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Erwin J, Burns L, Devalia U, Witton R, Shawe J, Wheat H, Axford N, Doughty J, Kaddour S, Nelder A, Brocklehurst P, Boswell S, Paisi M. Co-production of health and social science research with vulnerable children and young people: A rapid review. Health Expect 2024; 27:e13991. [PMID: 38403901 PMCID: PMC10895074 DOI: 10.1111/hex.13991] [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: 07/10/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND The term 'care-experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care-experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co-production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co-produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co-production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. AIM To learn how to meaningfully involve vulnerable CYP in the co-production of health and social science research. OBJECTIVES To identify: Different approaches to facilitating the engagement of vulnerable CYP in co-production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co-production of health and social science research and ways to overcome them and areas of best practice in relation to research co-production with vulnerable CYP. SEARCH STRATEGY A rapid review of peer-reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co-approaches to health and social research. MAIN RESULTS Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co-production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co-production. DISCUSSION AND CONCLUSION Co-production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co-production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well-being facilitates this approach. PATIENT AND PUBLIC CONTRIBUTION Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation.
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Affiliation(s)
- Jo Erwin
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | - Lorna Burns
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | | | - Robert Witton
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | - Jill Shawe
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | - Hannah Wheat
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | - Nick Axford
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
| | - Janine Doughty
- School of DentistryRoyal Liverpool University Dental HospitalLiverpoolUK
| | | | | | | | | | - Martha Paisi
- Peninsula Dental SchoolUniversity of PlymouthPlymouthUK
- School of Nursing and MidwiferyUniversity of PlymouthPlymouthUK
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The generative potential of mess in community-based participatory research with young people who use(d) drugs in Vancouver. Harm Reduct J 2022; 19:30. [PMID: 35337350 PMCID: PMC8956276 DOI: 10.1186/s12954-022-00615-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Community-based participatory research (CBPR) is increasingly standard practice for critical qualitative health research with young people who use(d) drugs in Vancouver, Canada. One aim of CBPR in this context is to redress the essentialization, erasure, and exploitation of people who use(d) drugs in health research. In this paper, we reflect on a partnership that began in 2018 between three university researchers and roughly ten young people (ages 17–28) who have current or past experience with drug use and homelessness in Greater Vancouver. We focus on moments when our guiding principles of shared leadership, safety, and inclusion became fraught in practice, forcing us in some cases to re-imagine these principles, and in others to accept that certain ethical dilemmas in research can never be fully resolved. We argue that this messiness can be traced to the complex and diverse positionalities of each person on our team, including young people. As such, creating space for mess was ethically necessary and empirically valuable for our CBPR project.
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Boden C, Edmonds AM, Porter T, Bath B, Dunn K, Gerrard A, Goodridge D, Stobart C. Patient partners' perspectives of meaningful engagement in synthesis reviews: A patient-oriented rapid review. Health Expect 2021; 24:1056-1071. [PMID: 34048618 PMCID: PMC8369105 DOI: 10.1111/hex.13279] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/26/2021] [Accepted: 04/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A growing literature describes promising practices for patient-oriented research (POR) generally; however, those for systematic reviews are largely derived through the lens of a researcher. This rapid review sought to understand meaningful engagement in synthesis reviews from the patient partner (PP) perspective. DESIGN The review team comprised PPs, librarians, SCPOR staff and academic faculty. We searched OVID MEDLINE and EMBASE, ProQuest Nursing and Allied Health, and core POR websites. Documents describing PP reflections on their involvement in synthesis reviews were included. Screening and data extraction were conducted by two independent reviewers. Thematic analysis was employed to identify themes in the data regarding PP perceptions of engagement in synthesis reviews. RESULTS The literature search yielded 1386 citations. Eight journal articles and one blog post were included. Seven studies focused on conducting systematic reviews on a particular health or patient-related topic to which PP involvement was an important part and two studies focused specifically on the experience of including PP in synthesis reviews. PPs engaged in the review process through a variety of mechanisms, levels and stages of the review process. Three major themes emerged from the data: (1) foster partnerships through team development, (2) provide opportunities for outcomes valued by PP and (3) strengthen the research endeavour. CONCLUSION Fostering partnerships through team development is foundational for meaningful engagement in synthesis reviews. It requires sensitively balancing of various needs (eg overburdening with contributions). Meaningful involvement in reviews has both personal and research benefits. PATIENT INVOLVEMENT Patient partners were equal collaborators in all aspects of the review.
