown.
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Affiliation(s)
- Nicola Lloyd
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Nerida Hyett
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
- Monash Rural Health, Monash University, Bendigo, VIC, Australia
| | - Amanda Kenny
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
- College of Social Science, University of Lincoln, Lincoln, UK
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Gonzalez M, Ogourtsova T, Zerbo A, Lalonde C, Spurway A, Gavin F, Shikako K, Weiss JA, Majnemer A. Patient engagement in a national research network: barriers, facilitators, and impacts. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:7. [PMID: 36890591 PMCID: PMC9993369 DOI: 10.1186/s40900-023-00418-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Little is known about patient engagement in the context of large teams or networks. Quantitative data from a larger sample of CHILD-BRIGHT Network members suggest that patient engagement was beneficial and meaningful. To extend our understanding of the barriers, facilitators, and impacts identified by patient-partners and researchers, we conducted this qualitative study. METHODS Participants completed semi-structured interviews and were recruited from the CHILD-BRIGHT Research Network. A patient-oriented research (POR) approach informed by the SPOR Framework guided the study. The Guidance for Reporting Involvement of Patients and the Public (GRIPP2-SF) was used to report on involvement of patient-partners. The data were analyzed using a qualitative, content analysis approach. RESULTS Twenty-five CHILD-BRIGHT Network members (48% patient-partners, 52% researchers) were interviewed on their engagement experiences in the Network's research projects and in network-wide activities. At the research project level, patient-partners and researchers reported similar barriers and facilitators to engagement. Barriers included communication challenges, factors specific to patient-partners, difficulty maintaining engagement over time, and difficulty achieving genuine collaboration. Facilitators included communication (e.g., open communication), factors specific to patient-partners (e.g., motivation), and factors such as respect and trust. At the Network level, patient-partners and researchers indicated that time constraints and asking too much of patient-partners were barriers to engagement. Both patient-partners and researchers indicated that communication (e.g., regular contacts) facilitated their engagement in the Network. Patient-partners also reported that researchers' characteristics (e.g., openness to feedback) and having a role within the Network facilitated their engagement. Researchers related that providing a variety of activities and establishing meaningful collaborations served as facilitators. In terms of impacts, study participants indicated that POR allowed for: (1) projects to be better aligned with patient-partners' priorities, (2) collaboration among researchers, patient-partners and families, (3) knowledge translation informed by patient-partner input, and (4) learning opportunities. CONCLUSION Our findings provide evidence of the positive impacts of patient engagement and highlight factors that are important to consider in supporting engagement in large research teams or networks. Based on these findings and in collaboration with patient-partners, we have identified strategies for enhancing authentic engagement of patient-partners in these contexts.
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Affiliation(s)
- Miriam Gonzalez
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, H3G 1Y5, Canada.
- Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montréal, H4A 3J1, Canada.
| | - Tatiana Ogourtsova
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, H3G 1Y5, Canada
- The Research Center of the Jewish Rehabilitation Hospital, Centre Intégré de Santé Et de Services Sociaux de Laval, Site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 3205 PI. Alton-Goldbloom, Laval, QC, H7V 1R2, Canada
| | - Alix Zerbo
- The CHILD-BRIGHT Patient-Oriented Research Network, 5252 Boul de Maisonneuve O., Montréal, H4A 3S5, Canada
| | - Corinne Lalonde
- The CHILD-BRIGHT Patient-Oriented Research Network, 5252 Boul de Maisonneuve O., Montréal, H4A 3S5, Canada
| | - Amy Spurway
- The CHILD-BRIGHT Patient-Oriented Research Network, 5252 Boul de Maisonneuve O., Montréal, H4A 3S5, Canada
| | - Frank Gavin
- The CHILD-BRIGHT Patient-Oriented Research Network, 5252 Boul de Maisonneuve O., Montréal, H4A 3S5, Canada
| | - Keiko Shikako
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, H3G 1Y5, Canada
- Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montréal, H4A 3J1, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (Mackay Site), 7000 Sherbrooke St. West, H4B 1R3, Montréal, Canada
| | - Jonathan A Weiss
- Department of Psychology, Faculty of Health, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada
| | - Annette Majnemer
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, H3G 1Y5, Canada
- Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montréal, H4A 3J1, Canada
- The Research Center of the Jewish Rehabilitation Hospital, Centre Intégré de Santé Et de Services Sociaux de Laval, Site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 3205 PI. Alton-Goldbloom, Laval, QC, H7V 1R2, Canada
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MacArthur C, Van Hoorn R, Lavis J, Straus S, Jones N, Bayliss L, Terry AL, Law S, Victor C, Prud'homme D, Riley J, Stewart M. Training and capacity development in patient-oriented research: Ontario SPOR SUPPORT Unit (OSSU) initiatives. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:5. [PMID: 36841819 PMCID: PMC9960159 DOI: 10.1186/s40900-023-00415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In Canada, the Canadian Institutes of Health Research launched the Strategy for Patient-Oriented Research (SPOR) in 2011. The strategy defines 'patient-oriented research' as a continuum of research that engages patients as partners, focuses on patient priorities, and leads to improved patient outcomes. The overarching term 'patient' is inclusive of individuals with personal experience of a health issue as well as informal caregivers including family and friends. The vision for the strategy is improved patient experiences and outcomes through the integration of patient-oriented research findings into practice, policy, and health system improvement. Building capacity in patient-oriented research among all relevant stakeholders, namely patients, practitioners, organizational leaders, policymakers, researchers, and research funders is a core element of the strategy. MAIN BODY The objective of this paper is to describe capacity building initiatives in patient-oriented research led by the Ontario SPOR SUPPORT Unit in Ontario, Canada over the period 2014-2020. CONCLUSION The Ontario SPOR SUPPORT Unit Working Group in Training and Capacity Development has led numerous capacity building initiatives: developed a Capacity Building Compendium (accessed greater than 45,000 times); hosted Masterclasses that have trained hundreds of stakeholders (patients, practitioners, organizational leaders, policymakers, researchers, and trainees) in the conduct and use of patient-oriented research; funded the development of online curricula on patient-oriented research that have reached thousands of stakeholders; developed a patient engagement resource center that has been accessed by tens of thousands of stakeholders; identified core competencies for research teams and research environments to ensure authentic and meaningful patient partnerships in health research; and shared these resources and learnings with stakeholders across Canada, North America, and internationally.
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Affiliation(s)
- Colin MacArthur
- Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | - Rob Van Hoorn
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - John Lavis
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Sharon Straus
- Keenan Research Center, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Nicola Jones
- Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | | | - Amanda L Terry
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Susan Law
- Trillium Health Partners, Institute for Better Health, Mississauga, ON, Canada
| | - Charles Victor
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - John Riley
- Patient Partner, Ontario SPOR SUPPORT Unit, Toronto, ON, Canada
| | - Moira Stewart
- Schulich School of Medicine and Dentistry, London, ON, Canada
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Clark C, Dorland A, Jaworska N, McQuaid RJ, Langlois M, Dzierszinski F. Benefits and barriers to engagement of mental health caregivers in advisory roles: Results from a cross-sectional survey. Health Sci Rep 2023; 6:e1114. [PMID: 36794126 PMCID: PMC9925831 DOI: 10.1002/hsr2.1114] [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: 09/07/2022] [Revised: 11/18/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Background and Aims Mental health institutions and community organizations have had difficulty recruiting patients and caregivers onto their Patient, Family, and Community Advisory Committees (PFACs). Previous research has focused on barriers and enablers of engaging patients and caregivers who have advisory experience. This study acknowledges the experiential difference between patients and caregivers by focusing only on caregivers; further, we compare the barriers and enablers between advising versus non-advising caregivers of loved ones with mental illness. Methods Data from a cross-sectional survey codesigned by researchers, staff, clients, and caregiver affiliated with a tertiary mental health center were completed by n = 84 caregivers (n = 40 past/current PFAC advising caregivers; n = 44 non-advising caregivers). Results Caregivers were disproportionately female and late middle-aged. Advising and non-advising caregivers differed on employment status. There were no differences of the demographics of their care-recipients. More non-advising caregivers reported being hindered from PFAC engagement by family-related duties and interpersonal demands. Finally, more advising caregivers considered being publicly acknowledged as important. Conclusions Advising and non-advising caregivers of loved ones with mental illness were similar in demographics and in reporting the enablers and hindrances that impact PFAC engagement. Nevertheless, our data highlights specific considerations that institutions/organizations should consider when recruiting and retaining caregivers on PFACs. Patient or Public Contribution This project was led by a caregiver advisor to address a need she saw in the community. The surveys were codesigned by a team of two caregivers, one patient, and one researcher. The surveys were reviewed by a group of five caregivers external to the project. The results of the surveys were discussed with two caregivers involved directly with the project.
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Affiliation(s)
- Cynthia Clark
- Institute of Mental Health ResearchUniversity of OttawaOttawaOntarioCanada,The Royal Ottawa Mental Health CentreOttawaOntarioCanada
| | - Alexis Dorland
- Institute of Mental Health ResearchUniversity of OttawaOttawaOntarioCanada
| | - Natalia Jaworska
- Institute of Mental Health ResearchUniversity of OttawaOttawaOntarioCanada,Department of NeuroscienceCarleton UniversityOttawaOntarioCanada,Department of Cellular Molecular MedicineUniversity of OttawaOttawaOntarioCanada
| | - Robyn J. McQuaid
- Institute of Mental Health ResearchUniversity of OttawaOttawaOntarioCanada,Department of NeuroscienceCarleton UniversityOttawaOntarioCanada
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Shahid A, Lalani IN, Rosgen BK, Sept BG, Longmore S, Parsons Leigh J, Stelfox HT, Fiest KM. A scoping review of methods to measure and evaluate citizen engagement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:72. [PMID: 36496455 PMCID: PMC9737710 DOI: 10.1186/s40900-022-00405-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/29/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND Citizen engagement, or partnering with interested members of the public in health research, is becoming more common. While ongoing assessment of citizen engagement practices is considered important to its success, there is little clarity around aspects of citizen engagement that are important to assess (i.e., what to look for) and methods to assess (i.e., how to measure and/ or evaluate) citizen engagement in health research. METHODS In this scoping review, we included peer-reviewed literature that focused primarily on method(s) to measure and/or evaluate citizen engagement in health research. Independently and in duplicate, we completed title and abstract screening and full-text screening and extracted data including document characteristics, citizen engagement definitions and goals, and methods to measure or evaluate citizen engagement (including characteristics of these methods). RESULTS Our search yielded 16,762 records of which 33 records (31 peer-reviewed articles, one government report, one conference proceeding) met our inclusion criteria. Studies discussed engaging citizens (i.e., patients [n = 16], members of the public [n = 7], service users/consumers [n = 4], individuals from specific disease groups [n = 3]) in research processes. Reported methods of citizen engagement measurement and evaluation included frameworks, discussion-based methods (i.e., focus groups, interviews), survey-based methods (e.g., audits, questionnaires), and other methods (e.g., observation, prioritization tasks). Methods to measure and evaluate citizen engagement commonly focused on collecting perceptions of citizens and researchers on aspects of citizen engagement including empowerment, impact, respect, support, and value. DISCUSSION AND CONCLUSION We found that methods to measure and/or evaluate citizen engagement in health research vary widely but share some similarities in aspect of citizen engagement considered important to measure or evaluate. These aspects could be used to devise a more standardized, modifiable, and widely applicable framework for measuring and evaluating citizen engagement in research. PATIENT OR PUBLIC CONTRIBUTION Two citizen team members were involved as equal partners in study design and interpretation of its findings. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (10.17605/OSF.IO/HZCBR).
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Affiliation(s)
- Anmol Shahid
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Inara N Lalani
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brianna K Rosgen
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Science and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bonnie G Sept
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shelly Longmore
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jeanna Parsons Leigh
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Dalhousie University, Halifax, NS, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Science and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Alberta Health Services, Calgary, AB, Canada.
| | - Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Science and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Kerr C, McConnell K, Savage H, Acheson M. Implementing public involvement standards in cerebral palsy register research. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:903167. [DOI: 10.3389/fresc.2022.903167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022]
Abstract
BackgroundIn 2018, the National Institute for Health Research launched Draft Standards for Public Involvement in Research. The Northern Ireland Cerebral Palsy Register (NICPR) was competitively selected as a “test-bed” project to pilot the Draft Standards over a one-year period.AimThis perspective paper aims to describe the NICPR's experience of piloting the Draft Standards for Public Involvement in Research, highlighting successes and challenges.MethodThree of the six Draft Standards were piloted from April 2018 to April 2019: Standard 2 “working together”, Standard 4 “communications” and Standard 5, “impact”.ResultsImplementation of Standard 2 resulted in formation of a dedicated Public Involvement Group. Standard 4 was implemented by revision of the NICPR's Privacy Notice and development of the NICPR website. Standard 5 was not implemented during the test-bed pilot period.DiscussionBenefits of use of the Draft Standards in cerebral palsy register research included development of relationships, improving quality, accessibility and relevance of NICPR materials, increasing skills and confidence, networking opportunities, advocating for others and feeling empowered to shape cerebral palsy research. Challenges included administrative issues, absence of dedicated and sustained funding, limitations in the availability and applicability of public involvement training and the time required for meaningful public involvement.ConclusionsStandards for Public Involvement provide a useful framework for structuring and embedding meaningful public involvement. Sustained, authentic public involvement in cerebral palsy register research ensures that people affected by the condition are empowered to engage, inform, develop and lead research that meets their needs.
