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Agbadje TT, Rahimi SA, Côté M, Tremblay AA, Diallo MP, Elidor H, Herron AP, Djade CD, Légaré F. Evaluation of a prenatal screening decision aid: A mixed methods pilot study. PATIENT EDUCATION AND COUNSELING 2022; 105:474-485. [PMID: 34088585 DOI: 10.1016/j.pec.2021.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND We developed a decision aid (DA) to help pregnant women and their partners make informed decisions about prenatal screening for trisomy. We aimed to determine its usefulness for preparing for decision-making and its acceptability among end-users. METHODS In this mixed-methods pilot study, we recruited participants in three prenatal care settings in Quebec City. Eligible women were over 18 and more than 16 weeks pregnant or had given birth recently. We asked them about the usefulness of the DA using an interview grid based on the Technology Acceptance Model. We performed descriptive statistics and deductive analysis. RESULTS Thirty-nine dyads or individuals participated in the study. Mean usefulness score was 86.2 ± 13. Most participants found the amount of information in the DA just right (79.5%), balanced (89.7%), and very useful (61.5%). They were less satisfied with the presentation and the values worksheet and suggested different values clarification methods. CONCLUSION Rigorous pilot tests of DAs with patients are an important stage in their development before the more formal assessments that precede scaling up the DA in clinical practice. PRACTICE IMPLICATIONS The next version of the DA will integrate the suggestions of end-users for better decision-making processes about prenatal screening for trisomy.
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Affiliation(s)
- Titilayo Tatiana Agbadje
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Mélissa Côté
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada
| | - Andrée-Anne Tremblay
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada
| | - Mariama Penda Diallo
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada
| | - Hélène Elidor
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada
| | - Alex Poulin Herron
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Faculty of Nursing, Université Laval, Quebec, QC, Canada
| | - Codjo Djignefa Djade
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada
| | - France Légaré
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Quebec, QC, Canada; Centre de recherche en santé durable (VITAM), Quebec, QC, Canada; Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada.
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Magasi S, Angell AM, Papadimitriou C, Ramirez RD, Ferlin A, Reis JP, Wilson T. Inside an Occupational Therapy-Disability Community Partnership to Promote Health Management: Ethnography of a Research Collaboration. Am J Occup Ther 2021; 75:7504180050. [PMID: 34780614 PMCID: PMC8369666 DOI: 10.5014/ajot.2021.045468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Disability studies-informed occupational therapy is predicated on full and equal partnerships among occupational therapy practitioners, researchers, and disability communities. Community-based participatory research (CBPR) is an approach to research that aligns with this vision yet is not without challenges. Understanding the tensions that arise from stakeholders' perspectives and priorities is critical for promoting collaboration between occupational therapy professionals and disability community partners. OBJECTIVE To understand the group dynamics and relational processes of a CPBR team in the context of an intervention development study focused on health management for people with disabilities (PWD). DESIGN This 9-mo ethnographic study included semistructured interviews and participant observation. Data were analyzed thematically. SETTING Community-based multiagency collaborative. PARTICIPANTS Nine participants (6 academic team members, 4 of whom were trained as occupational therapists; 2 disability partners; and 1 managed-care organization representative) took part. Three participants self-identified as PWD. FINDINGS CBPR processes, although productive, were fraught with challenges. Team members navigated competing priorities, varying power dynamics, and multifaceted roles and identities. Flexibility was needed to address diverse priorities, respond to unexpected challenges, and facilitate the project's success. CONCLUSIONS AND RELEVANCE Deep commitment to a shared goal of health care justice for PWD and team members' willingness to address tensions promoted successful collaboration. Intentional relationship building is needed for occupational therapy researchers to collaborate with members of disability communities as equal partners. What This Article Adds: Disability studies-informed occupational therapy research demands that team members intentionally nurture equitable relationships through shared governance, clear communication, and recognition of the fluid nature of power dynamics.