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Affiliation(s)
- Catherine Boden
- University Library, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Tom Porter
- Patient Partner, Saskatoon, Saskatchewan, Canada
| | - Brenna Bath
- School of Rehabilitations Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kate Dunn
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, Saskatchewan, Canada
| | - Angie Gerrard
- University Library, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Goodridge
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Christine Stobart
- Saskatchewan Centre for Patient-Oriented Research, Saskatoon, Saskatchewan, Canada
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Bird M, Ouellette C, Whitmore C, Li L, Nair K, McGillion MH, Yost J, Banfield L, Campbell E, Carroll SL. Preparing for patient partnership: A scoping review of patient partner engagement and evaluation in research. Health Expect 2020; 23:523-539. [PMID: 32157777 PMCID: PMC7321722 DOI: 10.1111/hex.13040] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 12/20/2019] [Accepted: 02/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Realizing patient partnership in research requires a shift from patient participation in ancillary roles to engagement as contributing members of research teams. While engaging patient partners is often discussed, impact is rarely measured. Objective Our primary aim was to conduct a scoping review of the impact of patient partnership on research outcomes. The secondary aim was to describe barriers and facilitators to realizing effective partnerships. Search Strategy A comprehensive bibliographic search was undertaken in EBSCO CINAHL, and Embase, MEDLINE and PsycINFO via Ovid. Reference lists of included articles were hand‐searched. Inclusion Criteria Included studies were: (a) related to health care; (b) involved patients or proxies in the research process; and (c) reported results related to impact/evaluation of patient partnership on research outcomes. Data Extraction and Synthesis Data were extracted from 14 studies meeting inclusion criteria using a narrative synthesis approach. Main Results Patient partners were involved in a range of research activities. Results highlight critical barriers and facilitators for researchers seeking to undertake patient partnerships to be aware of, such as power imbalances between patient partners and researchers, as well as valuing of patient partner roles. Discussion Addressing power dynamics in patient partner‐researcher relationships and mitigating risks to patient partners through inclusive recruitment and training strategies may contribute towards effective engagement. Further guidance is needed to address evaluation strategies for patient partnerships across the continuum of patient partner involvement in research. Conclusions Research teams can employ preparation strategies outlined in this review to support patient partnerships in their work.
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Affiliation(s)
- Marissa Bird
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Carley Ouellette
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Carly Whitmore
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Lin Li
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Kalpana Nair
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Michael H McGillion
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | | | - Sandra L Carroll
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada
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Colver A, Rapley T, Parr JR, McConachie H, Dovey-Pearce G, Couteur AL, McDonagh JE, Bennett C, Hislop J, Maniatopoulos G, Mann KD, Merrick H, Pearce MS, Reape D, Vale L. Facilitating the transition of young people with long-term conditions through health services from childhood to adulthood: the Transition research programme. PROGRAMME GRANTS FOR APPLIED RESEARCH 2019. [DOI: 10.3310/pgfar07040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background
As young people with long-term conditions move from childhood to adulthood, their health may deteriorate and their social participation may reduce. ‘Transition’ is the ‘process’ that addresses the medical, psychosocial and educational needs of young people during this time. ‘Transfer’ is the ‘event’ when medical care moves from children’s to adults’ services. In a typical NHS Trust serving a population of 270,000, approximately 100 young people with long-term conditions requiring secondary care reach the age of 16 years each year. As transition extends over about 7 years, the number in transition at any time is approximately 700.
Objectives
Purpose – to promote the health and well-being of young people with long-term conditions by generating evidence to enable NHS commissioners and providers to facilitate successful health-care transition. Objectives – (1) to work with young people to determine what is important in their transitional health care, (2) to identify the effective and efficient features of transitional health care and (3) to determine how transitional health care should be commissioned and provided.
Design, settings and participants
Three work packages addressed each objective. Objective 1. (i) A young people’s advisory group met monthly throughout the programme. (ii) It explored the usefulness of patient-held health information. (iii) A ‘Q-sort’ study examined how young people approached transitional health care. Objective 2. (i) We followed, for 3 years, 374 young people with type 1 diabetes mellitus (150 from five sites in England), autism spectrum disorder (118 from four sites in England) or cerebral palsy (106 from 18 sites in England and Northern Ireland). We assessed whether or not nine proposed beneficial features (PBFs) of transitional health care predicted better outcomes. (ii) We interviewed a subset of 13 young people about their transition. (iii) We undertook a discrete choice experiment and examined the efficiency of illustrative models of transition. Objective 3. (i) We interviewed staff and observed meetings in three trusts to identify the facilitators of and barriers to introducing developmentally appropriate health care (DAH). We developed a toolkit to assist the introduction of DAH. (ii) We undertook a literature review, interviews and site visits to identify the facilitators of and barriers to commissioning transitional health care. (iii) We synthesised learning on ‘what’ and ‘how’ to commission, drawing on meetings with commissioners.