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Consumer Engagement in Perioperative Clinical Trials. Anesth Analg 2022; 135:1001-1010. [PMID: 36135337 DOI: 10.1213/ane.0000000000006209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Consumer engagement (patient and public involvement) in perioperative medicine research is in its infancy. The patient experience and family/carer perspectives can provide an extra layer of insight to give more understanding as to what, why, and how we do research. Patients who have undergone surgery have a unique understanding of the issues, concerns, wants, and needs that they learned as a patient-they, therefore, can be considered as a professional given their experience(s)-thus warranting recognition as a partner in research. Knowledge of the consumer engagement literature and availability of resources should support anesthesia researchers aiming to include these perspectives in their research. This includes several existing engagement frameworks and assessment tools. We provide a framework for consumer engagement for adoption into anesthesia and other perioperative research. By incorporating the patient or caregiver into the design, funding application(s), data collection, and interpretation of the findings can be beneficial to all. This includes promoting knowledge and access to clinical trials, the wording of participant consent and information forms, methods of data collection, selection of important outcomes, and dissemination of results.
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DeBortoli E, Soyer HP, Milne D, Dissanayaka N, Gartner C, Holt J, Rae K, Robison L, Wallingford CK, McInerney-Leo AM. Measurable outcomes of consumer engagement in health research: A scoping review. Front Public Health 2022; 10:994547. [PMID: 36324444 PMCID: PMC9621387 DOI: 10.3389/fpubh.2022.994547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Consumer engagement is increasingly recognized as an instrumental component of health research, with many institutions and international bodies mandating it as part of the research and funding process. Given an increasing utilization of consumer engagement in health research, it is critical to identify the literature which support its value and tools that capture successful outcomes. To develop an overview of the literature, we conducted an umbrella scoping review exploring important outcomes of consumer engagement in health research combined with a scoping review of relevant frameworks. Specifically, we aimed to capture outcomes which reflect authentic and meaningful consumer engagement. Methods Four databases (PubMed, Embase, CINAHL and Cochrane Library) were searched using key search terms. Records were included if they were review articles or frameworks that addressed outcomes of consumer engagement in health research. Data was analyzed using descriptive statistics and an inductive qualitative content analysis. Identified outcomes were sorted based on the three most relevant stakeholder groups (consumer, researcher, institution). Results A total of twenty articles that explored a variety of health disciplines were included. We identified fifteen measurable outcomes of consumer engagement in health research. Eight core outcomes were relevant to all stakeholder groups, and were considered fundamental to authentic consumer engagement including (1) trust, (2) empowerment, (3) respect, (4) confidence in the outcomes of the research, (5) transparency of the research process, (6) satisfaction with the consumer engagement program, (7) knowledge and experiences of consumers, and (8) degree of consumer engagement. Outcomes pertaining to specific stakeholder groups included representativeness and diversity of the consumer groups, research relevance to consumers, funding opportunities, quality/validity of the research, recruitment/retention rates, translation and dissemination of research, and interpretation of results. Conclusion This review identified key measurable outcomes that could be captured when evaluating the impacts of consumer engagement on health research and the success of consumer engagement programs. All outcomes identified were relatively underexplored within the literature, and inadequately and/or inconsistently evaluated amongst studies. Future research should consult all stakeholder groups to identify outcomes perceived to be reflective of optimal consumer engagement.
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Affiliation(s)
- Emily DeBortoli
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - H. Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - David Milne
- Human Research Ethics Committee, Translational Research Institute, Brisbane, QLD, Australia
| | - Nadeeka Dissanayaka
- Faculty of Medicine, Royal Brisbane and Women's Hospital, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Coral Gartner
- Faculty of Medicine, School of Public Health, NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland, Brisbane, QLD, Australia
| | - Jeanette Holt
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Kym Rae
- Aubigny Place, Mater Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
| | - Laura Robison
- Australasian Kidney Trials Network, Translational Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Courtney K. Wallingford
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: Courtney K. Wallingford
| | - Aideen M. McInerney-Leo
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
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Jacques-Aviñó C, Roel E, Medina-Perucha L, McGhie J, Pons-Vigués M, Pujol-Ribera E, Turiel I, Berenguera A. Are we leaving someone behind? A critical discourse analysis on the understanding of public participation among people with experiences of participatory research. PLoS One 2022; 17:e0273727. [PMID: 36054140 PMCID: PMC9439240 DOI: 10.1371/journal.pone.0273727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022] Open
Abstract
Participatory research (PR) is on the rise. In Spain, PR is scarce in the field of health, although there is an increasing interest in the matter. A comprehensive understanding of the meanings and practical implications of “public participation” is essential to promote participation in health research. The aim of the study is to explore the discursive positions on PR among individuals with experience in participatory processes in different areas and how this understanding translates into practice. We conducted a critical discourse analysis of 21 individuals with experience in PR and participatory processes (13 women, 8 men), mainly from the field of health and other areas of knowledge. Sixteen were Spanish and the rest were from the United Kingdom (3), United States (1), and Canada (1). Interviews were conducted in person or by telephone. The fieldwork was conducted between March 2019 and November 2019. The dominant discourses on public participation are situated along two axes situated on a continuum: the purpose of public participation and how power should be distributed in public participation processes. The first is instrumental public participation, which sees participatory research as a tool to improve research results and focuses on institutional interests and power-decision making is hold by researchers and institutions. The second, is transformative public participation, with a focus on social change and an equitable sharing of decision-making power between the public and researchers. All discursive positions stated that they do not carry out specific strategies to include the most socially disadvantaged individuals or groups. A shift in the scientific approach about knowledge, along with time and resources, are required to move towards a more balanced power distribution in the processes involving the public.
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Affiliation(s)
- Constanza Jacques-Aviñó
- Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, Bellaterra, Cerdanyola del Vallès, Spain
- * E-mail: ,
| | - Elena Roel
- Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, Bellaterra, Cerdanyola del Vallès, Spain
| | - Laura Medina-Perucha
- Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, Bellaterra, Cerdanyola del Vallès, Spain
| | - Jasmine McGhie
- SerMas, Servicio de Salud, Centro de Salud de Potes, Villaverde, Madrid, Spain
| | - Mariona Pons-Vigués
- Servei Català de la Salut (CatSalut), Travessera de les Corts, Edifici Olímpia, Barcelona, Spain
- Departament d’Infermeria. Facultat d’Infermeria, Universitat de Girona, Girona, Spain
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, Bellaterra, Cerdanyola del Vallès, Spain
| | - Irene Turiel
- SESPA, Servicio de Salud, Área I Atención Primaria, Asturias, Spain
| | - Anna Berenguera
- Fundació Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, Bellaterra, Cerdanyola del Vallès, Spain
- SerMas, Servicio de Salud, Centro de Salud de Potes, Villaverde, Madrid, Spain
- Departament d’Infermeria. Facultat d’Infermeria, Universitat de Girona, Girona, Spain
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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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Burns KEA, McDonald E, Debigaré S, Zamir N, Vasquez M, Piche-Ayotte M, Oczkowski S. Patient and family engagement in patient care and research in Canadian intensive care units: a national survey. Can J Anaesth 2022; 69:1527-1536. [PMID: 36344874 PMCID: PMC9640777 DOI: 10.1007/s12630-022-02342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE While patient and family engagement may improve clinical care and research, current practices for engagement in Canadian intensive care units (ICUs) are unknown. METHODS We developed and administered a cross-sectional questionnaire to ICU leaders of current engagement practices, facilitators, and barriers to engagement, and whether engagement was a priority, using to an ordinal Likert scale from 1 to 10. RESULTS The response rate was 53.4% (124/232). Respondents were from 11 provinces and territories, mainly from medical surgical ICUs (76%) and community hospitals (70%). Engagement in patient care included bedside care (84%) and bedside rounds (66%), presence during procedures/crises (65%), and survey completion (77%). Research engagement included ethics committees (36%), protocol review (31%), and knowledge translation (30%). Facilitators of engagement in patient care included family meetings (87%), open visitation policies (81%), and engagement as an institutional priority (74%). Support from departmental (43%) and hospital (33%) leadership was facilitator of research engagement. Time was the main barrier to engagement in any capacity. Engagement was a higher priority in patient care vs research (median [interquartile range], 8 [7-9] vs 3 [1-7]; P < 0.001) and in pediatric vs adult ICUs (10 [9-10] vs 8 [7-9]; P = 0.003). Research engagement was significantly higher in academic vs other ICUs (7 [5-8] vs 2 [1-4]; P < 0.001), and pediatric vs adult ICUs (7 [5-8] vs 3 [1-6]; P = 0.01). CONCLUSIONS Organizational strategies and institutional support were key facilitators of engagement. Engagement in patient care was a higher priority than engagement in research.
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Affiliation(s)
- Karen E A Burns
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada.
- Unity Health Toronto - St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, M5B 1W8, Canada.
- Department of Health Research Methods, Impact and Evaluation, McMaster University, Hamilton, ON, Canada.
| | | | | | - Nasim Zamir
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
| | - Moises Vasquez
- Juravinski Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Simon Oczkowski
- Department of Health Research Methods, Impact and Evaluation, McMaster University, Hamilton, ON, Canada
- Juravinski Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Morassaei S, Campbell M, Di Prospero L. Measuring the Impact of Patient Engagement From the Perspective of Health Professionals Leading Quality Improvement Projects. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:247-252. [PMID: 34825900 DOI: 10.1097/ceh.0000000000000405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The value of engaging patients and families in health care quality improvement (QI) initiatives is to help align health care system efforts with patient priorities. Meaningful evaluation of engaging with patients and families within QI may promote future collaboration. The aim of this study was to identify the experiential impact of patient engagement from the perspective of health professionals who were leading health care QI projects. METHODS Point-of-care health professionals who completed a fellowship capacity building program between 2014 and 2018 that provided an opportunity to learn about patient engagement concepts and to engage patients, families, and caregivers in their QI projects were invited to participate in the study. The Most Significant Change technique was used as a participatory approach to obtain qualitative evaluative data from semistructured interviews with health professional fellows. Significant change stories were curated from self-narratives grounded in the experiences of health professional fellows. RESULTS The stories demonstrated that gaining new knowledge on concepts related to patient engagement as part of a structured curriculum is effective in both supporting engagement in practice and cultivating the importance of patient engagement among health professionals. The early and ongoing involvement of patients was a key factor in shaping the project while fostering a patient-centered focus. Seeking out the patient voice throughout the QI project led to improvements in patient care experiences. DISCUSSION The findings of this study can inform programs seeking to promote patient engagement in health care QI. The positive changes that stem from aligning capacity building programs with patient-oriented priorities support the vision that patient engagement should be at the foundation of health care QI.
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Affiliation(s)
- Sara Morassaei
- Ms. Morassaei: Program Manager, Practice-Based Research and Innovation, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and PhD candidate and Teaching Fellow, School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada. Ms. Campbell: Strategic Initiatives Manager, Radiation Treatment Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and Assistant Professor, Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Ms. Di Prospero: Director, Practice-Based Research and Innovation, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and Assistant Professor, Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Greenwood K, Robertson S, Vogel E, Vella C, Ward T, McGourty A, Sacadura C, Hardy A, Rus-Calafell M, Collett N, Emsley R, Freeman D, Fowler D, Kuipers E, Bebbington P, Dunn G, Garety P. The impact of Patient and Public Involvement in the SlowMo study: Reflections on peer innovation. Health Expect 2021; 25:191-202. [PMID: 34585482 PMCID: PMC8849241 DOI: 10.1111/hex.13362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/19/2021] [Accepted: 09/11/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The SlowMo study demonstrated the effects of SlowMo, an eight-session digitally supported reasoning intervention, on paranoia in a large-scale randomized-controlled trial with 362 participants with schizophrenia-spectrum psychosis. AIM The current evaluation aimed to investigate the impact of Patient and Public Involvement (PPI) in the SlowMo study. METHOD PPI members were six women and three men from Sussex, Oxford and London with experience of using mental health services for psychosis. They received training and met at least 3-monthly throughout the project. The impact of PPI was captured quantitatively and qualitatively through (i) a PPI log of recommendations and implementation; (ii) written subjective experiences of PPI members; (iii) meeting minutes; and (iv) outputs produced. RESULTS The PPI log revealed 107 recommendations arising from PPI meetings, of which 87 (81%) were implemented. Implementation was greater for recruitment-, data collection- and organization-related actions than for dissemination and emergent innovations. Qualitative feedback revealed impacts on study recruitment, data collection, PPI participants' confidence, knowledge, career aspirations and society more widely. Outputs produced included a film about psychosis that aired on BBC primetime television, novel webpages and journal articles. Barriers to PPI impact included geography, travel, funding, co-ordination and well-being. DISCUSSION A future challenge for PPI impact will be the extent to which peer innovation (innovative PPI-led ideas) can be supported within research study delivery. PATIENT AND PUBLIC CONTRIBUTION Planned Patient and Public Contribution in SlowMo comprised consultation and collaboration in (i) design, (ii) recruitment, (iii) qualitative interviews and analysis of service users' experiences of SlowMo therapy and (iv) dissemination.