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Affiliation(s)
- Susan Magasi
- Susan Magasi, PhD, is Associate Professor, Departments of Occupational Therapy and Disability and Human Development, University of Illinois at Chicago;
| | - Amber M Angell
- Amber M. Angell, PhD, OTR/L, is Assistant Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles. At the time of the study, Angell was Postdoctoral Fellow, Department of Occupational Therapy, University of Illinois at Chicago
| | - Christina Papadimitriou
- Christina Papadimitriou, PhD, is Associate Professor, Department of Interdisciplinary Health Sciences and Department of Sociology, Oakland University, Rochester, MI
| | - Ricardo D Ramirez
- Ricardo D. Ramirez, OTD, OTR/L, is Occupational Therapist, University of Illinois Hospital and Health Systems, Chicago. At the time of the study, Ramirez was Doctoral Student and Research Specialist, Department of Occupational Therapy, University of Illinois at Chicago
| | - Alli Ferlin
- Alli Ferlin, OTD, OTR/L, is Occupational Therapist, Vibra Rehabilitation Hospital of Denver, Denver, CO. At the time of the study, Ferlin was Doctoral Student, Department of Occupational Therapy, University of Illinois at Chicago
| | - Judy Panko Reis
- Judy Panko Reis, MS, MA, is Robert Wood Johnson Community Health Leader, Chicago. At the time of the study, Reis was Health Policy Analyst, Access Living Center for Independent Living, Chicago
| | - Tom Wilson
- Tom Wilson, MS, is Community Activist, Chicago. At the time of the study, Wilson was Community Development Organizer for Health Care, Access Living Center for Independent Living, Chicago
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Ramji R, Carlson E, Brogårdh-Roth S, Olofsson AN, Kottorp A, Rämgård M. Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden. BMJ Open 2020; 10:e035732. [PMID: 32265249 PMCID: PMC7245372 DOI: 10.1136/bmjopen-2019-035732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/03/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden. SETTING The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health. PARTICIPANTS Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis. RESULTS Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines. CONCLUSIONS The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.
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Affiliation(s)
- Rathi Ramji
- Department of Care Science, Malmö Universitet, Malmö, Skane, Sweden
| | | | - Susanne Brogårdh-Roth
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö Universitet, Malmö, Skåne, Sweden
| | - Anna Nilvéus Olofsson
- Department of Odontology and Scientific Affairs, TePe Oral Hygiene Products, Malmö, Skåne, Sweden
| | - Anders Kottorp
- Department of Care Science, Malmö Universitet, Malmö, Skane, Sweden
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Choi EH, Jung HS. Models for Developing Community Organizations to Reinforce Health Management in Small Businesses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072444. [PMID: 32260225 PMCID: PMC7177578 DOI: 10.3390/ijerph17072444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/16/2020] [Accepted: 03/27/2020] [Indexed: 11/16/2022]
Abstract
The incidence of occupational diseases in small businesses is higher than in big ones, and this fact puts the former in need of a healthcare management model they can administer. This study established a model based on community organizational development theory to reinforce worker empowerment for healthcare in small businesses, focusing on health centers for workers (HCFW). The researchers surveyed 408 workers at 39 small businesses in the B region of South Korea, according to the characteristics of business sites, general characteristics of workers, and elements of community organizational development theory, and analyzed their results with a structural equation. The research period was September, 2015. Five concepts were examined: empowerment in healthcare, community capacity, participation and relevance, critical consciousness, and issue selection. The results revealed that greater community capacity led to greater participation and relevance (γ = 0.39) and empowerment in healthcare (γ = 0.25), while greater participation and relevance led to greater empowerment in healthcare (γ = 0.76). In addition, greater critical consciousness led to greater participation and relevance (γ = 0.12). Finally, greater community capacity led to greater issues selection (γ = 0.56), which in turn led to greater participation and relevance (γ = 0.25). The study makes proposals for directions of health centers for workers and community networks. Confirmation of this model for worker empowerment suggests several directions to HCFW in relation to workers and community networks.