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Affiliation(s)
- Kathryn Greenwood
- School of Psychology, University of Sussex, Brighton, UK.,Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Sam Robertson
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Evelin Vogel
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Claire Vella
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Thomas Ward
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Cat Sacadura
- Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Freeman
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychiatry, Oxford University, Oxford, UK
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, UK.,Sussex Partnership NHS Foundation Trust, Worthing, UK
| | - Elizabeth Kuipers
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul Bebbington
- Division of Psychiatry, University College London, London, UK
| | - Graham Dunn
- Centre for Biostatistics, School of Health Sciences, Manchester Academic Health Science CentreManchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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McCarron TL, Clement F, Rasiah J, Moran C, Moffat K, Gonzalez A, Wasylak T, Santana M. Patients as partners in health research: A scoping review. Health Expect 2021; 24:1378-1390. [PMID: 34153165 PMCID: PMC8369093 DOI: 10.1111/hex.13272] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/10/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The role of patient involvement in health research has evolved over the past decade. Despite efforts to engage patients as partners, the role is not well understood. We undertook this review to understand the engagement practices of patients who assume roles as partners in health research. METHODS Using a recognized methodological approach, two academic databases (MEDLINE and EMBASE) and grey literature sources were searched. Findings were organized into one of the three higher levels of engagement, described by the Patient and Researcher Engagement framework developed by Manafo. We examined and quantified the supportive strategies used during involvement, used thematic analysis as described by Braun and Clarke and themed the purpose of engagement, and categorized the reported outcomes according to the CIHR Engagement Framework. RESULTS Out of 6621 records, 119 sources were included in the review. Thematic analysis of the purpose of engagement revealed five themes: documenting and advancing PPI, relevance of research, co-building, capacity building and impact on research. Improved research design was the most common reported outcome and the most common role for patient partners was as members of the research team, and the most commonly used strategy to support involvement was by meetings. CONCLUSION The evidence collected during this review advanced our understanding of the engagement of patients as research partners. As patient involvement becomes more mainstream, this knowledge will aid researchers and policy-makers in the development of approaches and tools to support engagement. PATIENT/USER INVOLVEMENT Patients led and conducted the grey literature search, including the synthesis and interpretation of the findings.
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Affiliation(s)
- Tamara L. McCarron
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Fiona Clement
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Jananee Rasiah
- Faculty of Nursing3‐141 Edmonton Clinic Health Academy (ECHA)University of AlbertaEdmontonABCanada
| | - Chelsea Moran
- The Department PsychologyUniversity of CalgaryCalgaryABCanada
| | - Karen Moffat
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
- Patient PartnerCalgaryABCanada
| | - Andrea Gonzalez
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
| | - Tracy Wasylak
- Alberta Health ServicesCalgaryABCanada
- Faculty of NursingUniversity of CalgaryCalgaryABCanada
| | - Maria Santana
- The Department Community Health SciencesCalgaryABCanada
- O’Brien Institute for Public HealthCalgaryABCanada
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Postma L, Luchtenberg ML, Verhagen AAE, Maeckelberghe ELM. The attitudes of healthy children and researchers towards the challenges of involving children in research: an exploratory study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:30. [PMID: 33990230 PMCID: PMC8120777 DOI: 10.1186/s40900-021-00263-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/22/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND A growing trend in research is to involve co-researchers. It is referred to as Patient and Public Involvement (PPI) and comprises three groups: the patients, the public, and the researchers. Like in adult public involvement, healthy children can also be considered as 'the public'. Paediatric patients and researchers experienced in conducting child-inclusive research are often asked about their attitudes towards the challenges they encounter. This is not the case for healthy children and researchers without such experience. Our aim was to investigate the attitudes of these children and researchers towards the challenges encountered during child-inclusive research. METHODS This was an exploratory study. We interviewed healthy children and adult researchers without prior experience in child-inclusive research. We recruited the children through a foundation for young researchers and the adult researchers from two hospitals, both in Groningen, the Netherlands. We audio recorded the interviews, and they were transcribed verbatim. We analysed the data using qualitative content analysis. RESULTS We interviewed five adult researchers and seven healthy children, aged 9 to 14 years. Both groups thought that it was best to involve children in paediatric research from as early a stage as possible. The children assumed that no prior training would be needed because they had already been trained at school. The researchers' attitudes varied regarding training children beforehand. Both groups thought that researchers did not need prior training on how to involve children if they worked with children on a daily basis. The children felt that recognition and a modest financial reward was appropriate. Adult researchers were cautious about rewarding the children. They feared it might render the children less intrinsically motivated. CONCLUSION Our study indicated that young and adult researchers have clear attitudes towards the challenges encountered during child-inclusive research. Young researchers could help adult researchers to find solutions to these challenges, even if they have no prior experience in child-inclusive research. Adult researchers who acknowledge the importance of child-inclusive research represent a significant step towards meaningful involvement of children. Our results imply that children could be involved in the decision-making process concerning the challenges encountered in child-inclusive research.
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Affiliation(s)
- Laura Postma
- Wenckebach Institute for Education and Training, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands.
| | - Malou L Luchtenberg
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, the Netherlands
| | - A A Eduard Verhagen
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, the Netherlands
| | - Els L M Maeckelberghe
- Wenckebach Institute for Education and Training, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
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19
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Macarthur C, Walsh CM, Buchanan F, Karoly A, Pires L, McCreath G, Jones NL. Development of the patient-oriented research curriculum in child health (PORCCH). RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:27. [PMID: 33971980 PMCID: PMC8111753 DOI: 10.1186/s40900-021-00276-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Canadian Institutes for Health Research launched a national 'Strategy for Patient-Oriented Research' (SPOR) in 2011. Patient-oriented research is defined as a continuum of research that engages patients as partners, focuses on patient-identified priorities, and improves patient outcomes. Capacity development is a core element of SPOR. Barriers to patient-oriented research include unfamiliarity with the research process for patients and families and unfamiliarity with the methods of patient and family engagement for researchers. METHODS The aim of the Patient-Oriented Research Curriculum in Child Health (PORCCH) is to build capacity in patient-oriented research in child health among patients and families, researchers, healthcare professionals, decision-makers, and trainees through a curriculum delivered via a series of interactive online modules (e-learning). A multi-disciplinary, multi-stakeholder steering committee, which included patients and families, guided the development of the curriculum and provided feedback on individual modules. The content, design, and development of each module were co-led by a parent and researcher in an equal partnership. RESULTS PORCCH consists of a series of five modules. All modules are interactive and include video vignettes and knowledge comprehension questions. Access to the modules is free and each module takes approximately 30 min to complete. The five modules are: Research 101 (an Introduction to Patient-Oriented Research, parts 1 and 2), Patient Engagement 101 (an Introduction to Patient Engagement in Child Health Research, parts 1 and 2), and Research Ethics 101. CONCLUSIONS PORCCH was developed specifically to overcome recognized barriers to the engagement of patients and families in child health research. The aim of the curriculum is to build capacity in patient-oriented research in child health. The goal is for PORCCH to be a useful resource for all stakeholders involved in patient-oriented research: patients and families, researchers, healthcare professionals, decision-makers, and trainees.
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Affiliation(s)
- Colin Macarthur
- SickKids Research Institute, Hospital for Sick Children, Toronto, Canada.
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Catharine M Walsh
- SickKids Research Institute, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada
- SickKids Learning Institute, Hospital for Sick Children, Toronto, Canada
- The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Francine Buchanan
- Family Advisor, Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Aliza Karoly
- Family Advisor, Hospital for Sick Children, Toronto, Canada
| | - Linda Pires
- Canadian Child Health Clinician Scientist Program, Toronto, Canada
| | - Graham McCreath
- SickKids Research Institute, Hospital for Sick Children, Toronto, Canada
| | - Nicola L Jones
- SickKids Research Institute, Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada
- SickKids Learning Institute, Hospital for Sick Children, Toronto, Canada
- Department of Physiology, University of Toronto, Toronto, Canada
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20
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Gutman T, Tong A, Howell M, Dansie K, Hawley CM, Craig JC, Jesudason S, Chapman JR, Johnson DW, Murphy L, Reidlinger D, Crowe S, Duncanson E, Muthuramalingam S, Scholes-Robertson N, Williamson A, McDonald S. Principles and strategies for involving patients in research in chronic kidney disease: report from national workshops. Nephrol Dial Transplant 2021; 35:1585-1594. [PMID: 31093667 DOI: 10.1093/ndt/gfz076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/15/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is widespread recognition that research will be more impactful if it arises from partnerships between patients and researchers, but evidence on best practice for achieving this remains limited. METHODS We convened workshops in three Australian cities involving 105 patients/caregivers and 43 clinicians/researchers. In facilitated breakout groups, participants discussed principles and strategies for effective patient involvement in chronic kidney disease research. Transcripts were analysed thematically. RESULTS Five major themes emerged. 'Respecting consumer expertise and commitment' involved valuing unique and diverse experiential knowledge, clarifying expectations and responsibilities, equipping for meaningful involvement and keeping patients 'in the loop'. 'Attuning to individual context' required a preference-based multipronged approach to engagement, reducing the burden of involvement and being sensitive to the patient journey. 'Harnessing existing relationships and infrastructure' meant partnering with trusted clinicians, increasing research exposure in clinical settings, mentoring patient to patient and extending reach through established networks. 'Developing a coordinated approach' enabled power in the collective and united voice, a systematic approach for equitable inclusion and streamlining access to opportunities and trustworthy information. 'Fostering a patient-centred culture' encompassed building a community, facilitating knowledge exchange and translation, empowering health ownership, providing an opportunity to give back and cultivating trust through transparency. CONCLUSIONS Partnering with patients in research requires respect and recognition of their unique, diverse and complementary experiential expertise. Establishing a supportive, respectful research culture, responding to their individual context, coordinating existing infrastructure and centralizing the flow of information may facilitate patient involvement as active partners in research.
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Affiliation(s)
- Talia Gutman
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Kathryn Dansie
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, SA, Australia
| | - Carmel M Hawley
- Australasian Kidney Trials Network, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service and Royal Adelaide Hospital, Adelaide, SA, Australia.,Kidney Health Australia, Melbourne, SA, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Jeremy R Chapman
- Westmead Clinical School, Westmead Institute for Medical Research, NSW, Australia
| | - David W Johnson
- Australasian Kidney Trials Network, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Lisa Murphy
- Kidney Health Australia, Melbourne, SA, Australia
| | - Donna Reidlinger
- Australasian Kidney Trials Network, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, SA, Australia
| | | | - Nicole Scholes-Robertson
- Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia.,BEAT-CKD Consumer Advisory Board, BEAT-CKD, SA, Australia
| | - Amber Williamson
- BEAT-CKD Consumer Advisory Board, BEAT-CKD, SA, Australia.,Queensland Consumer Consultative Committee, Kidney Health Australia, Brisbane, QLD, Australia
| | - Stephen McDonald
- Australia and New Zealand Dialysis and Transplant Registry, SA Health and Medical Research Institute, Adelaide, SA, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
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21
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Kaisler RE, Grill C. Enabling Transdisciplinary Collaboration: Stakeholder Views on Working With "Children With Mentally Ill Parents" Research Groups. Front Psychiatry 2021; 12:760716. [PMID: 34887787 PMCID: PMC8649715 DOI: 10.3389/fpsyt.2021.760716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
Working collaboratively and openly together with stakeholders has become a common phenomenon in research. While previous studies have gathered a clear picture on researchers' attitudes, motivations, and barriers for actively involving stakeholders in transdisciplinary research, the stakeholder perspective is yet unknown. Therefore, this paper sets out to identify how stakeholders perceive transdisciplinary collaborations with researchers. This paper in particular reveals the enablers and barriers for such collaborations from the viewpoint of stakeholders. To do so, we look at how stakeholders, who were actively involved in the governance structure of two "children with mentally ill parents" research groups in Austria, perceived their collaboration with researchers. We used a mixed-method, quantitative-qualitative design. We conducted an online survey and interviews with the members of the advisory board and competence group. These stakeholders reported great satisfaction with the transdisciplinary collaboration and emphasized the value of different expertise. As the most important enablers for successful, transdisciplinary collaboration stakeholders emphasized researchers' open-mindedness toward new perspectives and approaches, flexibility to adapt to the research process along the way, and creativity dealing with diverse backgrounds and skills. Stakeholders further underlined the importance of a person facilitating the collaboration process between researchers and stakeholders to resolve any tensions and insecurities. Concluding, researchers' attitudes, and in particular their understanding of the value of stakeholder involvement in research are key enablers for successful transdisciplinary research collaborations.
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Affiliation(s)
- Raphaela E Kaisler
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
| | - Christiane Grill
- LBG Open Innovation in Science Center, Ludwig Boltzmann Gesellschaft (LBG), Vienna, Austria
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22
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Russell J, Fudge N, Greenhalgh T. The impact of public involvement in health research: what are we measuring? Why are we measuring it? Should we stop measuring it? RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:63. [PMID: 33133636 PMCID: PMC7592364 DOI: 10.1186/s40900-020-00239-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/07/2020] [Indexed: 05/20/2023]
Abstract
As public involvement in the design, conduct and dissemination of health research has become an expected norm and firmly enshrined in policy, interest in measuring its impact has also grown. Despite a drive to assess the impact of public involvement, and a growing body of studies attempting to do just this, a number of questions have been largely ignored. This commentary addresses these omissions: What is the impact of all this focus on measuring impact? How is the language of impact shaping the debate about, and the practice of, public involvement in health research? And how have shifting conceptualisations of public involvement in health research shaped, and been shaped by, the way we think about and measure impact? We argue that the focus on impact risks distorting how public involvement in health research is conceptualised and practised, blinding us to possible negative impacts. We call for a critical research agenda for public involvement that [a] considers public involvement not as an instrumental intervention but a social practice of dialogue and learning between researchers and the public; [b] explores how power relations play out in the context of public involvement in health research, what empowerment means and whose interests are served by it, and [c] asks questions about possible harms as well as benefits of public involvement, and whether the language of impact is helpful or not.
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Affiliation(s)
- Jill Russell
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nina Fudge
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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23
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Noble A, Nevitt S, Holmes E, Ridsdale L, Morgan M, Tudur-Smith C, Hughes D, Goodacre S, Marson T, Snape D. Seizure first aid training for people with epilepsy attending emergency departments and their significant others: the SAFE intervention and feasibility RCT. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
No seizure first aid training intervention exists for people with epilepsy who regularly attend emergency departments and their significant others, despite such an intervention’s potential to reduce clinically unnecessary and costly visits.
Objectives
The objectives were to (1) develop Seizure first Aid training For Epilepsy (SAFE) by adapting a broader intervention and (2) determine the feasibility and optimal design of a definitive randomised controlled trial to test SAFE’s efficacy.
Design
The study involved (1) the development of an intervention informed by a co-design approach with qualitative feedback and (2) a pilot randomised controlled trial with follow-ups at 3, 6 and 12 months and assessments of treatment fidelity and the cost of SAFE’s delivery.
Setting
The setting was (1) third-sector patient support groups and professional health-care organisations and (2) three NHS emergency departments in England.
Participants
Participants were (1) people with epilepsy who had visited emergency departments in the prior 2 years, their significant others and emergency department, paramedic, general practice, commissioning, neurology and nursing representatives and (2) people with epilepsy aged ≥ 16 years who had been diagnosed for ≥ 1 year and who had made two or more emergency department visits in the prior 12 months, and one of their significant others. Emergency departments identified ostensibly eligible people with epilepsy from attendance records and patients confirmed their eligibility.
Interventions
Participants in the pilot randomised controlled trial were randomly allocated 1 : 1 to SAFE plus treatment as usual or to treatment as usual only.
Main outcome measures
Consent rate and availability of routine data on emergency department use at 12 months were the main outcome measures. Other measures of interest included eligibility rate, ease with which people with epilepsy could be identified and routine data secured, availability of self-reported emergency department data, self-reported emergency department data’s comparability with routine data, SAFE’s effect on emergency department use, and emergency department use in the treatment as usual arm, which could be used in sample size calculations.
Results
(1) Nine health-care professionals and 23 service users provided feedback that generated an intervention considered to be NHS feasible and well positioned to achieve its purpose. (2) The consent rate was 12.5%, with 53 people with epilepsy and 38 significant others recruited. The eligibility rate was 10.6%. Identifying people with epilepsy from attendance records was resource intensive for emergency department staff. Those recruited felt more stigmatised because of epilepsy than the wider epilepsy population. Routine data on emergency department use at 12 months were secured for 94.1% of people with epilepsy, but the application process took 8.5 months. Self-reported emergency department data were available for 66.7% of people with epilepsy, and people with epilepsy self-reported more emergency department visits than were captured in routine data. Most participants (76.9%) randomised to SAFE received the intervention. The intervention was delivered with high fidelity. No related serious adverse events occurred. Emergency department use at 12 months was lower in the SAFE plus treatment as usual arm than in the treatment as usual only arm, but not significantly so. Calculations indicated that a definitive trial would need ≈ 674 people with epilepsy and ≈ 39 emergency department sites.
Limitations
Contrary to patient statements on recruitment, routine data secured at the pilot trial’s end indicated that ≈ 40% may not have satisfied the inclusion criterion of two or more emergency department visits.
Conclusions
An intervention was successfully developed, a pilot randomised controlled trial conducted and outcome data secured for most participants. The consent rate did not satisfy a predetermined ‘stop/go’ level of ≥ 20%. The time that emergency department staff needed to identify eligible people with epilepsy is unlikely to be replicable. A definitive trial is currently not feasible.
Future work
Research to more easily identify and recruit people from the target population is required.
Trial registration
Current Controlled Trials ISRCTN13871327.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 39. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adam Noble
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Sarah Nevitt
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Emily Holmes
- Centre for Health Economics and Medicine Evaluation, Bangor University, Bangor, UK
| | - Leone Ridsdale
- Department of Basic and Clinical Neuroscience, King’s College London, London, UK
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King’s College London, London, UK
| | | | - Dyfrig Hughes
- Centre for Health Economics and Medicine Evaluation, Bangor University, Bangor, UK
| | - Steve Goodacre
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tony Marson
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Darlene Snape
- Department of Health Services Research, University of Liverpool, Liverpool, UK
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24
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Fitzgibbon J, Cleary K, Nelson A. The development of a scheme of Public & Patient Involvement (PPI) in the Wales Cancer Research Centre (WCRC) and reflections on the process. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:55. [PMID: 32974051 PMCID: PMC7507717 DOI: 10.1186/s40900-020-00221-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
The Wales Cancer Research Centre (WCRC) was established in 2015. It made an early and strong commitment to Public and Patient Involvement (PPI) in all its work. That commitment was made manifest through the immediate appointment of Lay and Researcher Leads and an administrator to develop and implement a scheme of PPI. At the core of the scheme was the allocation to each of the centre's four themes two Research Partners (RPs), who were to offer routine and strategic support to researchers but also to have a wider ambassadorial role, acting as champions for PPI. The RPs were appointed through a full recruitment process and supported financially, with a 'budget' of 10 half days per annum, with training where needed and supported by a mentor. Their core tasks were defined through an audit of then current practice in PPI within the themes. Monitoring of progress was undertaken at regular group PPI meetings, reports to the centre's funders against key performance indicators and against a rerun of the initial audit. A library of documents was produced to support this work, including a centre policy statement, procedures for the recruitment, training and support of RPs, a partnership agreement between RPs and researchers and a mentorship agreement. Most recently procedures have been drafted to assess the impact on research of PPI. The scheme has been regarded as largely successful by researchers, RPs and the Centre's External Advisory Board. However there remains much to do to ensure consistently high quality involvement of RPs in the centre's research. A significant stumbling block to making progress has been the lack of time given to researchers by funders to become involved in PPI. A reflection on progress against the UK Standards for PPI has identified a number of key actions for the future. They include the roll out of a scheme to assess the impact of PPI and to increase diversity in the centre's pool of RPs.
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Affiliation(s)
- Jim Fitzgibbon
- Lead Research Partner, Wales Cancer Research Centre, Cardiff, Wales UK
| | - Kate Cleary
- Administrative Officer, Wales Cancer Research Centre, Cardiff, Wales UK
| | - Annmarie Nelson
- Lead Researcher for Public and Patient Involvement, Wales Cancer Research Centre and Marie Curie Professor of Supportive and Palliative Care, Marie Curie Palliative Care Research Centre, Cardiff, Wales UK
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25
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Coulman KD, Nicholson A, Shaw A, Daykin A, Selman LE, Macefield R, Shorter GW, Cramer H, Sydes MR, Gamble C, Pick ME, Taylor G, Lane JA. Understanding and optimising patient and public involvement in trial oversight: an ethnographic study of eight clinical trials. Trials 2020; 21:543. [PMID: 32552907 PMCID: PMC7302397 DOI: 10.1186/s13063-020-04495-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/10/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Trial oversight is important for trial governance and conduct. Patients and/or lay members of the public are increasingly included in trial oversight committees, influenced by international patient and public involvement (PPI) initiatives to improve the quality and relevance of research. However, there is a lack of guidance on how to undertake PPI in trial oversight and tokenistic PPI remains an issue. This paper explores how PPI functions in existing trial oversight committees and provides recommendations to optimise PPI in future trials. This was part of a larger study investigating the role and function of oversight committees in trials facing challenges. METHODS Using an ethnographic study design, we observed oversight meetings of eight UK trials and conducted semi-structured interviews with members of their trial steering committees (TSCs) and trial management groups (TMGs) including public contributors, trial sponsors and funders. Thematic analysis of data was undertaken, with findings integrated to provide a multi-perspective account of how PPI functions in trial oversight. RESULTS Eight TSC and six TMG meetings from eight trials were observed, and 66 semi-structured interviews conducted with 52 purposively sampled oversight group members, including three public contributors. PPI was reported as beneficial in trial oversight, with public members contributing a patient voice and fulfilling a patient advocacy role. However, public contributors were not always active at oversight meetings and were sometimes felt to have a tokenistic role, with trialists reporting a lack of understanding of how to undertake PPI in trial oversight. To optimise PPI in trial oversight, the following areas were highlighted: the importance of planning effective strategies to recruit public contributors; considering the level of oversight and stage(s) of trial to include PPI; support for public contributors by the trial team between and during oversight meetings. CONCLUSIONS We present evidence-based recommendations to inform future PPI in trial oversight. Consideration should be given at trial design stage on how to recruit and involve public contributors within trial oversight, as well as support and mentorship for both public contributors and trialists (in how to undertake PPI effectively). Findings from this study further strengthen the evidence base on facilitating meaningful PPI within clinical trials.
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Affiliation(s)
- K D Coulman
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.
| | - A Nicholson
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - A Shaw
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - A Daykin
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - L E Selman
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - R Macefield
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - G W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, BT9 5BN, UK
| | - H Cramer
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, WC1J 6JL, UK
- MRC London Hub for Trial Methodology Research, London, UK
| | - C Gamble
- MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK
| | - M E Pick
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - G Taylor
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - J A Lane
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
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26
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Aubin D, Hebert M, Eurich D. The importance of measuring the impact of patient-oriented research. CMAJ 2020; 191:E860-E864. [PMID: 31387956 DOI: 10.1503/cmaj.190237] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Diane Aubin
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta.
| | - Marilynne Hebert
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Dean Eurich
- Career Development in Methods and Health Services Research (Aubin, Hebert, Eurich), Alberta SPOR SUPPORT Unit; School of Public Health (Aubin, Eurich), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Hebert), Cumming School of Medicine, University of Calgary, Calgary, Alta
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27
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Friesen P, Lignou S, Sheehan M, Singh I. Measuring the impact of participatory research in psychiatry: How the search for epistemic justifications obscures ethical considerations. Health Expect 2019; 24 Suppl 1:54-61. [PMID: 31854081 PMCID: PMC8137501 DOI: 10.1111/hex.12988] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/05/2019] [Accepted: 10/02/2019] [Indexed: 11/28/2022] Open
Abstract
Context Both within politics and practice, the field of psychiatry is undergoing a significant transformation, as increasing emphasis is placed on the importance of involving those with lived experience in research. In response to this participatory turn, a push towards measuring the impact of patient involvement is also growing, seeking to identify how participation can improve research. Objective This paper examines the recent push towards measuring impact in relation to justifications underlying the democratization of research in psychiatry, revealing a disconnect between the two, and harms that could result from a singular focus on measuring impact. Discussion While those promoting and regulating participatory research tend to focus on the epistemic benefits of such research, many have pointed to both epistemic and ethical justifications underlying participatory research. The ethical reasons for involving service users loom especially large in psychiatry, given its unique history of abuse, the ways diagnoses can be utilized as tools for oppression, and the prevalence of coercion. The current focus on measuring the impact of involvement can be harmful, in that it obscures ethical reasons in favour of epistemic ones, potentially exacerbating issues common to participatory research, such as role confusion and ineffective, tokenistic participatory efforts. Conclusions We argue that to take the ethical reasons behind involvement in mental health research seriously will involve looking beyond impact and towards sharing power. We suggest three ways this can be done: measuring more than impact, building service user capacities and sharing power in realms outside of research.