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Affiliation(s)
- Eun-Hi Choi
- Department of Nursing, Eulji University, Daejeon 34824, Korea;
| | - Hye-Sun Jung
- Department of Preventive Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence:
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Kim H, Shon S, Shin H. Exploring the unmet needs for creating an enabling environment for nurturing care to promote migrant child health in Bishkek, Kyrgyzstan: A theory-guided community-based participatory action research. EVALUATION AND PROGRAM PLANNING 2020; 80:101802. [PMID: 32109785 DOI: 10.1016/j.evalprogplan.2020.101802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 06/10/2023]
Abstract
Empirical evidence on community-driven child health promotion programs in disadvantaged migrant populations is limited despite various promotional strategies. Therefore, we implemented a developmental process to shape child health interventions using theory-guided community-based participatory action research (CBPAR) in a migrant community in Bishkek, Kyrgyzstan between 2015 and 2019. The collaborative and iterative CBPAR process was conducted through participatory workshops and focus group discussions with support from trusting and collegial partnerships between community members and the research team. The goal and scope of the intervention was guided by enabling environments for nurturing care, including the four domains of caregivers' capabilities, empowered communities, supportive services, and enabling policies. Diverse interests and needs identified by community members were aggregated in the theoretical model and reflected in the intervention. Community-driven intervention is perceived as a culturally acceptable, sustainable, sensitive and relevant approach to solve problems. There are several challenges in conducting the CBPAR, such as the effort and time spent on building partnerships, co-learning and mutual understanding, and the power equilibrium involved. Despite this, the success of the CBPAR process provided opportunities for community mobilization, empowerment and sustainability of the intervention. Evaluation of the process and outcomes of the intervention provided community health researchers and practitioners with evidence of the theory-guided community participatory approach.
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Affiliation(s)
- Hyerang Kim
- College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Soonyoung Shon
- College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Hyunsook Shin
- College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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Kyoon-Achan G, Lavoie J, Avery Kinew K, Phillips-Beck W, Ibrahim N, Sinclair S, Katz A. Innovating for Transformation in First Nations Health Using Community-Based Participatory Research. QUALITATIVE HEALTH RESEARCH 2018; 28:1036-1049. [PMID: 29484964 DOI: 10.1177/1049732318756056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.
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Affiliation(s)
- Grace Kyoon-Achan
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Josée Lavoie
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathi Avery Kinew
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Phillips-Beck
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Naser Ibrahim
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Sinclair
- 2 Nanaandawewiwgamig-First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- 1 University of Manitoba, Winnipeg, Manitoba, Canada
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Jull J, Giles A, Graham ID. Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge. Implement Sci 2017; 12:150. [PMID: 29258551 PMCID: PMC5735911 DOI: 10.1186/s13012-017-0696-3] [Citation(s) in RCA: 228] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/05/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Better use of research evidence (one form of "knowledge") in health systems requires partnerships between researchers and those who contend with the real-world needs and constraints of health systems. Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are research approaches that emphasize the importance of creating partnerships between researchers and the people for whom the research is ultimately meant to be of use ("knowledge users"). There exist poor understandings of the ways in which these approaches converge and diverge. Better understanding of the similarities and differences between CBPR and IKT will enable researchers to use these approaches appropriately and to leverage best practices and knowledge from each. The co-creation of knowledge conveys promise of significant social impacts, and further understandings of how to engage and involve knowledge users in research are needed. MAIN TEXT We examine the histories and traditions of CBPR and IKT, as well as their points of convergence and divergence. We critically evaluate the ways in which both have the potential to contribute to the development and integration of knowledge in health systems. As distinct research traditions, the underlying drivers and rationale for CBPR and IKT have similarities and differences across the areas of motivation, social location, and ethics; nevertheless, the practices of CBPR and IKT converge upon a common aim: the co-creation of knowledge that is the result of knowledge user and researcher expertise. We argue that while CBPR and IKT both have the potential to contribute evidence to implementation science and practices for collaborative research, clarity for the purpose of the research-social change or application-is a critical feature in the selection of an appropriate collaborative approach to build knowledge. CONCLUSION CBPR and IKT bring distinct strengths to a common aim: to foster democratic processes in the co-creation of knowledge. As research approaches, they create opportunities to challenge assumptions about for whom, how, and what is defined as knowledge, and to develop and integrate research findings into health systems. When used appropriately, CBPR and IKT both have the potential to contribute to and advance implementation science about the conduct of collaborative health systems research.
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Affiliation(s)
- Janet Jull
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario Canada
| | - Audrey Giles
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Ian D. Graham
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario Canada
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Clark L, Ventres W. Qualitative Methods in Community-Based Participatory Research: Coming of Age. QUALITATIVE HEALTH RESEARCH 2016; 26:3-4. [PMID: 26679940 DOI: 10.1177/1049732315617445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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