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Affiliation(s)
- Phoebe Friesen
- Department of Population Health, Ethox Centre, University of Oxford, Oxford, UK
| | - Sapfo Lignou
- NEUROSEC, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mark Sheehan
- Department of Population Health, Ethox Centre, University of Oxford, Oxford, UK
| | - Ilina Singh
- NEUROSEC, Department of Psychiatry, University of Oxford, Oxford, UK
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28
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Warner G, Baghdasaryan Z, Osman F, Lampa E, Sarkadi A. 'I felt like a human being'-An exploratory, multi-method study of refugee involvement in the development of mental health intervention research. Health Expect 2019; 24 Suppl 1:30-39. [PMID: 31705620 PMCID: PMC8137488 DOI: 10.1111/hex.12990] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022] Open
Abstract
Background Great advancements have been made in patient and public involvement (PPI), including the development of guidance on how to conduct, report and evaluate PPI. Despite these efforts, the evidence base remains relatively weak. A substantive methodological development is required. This is particularly important for vulnerable groups within society, for whom PPI can be challenging but has the potential to play a transformative role in shaping research. Objectives To describe the group dynamic characteristics and immediate impact of PPI from the user representatives’ perspective in a case study of refugee involvement in the development of mental health intervention research. To pilot and methodologically appraise the Active Involvement of Users in Research Observation Schedule and Questionnaire. Design The Active Involvement of Users in Research Observation Schedule and Questionnaire were administered together with a focus group discussion. Setting ‘Refugee Advisors’ were involved in the development of a randomized controlled trial protocol evaluating a brief group intervention for refugee children experiencing symptoms of post‐traumatic stress in Sweden. Results The multi‐method approach demonstrated good feasibility. There were clear examples of how the advisors influenced research development. The advisors described a perceived impact on the research, equality and acceptance, and knowledge gain. A sense of appreciation and empowerment was also interpreted. However, potential issues relating to the relevance of contributions and use of an interpreter were identified. Discussion and conclusion The methodological approach piloted in this study offers a promising, rigorous way to evaluate PPI. The research tools require further refinement and validation.
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Affiliation(s)
- Georgina Warner
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Zaruhi Baghdasaryan
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Fatumo Osman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Elin Lampa
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Burns KEA, Misak C, Herridge M, Meade MO, Oczkowski S. Patient and Family Engagement in the ICU. Untapped Opportunities and Underrecognized Challenges. Am J Respir Crit Care Med 2019; 198:310-319. [PMID: 29624408 DOI: 10.1164/rccm.201710-2032ci] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The call for meaningful patient and family engagement in health care and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, we review the rationale and the current state of patient and family engagement in patient care and research in the ICU. We identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. We also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, we provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
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Affiliation(s)
- Karen E A Burns
- 1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,2 Interdepartmental Division of Critical Care and.,3 Department of Clinical Epidemiology and Biostatistics and
| | - Cheryl Misak
- 4 Department of Philosophy, University of Toronto, Toronto, Ontario, Canada; and
| | - Margaret Herridge
- 1 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,2 Interdepartmental Division of Critical Care and
| | - Maureen O Meade
- 3 Department of Clinical Epidemiology and Biostatistics and.,5 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Simon Oczkowski
- 3 Department of Clinical Epidemiology and Biostatistics and.,5 Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Chambers E, Gardiner C, Thompson J, Seymour J. Patient and carer involvement in palliative care research: An integrative qualitative evidence synthesis review. Palliat Med 2019; 33:969-984. [PMID: 31250702 PMCID: PMC6691598 DOI: 10.1177/0269216319858247] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patient/carer involvement in palliative care research has been reported as complex, difficult and less advanced compared to other areas of health and social care research. There is seemingly limited evidence on impact and effectiveness. AIM To examine the evidence regarding patient/carer involvement in palliative care research and identify the facilitators, barriers, impacts and gaps in the evidence base. DESIGN Qualitative evidence synthesis using an integrative review approach and thematic analysis. DATA SOURCES Electronic databases were searched up to March 2018. Additional methods included searching websites and ongoing/unpublished studies, author searching and contacting experts. Eligibility criteria were based on the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) framework. Two quality assessments on methodology and involvement were undertaken. RESULTS A total of 93 records were included. Eight main themes were identified, mainly concerning facilitators and barriers to effective patient and carer involvement in palliative care research: definitions/roles, values/principles, organisations/culture, training/support, networking/groups, perspectives/diversity, relationships/communication and emotions/impact. Evidence on the impact of involvement was limited, but when carried out effectively, involvement brought positive benefits for all concerned, improving the relevance and quality of research. Evidence gaps were found in non-cancer populations and collaborative/user-led involvement. CONCLUSION Evidence identified suggests that involvement in palliative care research is challenging, but not dissimilar to that elsewhere. The facilitators and barriers identified relate mainly to the conduct of researchers at an individual level; in particular, there exists a reluctance among professionals to undertake involvement, and myths still perpetuate that patients/carers do not want to be involved. A developed infrastructure, more involvement-friendly organisational cultures and a strengthening of the evidence base would also be beneficial.
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Affiliation(s)
- Eleni Chambers
- The School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Clare Gardiner
- The School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Jill Thompson
- The School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Jane Seymour
- The School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Zhao G, Kennedy C, Mabaya G, Okrainec K, Kiran T. Patient engagement in the development of best practices for transitions from hospital to home: a scoping review. BMJ Open 2019; 9:e029693. [PMID: 31383707 PMCID: PMC6687029 DOI: 10.1136/bmjopen-2019-029693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To explore the extent of patient engagement in the development of best practice reports related to transitions from hospital to home. DESIGN Scoping review. DATA SOURCES Electronic databases (MEDLINE, EMBASE, CINAHL, Scopus, Trip Database, DynaMed Plus and Public Health Plus) and multiple provincial regulatory agency and healthcare organisation websites. ELIGIBILITY CRITERIA We included best practice reports related to the transition from hospital to a long-term care facility, community dwelling or rehabilitation centre. We included documents disseminated in English between 1947 and 2019. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened for eligibility and one extracted and analysed data using a data extraction tool we developed based on established patient engagement frameworks. Only records actively engaging patients were analysed (n=11). The methodological quality of actively engaging patients was assessed using domain 2 (item 5) of stakeholder involvement from the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. RESULTS The search yielded 1921 citations of which 23 met the inclusion criteria and were included for narrative synthesis. These were disseminated between 1995 and 2019, with 18 (78%) published after 2010. Most were conducted in North America (USA 43%, Canada 22%), Europe (UK 30%) and Australia (4%). Eleven (48%) actively involved patients, of which only two involved patients across all stages of development. Most involved patients through direct or indirect consultation. The mean AGREE II domain 2 item 5 score (of those that actively engaged patients) was 5.9 out of 7. CONCLUSIONS Only half of existing best practice reports related to the transition from hospital to home actively involved patients in report development. However, the extent of patient engagement has been increasing over time. More organisations should strive to engage patients throughout the best practice development process and provide patients with opportunities for shared leadership.
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Affiliation(s)
- Grace Zhao
- MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carol Kennedy
- Quality Standards, Evidence Development and Standards, Health Quality Ontario, Toronto, Ontario, Canada
| | - Gracia Mabaya
- Quality Standards, Evidence Development and Standards, Health Quality Ontario, Toronto, Ontario, Canada
| | - Karen Okrainec
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Tara Kiran
- Quality Standards, Evidence Development and Standards, Health Quality Ontario, Toronto, Ontario, Canada
- Department of Family and Community Medicine, St. Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
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Musson LS, McDermott CJ, Hobson EV. Exploring patient and public involvement in motor neuron disease research. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:511-520. [PMID: 31373235 DOI: 10.1080/21678421.2019.1643373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Patient and public involvement (PPI) is a relatively new practice whereby researchers involve patients and the public in the conduct of their research. The Sheffield Motor Neurone Disorders Research Advisory Group (SMNDRAG) is one of the first groups to specialise in motor neuron disease (MND). Its members include people living with MND, carers, relatives, volunteers, clinicians, and scientists. Our aim was to explore the experiences of those who participate in, organise and work with the SMNDRAG. Methods: We conducted 13 semi-structured interviews: 10 with members of the SMNDRAG and three with researchers who have worked with the group. We used thematic analysis to identify ways in which the group influenced research and the barriers and enablers to PPI. Results: A number of motivations for participating in the SMNDRAG were reported but the majority were altruistic. The SMNDRAG offered individuals psychosocial and intellectual benefits. The SMNDRAG has overcome a number of practical and psychological barriers to developing a successful and effective collaborative partnership resulting in a positive impact on research and researchers at each stage of the research process. For example, the group identified research priorities which ensured that research was patient-focused. However, several barriers remain, including the lack of diversity within the group and the perception that PPI participation requires a "certain type of person." Conclusions: PPI can make a valuable contribution to all aspects of research and can have a positive impact on those involved. We recommend ways in which PPI can and should be incorporated into research.
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Affiliation(s)
- Lucy S Musson
- Sheffield Institute for Translational Neuroscience, University of Sheffield , Sheffield , United Kingdom
| | - Christopher J McDermott
- Sheffield Institute for Translational Neuroscience, University of Sheffield , Sheffield , United Kingdom.,Sheffield Motor Neuron Disease Care and Research Centre, Royal Hallamshire Hospital , Sheffield , United Kingdom
| | - Esther V Hobson
- Sheffield Institute for Translational Neuroscience, University of Sheffield , Sheffield , United Kingdom.,Sheffield Motor Neuron Disease Care and Research Centre, Royal Hallamshire Hospital , Sheffield , United Kingdom
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Giebel C, Hassan S, McIntyre JC, Corcoran R, Barr B, Gabbay M, Downing J, Comerford T, Alfirevic A. Public involvement in the dissemination of the North West Coast Household Health Survey: Experiences and lessons of co-producing research together. Health Expect 2019; 22:643-649. [PMID: 31355516 PMCID: PMC6737839 DOI: 10.1111/hex.12940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 01/24/2023] Open
Abstract
Background Engaging with the public is a key element of health research; however, little work has examined experiences of public involvement in research dissemination. The aim of this paper was to assess the extent of public involvement, experiences of public advisers and resulting changes in the dissemination of the North West Coast Household Health Survey (HHS). Methods Three writing groups allowed public advisers to contribute to the dissemination of the HHS. A public workshop was set up to aid the co‐production of the research evidence and discuss the experiences of public advisers involved with the survey in March 2018. A focus group with public advisers was conducted in August 2018 to understand their experiences of involvement. Data were analysed using thematic analysis and coded by two researchers. Writing groups are still on‐going. Results Fourteen public advisers contributed via three face‐to‐face writing groups, by actively interpreting findings and helping in the write‐up of research articles and by presenting talks at the public workshop. At the workshop, seven public advisors contributed to setting priorities for data analysis from the HHS. Five public advisers took part in the focus group, which highlighted that whilst public advisers were generally satisfied with their involvement, they would like to be involved in more activities. Conclusions Members of the public shaped the dissemination of evidence and provided guidance for future steps. Public advisers were mostly positive about their involvement in the dissemination of the HHS, but highlighted the need for more transparency and support from researchers.
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Affiliation(s)
- Clarissa Giebel
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Shaima Hassan
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Jason C McIntyre
- School of Natural Sciences and Psychology, Liverpool John Moore's University, Liverpool, UK
| | - Rhiannon Corcoran
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Ben Barr
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Mark Gabbay
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Jennifer Downing
- Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Terence Comerford
- Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK
| | - Ana Alfirevic
- Collaboration for Leadership in Applied Health Research and Care North West Coast, Liverpool, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Nagpal A, Hillier S, Milton AG, Hamilton-Bruce MA, Koblar SA. PERSPECTIVES: Stroke survivors' views on the design of an early-phase cell therapy trial for patients with chronic ischaemic stroke. Health Expect 2019; 22:1069-1077. [PMID: 31332894 PMCID: PMC6803398 DOI: 10.1111/hex.12932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Stem cell research holds the potential for a paradigm shift in the management of diseases such as stroke. Patient and public involvement in research (PPIR) can bring a focus to issues of clinical relevance and accelerate translation to real-world clinical practice. OBJECTIVE A qualitative thematic analysis of the perspectives of stroke survivors regarding the conduct and design aspects of a proposed phase I clinical cell therapy study in stroke. DESIGN Twelve stroke survivors were purposively recruited in July 2016-August 2017 and participated in semi-structured, face-to-face interviews for input into the design of a proposed phase I clinical study of autologous dental pulp stem cells. Concurrent thematic analysis was conducted until data saturation was achieved. DISCUSSION AND CONCLUSIONS Participants conveyed that the most relevant outcomes to them were regaining participation, decreased dependence on caregivers and improvement in cognition, memory, mood, pain and fatigue. The perception of risk vs. benefit was likely influenced by the time elapsed since stroke, with participants being more willing to accept a higher level of risk early in the post-stroke disease course. They believed that all stroke survivors should be given an opportunity to participate in research, irrespective of their cognitive capacity. A relatively small sample population of 12 stroke survivors was studied as thematic saturation was achieved. PERSPECTIVES study applied principles of PPIR to early-phase cell research. Incorporation of outcomes relevant to patients' need within the study design is critical to generate data that will enable personalized application of regenerative medicine in stroke.
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Affiliation(s)
- Anjali Nagpal
- Stroke Research Programme, Adelaide Medical School, The University of Adelaide, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Susan Hillier
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Austin G Milton
- Stroke Research Programme, Departments of Neurology and Medicine, The Queen Elizabeth Hospital, & Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Adelaide, SA, Australia
| | - Monica A Hamilton-Bruce
- Stroke Research Programme, Adelaide Medical School, The University of Adelaide, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Stroke Research Programme, Departments of Neurology and Medicine, The Queen Elizabeth Hospital, & Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Adelaide, SA, Australia
| | - Simon A Koblar
- Stroke Research Programme, Adelaide Medical School, The University of Adelaide, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia.,Stroke Research Programme, Departments of Neurology and Medicine, The Queen Elizabeth Hospital, & Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Adelaide, SA, Australia
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Tembo D, Morrow E, Worswick L, Lennard D. Is Co-production Just a Pipe Dream for Applied Health Research Commissioning? An Exploratory Literature Review. FRONTIERS IN SOCIOLOGY 2019; 4:50. [PMID: 33869373 PMCID: PMC8022834 DOI: 10.3389/fsoc.2019.00050] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/27/2019] [Indexed: 05/20/2023]
Abstract
Background and Rationale: Internationally, the idea of "co-production' has become more popular in health research because of the promise of partnership between researchers and patients to create research that focuses on patients' needs. Patient and public involvement (PPI) at an early stage in deciding what research should be funded, can improve the quality and impact of research. However, professional power over the process places limits on the public practising their participatory rights for involvement in commissioning research that affects them and can leave members of the public feeling unheard or excluded, particularly within the context of early phase applied health research. Aim: This article explores whether and how the public can be involved in the co-production of research commissioning early on in the process, with a focus on the power relations that pervade basic and early phase translational applied health research. Methods: An exploratory literature review of international peer-reviewed and gray health research literature using structured searches of electronic databases and key search terms. Results: There is very little literature that critically evaluates how PPI is embedded into the early phases of the commissioning process. The field of basic or early translational applied research appear to be particularly challenging. Four themes which emerged from the review are: reasons for PPI in research commissioning; benefits of PPI at strategic levels of research commissioning; contributions of patients and members of the public; improving PPI in research commissioning. Conclusion: Although the public are being consulted at some stages of the research commissioning process, it is evident that the process of determining research priorities and agendas is far from being widely co-produced. Moving PPI from a consultative paternalistic model to a collaborative partnership model should be a priority for commissioners. Significant changes to communication, practices, systems, structures, or cultures that exclude patients and the public from contributing in meaningful ways, are needed to fulfill the potential of co-produced models of research commissioning.
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Affiliation(s)
- Doreen Tembo
- Wessex Institute, University of Southampton, Southampton, United Kingdom
| | - Elizabeth Morrow
- Independent Researcher, Research Support Northern Ireland, Killyleagh, Ireland
| | | | - Debby Lennard
- Public Member of National Institute for Health Research Evaluation Trials and Studies Coordinating Centre Patient and Public Involvement Reference Group, University of Southampton, Southampton, United Kingdom
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Jones JK, Evans BA, Fegan G, Ford S, Guy K, Jones S, Keen L, Khanom A, Longo M, Pallister I, Rees N, Russell IT, Seagrove AC, Watkins A, Snooks HA. Rapid Analgesia for Prehospital hip Disruption (RAPID): findings from a randomised feasibility study. Pilot Feasibility Stud 2019; 5:77. [PMID: 31210961 PMCID: PMC6560881 DOI: 10.1186/s40814-019-0454-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/06/2019] [Indexed: 11/29/2022] Open
Abstract
Background In managing hip fracture, effective pain relief before admission to hospital is difficult without risking side effects. Although emergency departments routinely use fascia iliaca compartment block (FICB), there has been little evaluation of its use by paramedics before hospital admission. We aimed to assess whether a multi-centre randomised trial to evaluate FICB was feasible. Methods Volunteer paramedics used scratchcards to allocate patients with hip fracture at random between FICB and pain relief as usual. Primary outcomes were mortality and quality of life. We also measured adverse events, costs, final diagnosis, length of stay in hospital, pain scores and quality of care and collected qualitative data about acceptability to patients in interviews, and paramedics in focus groups. We pre-specified criteria for deciding whether to progress to a fully powered trial based on the recruitment of paramedics and patients, delivery of FICB, retrieval of outcome data, safety, acceptability, and diagnostic accuracy of hip fracture. Results We effectively met all progression criteria: we recruited 19 paramedics who randomly allocated 71 patients between trial arms between 28 June 2016 and 31 July 2017; 57 (31 experimental arm, 26 usual care arm, 80% overall) retrospectively consented to follow-up. Just over half (17/31) of experimental participants received FICB; all others had contraindications, including nine taking anticoagulants. Four of the 31 participants assigned FICB and six of the 26 assigned usual care died within 6 months of hospital admission. Serious adverse events were also similar: 3/35 experimental versus 4/36 in usual care. Paramedics’ recognition of hip fracture had sensitivity of 49/64 (77%) with a positive predictive value of 46/57 (81%). We received quality of life questionnaires for 30 of 49 patients (61%) at 1 month and 12 of 17 (71%) at 6 months. Patient satisfaction was similar: experimental mean 3.4 (n = 20) versus 3.5 (n = 13) for usual care. Conclusions RAPID met all progression criteria within reasonable limits. As equipoise remains, we plan to undertake a fully powered multi-centre trial to test clinical and cost effectiveness of paramedic-administered FICB at the scene of hip fracture. Trial registration ISRCTN 60065373 sought 5 November 2015. Electronic supplementary material The online version of this article (10.1186/s40814-019-0454-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Greg Fegan
- 1Swansea University Medical School, Swansea, UK
| | - Simon Ford
- Swansea Bay University Health Board, Swansea, UK
| | - Katy Guy
- Swansea Bay University Health Board, Swansea, UK
| | - Sian Jones
- 3Patient and public representative, c/o Swansea University Medical School, Swansea, UK
| | - Leigh Keen
- 4Welsh Ambulance Services NHS Trust, Saint Asaph, UK
| | | | | | - Ian Pallister
- 1Swansea University Medical School, Swansea, UK.,Swansea Bay University Health Board, Swansea, UK
| | - Nigel Rees
- 4Welsh Ambulance Services NHS Trust, Saint Asaph, UK
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Boylan AM, Locock L, Thomson R, Staniszewska S. "About sixty per cent I want to do it": Health researchers' attitudes to, and experiences of, patient and public involvement (PPI)-A qualitative interview study. Health Expect 2019; 22:721-730. [PMID: 30927334 PMCID: PMC6737750 DOI: 10.1111/hex.12883] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 01/05/2023] Open
Abstract
Background Funders, policy‐makers and research organizations increasingly expect health researchers in the UK to involve patients and members of the public in research. It has been stated that it makes research “more effective, more credible and often more cost efficient.” However, the evidence base for this assertion is evolving and can be limited. There has been little research into how health researchers feel about involving people, how they go about it, how they manage formal policy rhetoric, and what happens in practice. Objective To explore researchers’ experiences and perceptions of patient and public involvement (PPI). Methods Semi‐structured interview study of 36 health researchers (both clinical and non‐clinical), with data collection and thematic analysis informed by the theoretical domains framework. Results In the course of our analysis, we developed four themes that encapsulate the participants’ experiences and perceptions of PPI. Participants expressed ambivalence, cynicism and enthusiasm about PPI, an activity that creates emotional labour, which is both rewarding and burdensome and requires practical and social support. It is operationalized in an academic context influenced by power and incentives. Discussion and conclusions Researchers’ experiences and attitudes towards patient and public involvement are a key factor in the successful embedding of involvement within the wider research culture. We call for a culture change that supports the development of effective organizational approach to support involvement.
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Affiliation(s)
- Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Richard Thomson
- Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
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Banner D, Bains M, Carroll S, Kandola DK, Rolfe DE, Wong C, Graham ID. Patient and Public Engagement in Integrated Knowledge Translation Research: Are we there yet? RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:8. [PMID: 30805202 PMCID: PMC6373045 DOI: 10.1186/s40900-019-0139-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 01/18/2019] [Indexed: 05/25/2023]
Abstract
PLAIN ENGLISH SUMMARY There have been many attempts to improve how healthcare services are developed and delivered. Despite this, we know that there are many gaps and differences in practice and that these can lead to poor patient outcomes. In addition, there are also concerns that research is being undertaken that does not reflects the realities or needs of those using healthcare services, and that the use of research findings in practice is slow. As such, shared approaches to research, such as integrated knowledge translation, are being used.Integrated knowledge translation (IKT) is a research approach that brings together researchers, along with other stakeholders that have knowledge about a particular healthcare issue. Stakeholders may include healthcare providers and policy-makers. More recently, there has been a growing awareness of the need to include patients and members of the public within research processes. These collaborative and patient-oriented research approaches are seen as a way to develop research that tackles ongoing gaps in practice and reflect the insights, needs and priorities of those most affected by health research outcomes. Despite great support, little is known about how these major research approaches are connected, or how they may bring about improvements in the development and use of research evidence. In this paper, we examine how IKT and patient engagement processes are linked, as well as exploring where differences exist. Through this, we highlight opportunities for greater patient engagement in IKT research and to identify areas that need to be understood further. ABSTRACT Healthcare organizations across the world are being increasingly challenged to develop and implement services that are evidence-based and bring about improvement in patient and health service outcomes. Despite an increasing emphasis upon evidence-based practice, large variations in practice remain and gaps pervade in the creation and application of knowledge that improves outcomes. More collaborative models of health research have emerged over recent years, including integrated knowledge translation (IKT), whereby partnerships with key knowledge users are developed to enhance the responsiveness and application of the findings. Likewise, the meaningful engagement of patients, in addition to the inclusion of patient-reported outcomes and priorities, has been hailed as another mechanism to improve the relevance, impact and efficiency of research.Collectively, both IKT and patient engagement processes provide a vehicle to support research that can address health disparities and improve the delivery of effective and responsive healthcare services. However, the evidence to support their impact is limited and while these approaches are inextricably connected through their engagement focus, it is unclear how IKT and patient engagement processes are linked conceptually, theoretically, and practically. In this paper, we will begin to critically examine some of the linkages and tensions that exist between IKT and patient-engagement for research and will examine potential opportunities for IKT researchers as they navigate and enact meaningful partnerships with patients and the public.
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Affiliation(s)
- Davina Banner
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, V2N4Z9 Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Sandra Carroll
- School of Nursing, Faculty of Health Sciences, McMaster University and Associate Scientist, the Population Health Research Institute, Hamilton, Canada
| | - Damanpreet K Kandola
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, V2N4Z9 Canada
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - Danielle E Rolfe
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Caroline Wong
- Centre of Excellence in Partnership with Patients and the Public, Montreal, Canada
| | - Ian D. Graham
- School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa and Centre for Practice Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada
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Crocker JC, Pratt-Boyden K, Hislop J, Rees S, Locock L, Olszowski S, Chant A, Treweek S, Cook JA, Woolfall K, Farrar N, Bostock J, Bulbulia R. Patient and public involvement (PPI) in UK surgical trials: a survey and focus groups with stakeholders to identify practices, views, and experiences. Trials 2019; 20:119. [PMID: 30744684 PMCID: PMC6371592 DOI: 10.1186/s13063-019-3183-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background and aims Historically, patient and public involvement (PPI) in the design and conduct of surgical trials has been absent or minimal, but it is now routinely recommended and even required by some research funders. We aimed to identify and describe current PPI practice in surgical trials in the United Kingdom, and to explore the views and experiences of surgical trial staff and patient or public contributors in relation to these practices. This was part of a larger study to inform development of a robust PPI intervention aimed at improving recruitment and retention in surgical trials. Methods Our study had two stages: 1) an online survey to identify current PPI practice in active UK-led, adult surgical trials; and 2) focus groups and interviews with key stakeholders (surgical trial investigators, administrators, and patient or public contributors) to explore their views and experiences of PPI. Results Of 129 eligible surgical trial teams identified, 71 (55%) took part in the survey. In addition, 54 stakeholders subsequently took part in focus groups or interviews. Sixty-five (92%) survey respondents reported some kind of PPI, most commonly at the design and dissemination stages and in oversight or advisory roles. The single most common PPI activity was developing participant information sheets (72%). Participants reported mixed practice and views on a variety of issues including the involvement of patients versus lay members of the public, recruitment methods, use of role descriptions and payment for the time of PPI contributors. They suggested some solutions, including the use of written role descriptions and databases of potential PPI contributors to aid recruitment. Conclusions UK surgical trials involve patients and members of the public in a variety of different ways, most commonly at the beginning and end of the trial lifecycle and in oversight or advisory roles. These are not without challenges and there remain uncertainties about who best to involve, why, and how. Future research should aim to address these issues. Electronic supplementary material The online version of this article (10.1186/s13063-019-3183-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joanna C Crocker
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. .,NIHR Oxford Biomedical Research Centre, Oxford, UK. .,MRC ConDuCT-II (Collaboration and innovation for Difficult and Complex randomised controlled Trials In Invasive procedures) Hub for Trials Methodology Research, Bristol Medical School, Bristol, UK.
| | - Keira Pratt-Boyden
- School of Anthropology and Conservation, University of Kent, Canterbury, UK.,Formerly Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jenny Hislop
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sian Rees
- Oxford Academic Health Science Network, Oxford, UK
| | - Louise Locock
- Formerly Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Sophie Olszowski
- Formerly NIHR Oxford Biomedical Research Centre and Unit, Oxford, UK
| | | | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jonathan A Cook
- MRC ConDuCT-II (Collaboration and innovation for Difficult and Complex randomised controlled Trials In Invasive procedures) Hub for Trials Methodology Research, Bristol Medical School, Bristol, UK.,Surgical Intervention Trials Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kerry Woolfall
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,MRC North West Hub for Trials Methodology Research, Liverpool, UK
| | - Nicola Farrar
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Formerly Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Richard Bulbulia
- MRC CTSU (Clinical Trial Service Unit) Hub for Trials Methodology Research, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,MRC Population Health Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
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Crockett LK, Shimmin C, Wittmeier KDM, Sibley KM. Engaging patients and the public in Health Research: experiences, perceptions and training needs among Manitoba health researchers. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:28. [PMID: 31608160 PMCID: PMC6781300 DOI: 10.1186/s40900-019-0162-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/04/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND The significance of patient and public engagement is increasingly recognized in health research, demonstrated by explicit requirements for patient and public engagement by funding agencies and journals. Such requirements have charged health researchers with leading patient and public engagement efforts, but evidence suggests that this practice is still evolving. Little research has explored the experiences and training needs of health researchers. This study aimed to establish a baseline understanding of the experiences, perceptions and training needs of health researchers in engaging patients and the public in health research in the context of Manitoba. METHODS A cross-sectional 50-item questionnaire was distributed using a multi-phase purposive sampling strategy targeting health researchers in Manitoba, Canada. Data was summarized using frequencies, percentages and analyzed using chi-square testing. A local patient engagement advisory group was consulted at the interpretation stage of the study to obtain feedback and input on the findings and their implications. RESULTS Responses from 53 health researchers were included. Most participants had engaged patients and the public in their own research (n = 43, 81.1%). Those who had engaged reported having some (n = 19, 44.2%), extensive (n = 14, 32.6%) or a little (n = 10, 23.3%) experience with this process. Most engaged at the levels of inform, consult or involve (81.3, 64.6 and 54.2% respectively), while fewer engaged at the collaborate (37.5%) or patient-directed levels (12.5%). Recruitment occurred using a number of approaches and engagement occurred at various phases of the research process, while main groups engaged were patients (n = 38, 82.6%) and families/caregivers (n = 25, 54.4%). Barriers to engaging patients and the public in health research included funding, time, compensation, logistics, recruitment, motivation at both the patient and researcher level, and skills of researchers to engage. Researchers reported an overwhelming need and interest for supports, funding and training to effectively engage patients and the public in health research. Consultation with the patient advisory group provided further insight on study findings and areas for future research. CONCLUSIONS Participating Manitoba health researchers engaged patients and the public in health research at multiple, but typically lower levels of involvement. Findings highlight the barriers to effective, authentic and meaningful patient and public engagement and support the need for targeted training, supports, funding and time for health researchers.
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Affiliation(s)
- Leah K. Crockett
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 374(1) – 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
- George and Fay Yee Centre for Healthcare Innovation, 379 – 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
| | - Carolyn Shimmin
- George and Fay Yee Centre for Healthcare Innovation, 379 – 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
| | - Kristy D. M. Wittmeier
- Department of Physiotherapy, Winnipeg Health Sciences Centre, RR132 - 820 Sherbrook St, Winnipeg, MB R3A 1R9 Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, 715 McDermot Avenue, Winnipeg, MB R3E 3P4 Canada
| | - Kathryn M. Sibley
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 374(1) – 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
- George and Fay Yee Centre for Healthcare Innovation, 379 – 753 McDermot Avenue, Winnipeg, MB R3E 0T6 Canada
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Jewell A, Pritchard M, Barrett K, Green P, Markham S, McKenzie S, Oliver R, Wan M, Downs J, Stewart R. The Maudsley Biomedical Research Centre (BRC) data linkage service user and carer advisory group: creating and sustaining a successful patient and public involvement group to guide research in a complex area. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:20. [PMID: 31205751 PMCID: PMC6558776 DOI: 10.1186/s40900-019-0152-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/20/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) in health and social care research has been shown to improve the quality and relevance of research. PPI in data linkage research is important in ensuring the legitimacy of future health informatics initiatives, but remains sparse and under-developed. This article describes the setting up and evaluation of a service user and carer advisory group with the aim of providing feedback and advice to researchers developing or making use of database linkages in the field of mental health. AIM The aim of this study is to describe the creation and formative evaluation of the service user and carer advisory group after a trial period of 12 months. METHOD Six individuals were recruited to the group all of whom had personal experience of mental illness. A formative evaluation was conducted after a trial period of 12 months. RESULTS Evaluation revealed that the group succeeded in promoting dialogue between service users/carers and researchers. Factors that contributed to the success of the group's first year included the opportunity it provided for researchers to involve service users and carers in their projects, the training provided to group members, and the openness of researchers to receiving feedback from the group. CONCLUSION The group encourages the incorporation of PPI in data linkage research which helps to ensure the legitimacy of data linkage practices and governance systems whilst also improving the quality and relevance of the research being conducted using linked data.
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Affiliation(s)
- Amelia Jewell
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Megan Pritchard
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Patrick Green
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sarah Markham
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Roger Oliver
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Maria Wan
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Johnny Downs
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Biggane AM, Olsen M, Williamson PR. PPI in research: a reflection from early stage researchers. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:35. [PMID: 31832239 PMCID: PMC6865031 DOI: 10.1186/s40900-019-0170-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 11/08/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND The importance of patient and public involvement (PPI) in the design and conduct of health research projects is gaining widespread recognition; however, it is still a developing area. Furthermore, PPI in methodological health research can help increase research value Thus, it is of great importance that researchers, especially early stage researchers continue to discuss and learn about the future challenges and opportunities of PPI. OBJECTIVE With this commentary, we aim to disseminate i) key messages from a recent PPI training event and ii) discuss what early stage researchers (ESRs) in the "Methods in Research on Research" (MiRoR) project can do to improve our current and future work by considering and incorporating PPI. MAIN BODY The latest MiRoR network meeting held at the University of Split in Croatia (2nd-3rd October), included a PPI training session with presentations from Mr. Stephens a patient, about "Waste in research" and Dr. Westmore a funder on "Research integrity", followed by smaller round-table discussions. This provided early stage researchers (ESRs) with an opportunity to discuss and explore the benefits and challenges of PPI in research, and the appropriate questions and research that is required for improving the implementation of PPI in clinical research. CONCLUSION As with intervention research, PPI is also important for methodological research since this will help to increase both the value, integrity and quality of research.By providing early stage researchers with appropriate educational, interactive and real-world training, this will introduce the various merits and challenges associated with PPI in early-stage research.
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Affiliation(s)
- Alice M. Biggane
- Department of Biostatistics, University of Liverpool, Liverpool, UK
- Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
| | - Maria Olsen
- Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Pons-Vigués M, Pujol-Ribera E, Berenguera A, Violán C, Mahtani-Chugani V. [Public participation in research from the perspective of primary health care researchers]. GACETA SANITARIA 2018; 33:536-546. [PMID: 30337182 DOI: 10.1016/j.gaceta.2018.05.011] [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: 02/13/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Explore the strengths, weaknesses, opportunities and threats (SWOT) for development of public involvement in research by Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol) according to primary health care researchers in Catalonia (Spain). METHODS Cross-sectional study carried out in 2017 with 36 primary health care research teams accredited by IDIAPJGol and its management staff. An open questionnaire (paper and online) was designed and piloted to develop a SWOT technique, and 65 answers were obtained (14 in paper and 51 online). A thematic content analysis was carried out. RESULTS Most informants consider public involvement in research a useful, innovative, viable and essential strategy, but it requires a change of mentality and a move away from the hierarchical paradigm. It can be difficult to execute and can complicate studies. They are concerned about which citizens should be involve, how to select them, possible conflicts of interest and training needs. The main proposals for its implementation are to disseminate previous strategies, encourage motivation and synergies among citizens, researchers and institutions, and to clarify the roles of the actors involved. IDIAPJGol should develop recommendations for the public involvement in research, encourage their inclusion, have a mentor and advise the research teams. CONCLUSIONS Despite the challenges, developing public involvement in research in primary health care is essential and feasible, what it is more should be based on a participatory strategy with all actors. The citizens can participate in any kind of design and phase of the research, adapting each project, being the primary health care a privileged area to develop the public involvement in research.
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Affiliation(s)
- Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España; Facultat d'Infermeria, Universitat de Girona, Girona, España.
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España; Facultat d'Infermeria, Universitat de Girona, Girona, España
| | - Anna Berenguera
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, España
| | - Vinita Mahtani-Chugani
- Unidad de Investigación, Hospital Nuestra Señora de la Candelaria y Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España
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Collins M, Long R, Page A, Popay J, Lobban F. Using the Public Involvement Impact Assessment Framework to assess the impact of public involvement in a mental health research context: A reflective case study. Health Expect 2018; 21:950-963. [PMID: 29696740 PMCID: PMC6250886 DOI: 10.1111/hex.12688] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 11/29/2022] Open
Abstract
Background We assess the utility of the Public Involvement Impact Assessment Framework (PiiAF) as a resource to support research teams in assessing the impact of Public Involvement across diverse research and public involvement (PI) contexts. PiiAF was developed in response to a well‐documented growth in Public Involvement in health research in the United Kingdom that demands a more sophisticated evidence base to demonstrate its impact. Design We used a reflective case study approach drawing on contemporaneous meeting notes, PiiAF website resources and retrospective reflections to describe how PiiAF helped us to develop an impact assessment plan of the PI in a university‐based mental health research centre. Discussion We consider key aspects of our experiences of using PiiAF as a tool to help us design an impact assessment of PI, interpret these experiences with reference to relevant theory and research and share insights that may be useful to other teams considering using PiiAF. Conclusion These insights include understanding the commitment of time and effort required to develop effective PI impact assessment plans; the flexibility of PiiAF and its ability to be used in a range of research and PI contexts; and the advantages of involving all stakeholders (including the public) in the development of an PI assessment plan.
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Affiliation(s)
- Michelle Collins
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Rita Long
- Spectrum Centre, Lancaster University, Lancaster, UK
| | - Anthony Page
- Spectrum Centre, Lancaster University, Lancaster, UK
| | - Jennie Popay
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Fiona Lobban
- Spectrum Centre, Lancaster University, Lancaster, UK
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Anderson de Cuevas R, Nylén L, Burström B, Whitehead M. Involving the public in epidemiological public health research: a qualitative study of public and stakeholder involvement in evaluation of a population-wide natural policy experiment. BMJ Open 2018; 8:e019805. [PMID: 29678973 PMCID: PMC5914713 DOI: 10.1136/bmjopen-2017-019805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research. OBJECTIVES To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: 'Flexicurity'. SETTING Stockholm County, Sweden. PARTICIPANTS Members of the public from different occupational groups represented by blue-collar and white-collar trade union representatives. Also, members of three stakeholder groups: the Swedish national employment agency; an employers' association and politicians sitting on a national labour market committee. Total: 17 participants. METHODS Qualitative study of process and outcomes of public and stakeholder participation in four focused workshops on the interpretation of initial findings from the flexicurity evaluation. OUTCOME MEASURES New insights from participants benefiting the interpretation of our research findings or conceptualisation of future research. RESULTS Participants sensed more drastic and nuanced change in the Swedish welfare system over recent decades than was evident from our literature reviews and policy analysis. They also elaborated hidden developments in the Swedish labour market that were increasingly leading to 'insiders' and 'outsiders', with differing experiences and consequences for financial and job security. Their explanation of the differential effects of the various collective agreements for different occupational groups was new and raised further potential research questions. Their first-hand experience provided new insights into how changes to the social protection system were contributing to the increasing trends in poverty among unemployed people with limiting long-standing illness. The politicians provided further reasoning behind some of the policy changes and their intended and unintended consequences. These insights fed into subsequent reporting of the flexicurity evaluation results, as well as the conceptualisation of new research that could be pursued in a future programme.
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Affiliation(s)
| | - Lotta Nylén
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Bo Burström
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Margaret Whitehead
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Winch R, McColgan MP, Sparrow E, Modi N, Greenough A. Public and patient involvement in child health research and service improvements: a survey of hospital doctors. BMJ Paediatr Open 2018; 2:e000206. [PMID: 29687081 PMCID: PMC5911149 DOI: 10.1136/bmjpo-2017-000206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To determine whether paediatricians are supported by their organisations to encourage patient and public involvement (PPI) in research activities and clinical improvement work, the challenges they face and how they think these could be addressed by the Royal College of Paediatrics and Child Health (RCPCH). DESIGN A survey. SETTING UK consultant paediatricians and staff associate specialist and specialty (SAS) doctors who are members of RCPCH. MAIN OUTCOME MEASURES The proportion of respondents who said that PPI was central to research and service improvements in their organisation, the type of local support for PPI activity, challenges in undertaking PPI and the support members wanted from RCPCH. RESULTS There was a response rate of 44.4% (n=1924). In their organisation, 29.1% of respondents stated PPI was central to research and 36.1% to service improvement; 46% were unaware of support for PPI and 15% said there was no support. The main challenges for PPI activity were a lack of clinician time, local support and funding. Respondents wanted RCPCH to advocate for protected time for PPI, provide access to PPI groups and deliver guidance and training. CONCLUSIONS The majority of paediatricians feel unsupported to undertake PPI activity by their local organisation. The RCPCH has a key role to enable all paediatricians to work with children, young people and their carers to improve the quality of research and clinical services as demonstrated by RCPCH's ongoing activity in these crucial and important areas.
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Affiliation(s)
- Rachel Winch
- Royal College of Paediatrics and Child Health, London, UK
| | | | - Emma Sparrow
- Royal College of Paediatrics and Child Health, London, UK
| | - Neena Modi
- Royal College of Paediatrics and Child Health, London, UK
- Section of Neonatal Medicine, Department of Medicine, Imperial College London, London, UK
| | - Anne Greenough
- Royal College of Paediatrics and Child Health, London, UK
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King’s College London, London, UK
- Department of Women and Children’s Health, School of Life Sciences, Faculty of Life Science and Medicine, Kings College London, London, UK
- NIHR Biomedical Research Centre at Guy’s, St Thomas’ NHS FoundationTrust, King’s College London, London, UK
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Price A, Schroter S, Snow R, Hicks M, Harmston R, Staniszewska S, Parker S, Richards T. Frequency of reporting on patient and public involvement (PPI) in research studies published in a general medical journal: a descriptive study. BMJ Open 2018; 8:e020452. [PMID: 29572398 PMCID: PMC5875637 DOI: 10.1136/bmjopen-2017-020452] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES While documented plans for patient and public involvement (PPI) in research are required in many grant applications, little is known about how frequently PPI occurs in practice. Low levels of reported PPI may mask actual activity due to limited PPI reporting requirements. This research analysed the frequency and types of reported PPI in the presence and absence of a journal requirement to include this information. DESIGN AND SETTING A before and after comparison of PPI reported in research papers published in The BMJ before and 1 year after the introduction of a journal policy requiring authors to report if and how they involved patients and the public within their papers. RESULTS Between 1 June 2013 and 31 May 2014, The BMJ published 189 research papers and 1 (0.5%) reported PPI activity. From 1 June 2015 to 31 May 2016, following the introduction of the policy, The BMJ published 152 research papers of which 16 (11%) reported PPI activity. Patients contributed to grant applications in addition to designing studies through to coauthorship and participation in study dissemination. Patient contributors were often not fully acknowledged; 6 of 17 (35%) papers acknowledged their contributions and 2 (12%) included them as coauthors. CONCLUSIONS Infrequent reporting of PPI activity does not appear to be purely due to a failure of documentation. Reporting of PPI activity increased after the introduction of The BMJ's policy, but activity both before and after was low and reporting was inconsistent in quality. Journals, funders and research institutions should collaborate to move us from the current situation where PPI is an optional extra to one where PPI is fully embedded in practice throughout the research process.
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Affiliation(s)
- Amy Price
- The BMJ, London, UK
- Department for Continuing Education, The University of Oxford, Oxford, UK
| | | | - Rosamund Snow
- Health Experiences Institute, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
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Bélisle-Pipon JC, Rouleau G, Birko S. Early-career researchers' views on ethical dimensions of patient engagement in research. BMC Med Ethics 2018. [PMID: 29514618 PMCID: PMC5842523 DOI: 10.1186/s12910-018-0260-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Increasing attention and efforts are being put towards engaging patients in health research, and some have even argued that patient engagement in research (PER) is an ethical imperative. Yet there is relatively little empirical data on ethical issues associated with PER. Methods A three-round Delphi survey was conducted with a panel of early-career researchers (ECRs) involved in PER. One of the objectives was to examine the ethical dimensions of PER as well as ECRs’ self-perceived level of preparedness to conduct PER ethically. The study was conducted among awardees of the Québec SPOR-SUPPORT Unit in Canada, who represent the next generation of researchers involved in PER. Many themes were addressed throughout the study, such as definition, values, patients’ roles, expected characteristics of patients, and anticipated challenges (including ethical issues). Open-ended questions were used, and all quantitative data were collected through statements using 7-point Likert scales. Results Between April and November 2016, 25 ECRs were invited to participate; 18 completed both the first and second rounds, and 16 completed the third round. Panelists consisted of nine women and seven men with various backgrounds (general practitioners and postgraduate students). The majority were between 25 and 44 years old. Panelists’ responses showed PER raises important ethical issues: 1) professionalization of patients involved in research (with risks of patients becoming less representative); 2) adequate remuneration of patients; 3) fair recognition of patients’ experiential knowledge; and 4) tokenism (engaging patients only for symbolic appeal). While the panelists felt moderately prepared to confront these ethical issues, they reported being uncomfortable applying for an ethics certificate for a PER project. Conclusion If PER is an ethical imperative, it is vital to establish clear ethical standards and to train and support the PER community to identify and resolve ethical issues. Despite their overall readiness to conduct PER, panelists did not feel adequately prepared to address many of these issues. It is not easy for ECRs to reconcile ethical desiderata and logistical imperatives. Additional research should focus on supporting the responsible conduct of PER, which, if not done, can undermine the credibility and feasibility of the entire PER enterprise.
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Affiliation(s)
- Jean-Christophe Bélisle-Pipon
- Petrie-Flom Center, Harvard Law School, 23 Everett St., Room 324, Cambridge, MA, 02138, USA. .,Health Law Institute, Dalhousie University, Halifax, NS, Canada.
| | - Geneviève Rouleau
- Faculty of Nursing, Laval University, Quebec City, QC, Canada.,University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Stanislav Birko
- Bioethics Program, University of Montreal School of Public Health, Montreal, QC, Canada.,University of Montreal Public Health Research Institute, Montreal, QC, Canada
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de Wit M, Beurskens A, Piškur B, Stoffers E, Moser A. Preparing researchers for patient and public involvement in scientific research: Development of a hands-on learning approach through action research. Health Expect 2018; 21:752-763. [PMID: 29418053 PMCID: PMC6117481 DOI: 10.1111/hex.12671] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background Acquiring the theoretical and practical knowhow of conducting patient and public involvement (PPI) in research is not part of the traditional curriculum of researchers. Zuyd University of Applied Sciences and Huis voor de Zorg, a regional umbrella patient organization, therefore started a 1.5‐year coaching programme. Objective To establish a community of practice by developing a PPI coaching programme for senior and junior health services researchers of Zuyd University. The context consisted of research projects conducted by the participants. Methods A participatory action research methodology. Data were collected from reports of thematic group meetings and individual sessions with participants, field notes and regular reflection meetings with the project team. Data were analysed by reflexive deliberation. Findings The programme comprised a kick‐off meeting (52 attendees), followed by 7 group meetings with 11 junior and 9 senior researchers. The project team constructed a serious game based on the concept of the participation ladder. Questions and concerns differed for junior and senior researchers, and separate tailored meetings were organized for both groups. Between group meetings, participants received individual assignments. Group meetings were accompanied by individual coaching sessions to provide tailor‐made feedback. The programme concluded with a combined meeting with all stakeholders. Conclusion Building a community of PPI practice through action research facilitates the development of a coaching programme that fosters social learning, empowerment and the development of a shared identity concerning PPI. The role and responsibilities of senior researchers should be distinguished from those of junior researchers.
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Affiliation(s)
- Maarten de Wit
- Stichting Tools patient empowerment, Bussum, the Netherlands
| | - Anna Beurskens
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
| | | | - Albine Moser
- Research Centre for Autonomy and Participation for People with Chronic Illnesses, Zuyd University of Applied Sciences, Heerlen, the Netherlands.,Department of Family Medicine, CAPHRI School for Public health and Primary Care, Maastricht University, Maastricht, the Netherlands
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Manafo E, Petermann L, Mason-Lai P, Vandall-Walker V. Patient engagement in Canada: a scoping review of the 'how' and 'what' of patient engagement in health research. Health Res Policy Syst 2018; 16:5. [PMID: 29415734 PMCID: PMC5804082 DOI: 10.1186/s12961-018-0282-4] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/10/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Over the last 10 years, patient engagement in health research has emerged as the next evolution in healthcare research. However, limited evidence about the clear role and scope of patient engagement in health research and a lack of evidence about its impact have influenced the uptake, implementation and ongoing evolution of patient engagement. The present study aims to conduct a scoping review to identify methods for and outcomes of patient engagement in health research. METHODS An adaptation of the scoping review methodology originally described by Arksey and O'Malley and updated by Levac, Colquhoun and O'Brien was applied. Sources from a formal database search and relevant documents from a grey literature search were compiled into data extraction tables. Articles were synthesised into key themes according to the (1) methods and (2) outcomes of patient engagement in health research. RESULTS The total yield for the scoping review was 55 records from across Canada, the United Kingdom and the United States. While evidence about the methods used to engage patients in health research is increasing, stronger evidence of specific patient and healthcare system outcomes is required. This necessitates further mobilisation of research that explores outcomes and that validates specific tools to evaluate engagement. Additionally, theoretical frameworks that can better inform and sustain patient engagement across the lifecycle of health research are lacking. CONCLUSION Further increasing the volume and reach of evidence about patient engagement in health research will support the paradigmatic shift needed to normalise the patient's role in research beyond 'subject' or 'participant', so as to ultimately improve patient health outcomes and better address healthcare reform in Canada.
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Affiliation(s)
- Elizabeth Manafo
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3 Canada
| | - Lisa Petermann
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3 Canada
| | - Ping Mason-Lai
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A Canada
| | - Virgnia Vandall-Walker
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A Canada
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