Main outcome measures
Participation in life situations, mental well-being, satisfaction with services and condition-specific outcomes.
Strengths
This was a longitudinal study with a large sample; the conditions chosen were representative; non-participation and attrition appeared unlikely to introduce bias; the research on commissioning was novel; and a young person’s group was involved.
Limitations
There is uncertainty about whether or not the regions and trusts in the longitudinal study were representative; however, we recruited from 27 trusts widely spread over England and Northern Ireland, which varied greatly in the number and variety of the PBFs they offered. The quality of delivery of each PBF was not assessed. Owing to the nature of the data, only exploratory rather than strict economic modelling was undertaken.
Results and conclusions
(1) Commissioners and providers regarded transition as the responsibility of children’s services. This is inappropriate, given that transition extends to approximately the age of 24 years. Our findings indicate an important role for commissioners of adults’ services to commission transitional health care, in addition to commissioners of children’s services with whom responsibility for transitional health care currently lies. (2) DAH is a crucial aspect of transitional health care. Our findings indicate the importance of health services being commissioned to ensure that providers deliver DAH across all health-care services, and that this will be facilitated by commitment from senior provider and commissioner leaders. (3) Good practice led by enthusiasts rarely generalised to other specialties or to adults’ services. This indicates the importance of NHS Trusts adopting a trust-wide approach to implementation of transitional health care. (4) Adults’ and children’s services were often not joined up. This indicates the importance of adults’ clinicians, children’s clinicians and general practitioners planning transition procedures together. (5) Young people adopted one of four broad interaction styles during transition: ‘laid back’, ‘anxious’, ‘wanting autonomy’ or ‘socially oriented’. Identifying a young person’s style would help personalise communication with them. (6) Three PBFs of transitional health care were significantly associated with better outcomes: ‘parental involvement, suiting parent and young person’, ‘promotion of a young person’s confidence in managing their health’ and ‘meeting the adult team before transfer’. (7) Maximal service uptake would be achieved by services encouraging appropriate parental involvement with young people to make decisions about their care. A service involving ‘appropriate parental involvement’ and ‘promotion of confidence in managing one’s health’ may offer good value for money.
Future work
How might the programme’s findings be implemented by commissioners and health-care providers? What are the most effective ways for primary health care to assist transition and support young people after transfer?
Study registration
This study is registered as UKCRN 12201, UKCRN 12980, UKCRN 12731 and UKCRN 15160.
Funding
The National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Allan Colver
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Tim Rapley
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Great North Children’s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Complex Neurodevelopmental Disorders Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gail Dovey-Pearce
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Complex Neurodevelopmental Disorders Service, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Janet E McDonagh
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Jennifer Hislop
- Health Economics Group, Newcastle University, Newcastle upon Tyne, UK
| | | | - Kay D Mann
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Hannah Merrick
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Mark S Pearce
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Debbie Reape
- Child Health Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Luke Vale
- Health Economics Group, Newcastle University, Newcastle upon Tyne, UK
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6
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Marco-Crespo B, Casapulla S, Nieto-Sanchez C, Urrego JGG, Grijalva MJ. Youth participatory research and evaluation to inform a Chagas disease prevention program in Ecuador. EVALUATION AND PROGRAM PLANNING 2018; 69:99-108. [PMID: 29753193 DOI: 10.1016/j.evalprogplan.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 03/15/2018] [Accepted: 04/29/2018] [Indexed: 06/08/2023]
Abstract
This qualitative study engaged a group of young people in participatory research and evaluation activities in order to study to what extent engaging youth in health interventions can inform research and evaluation processes. We applied a youth participatory research and evaluation approach (PRE) to inform research and evaluation on the impact of a Chagas disease control program in southern Ecuador. Our main interest was to examine the methodological contributions of PRE to knowledge sharing for health intervention planning in the context of global health and neglected tropical diseases. The results of this study suggest that by demystifying research and evaluation practices and rendering them accessible and relevant, marginalized youth can develop critical and reflexive thinking skills that could be useful for decision-making on health promotion. Our findings also reveal the potential of youth as active participants in project development in ways that enhance, validate, and improve health interventions. Young people are interested in learning about and sharing local knowledge that can benefit research and evaluation processes. Despite the numerous strengths demonstrated by PRE, the inherent complexities of international development, such as cultural differences, asymmetrical power relations, and the ongoing challenges of sustainability, remain.
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Affiliation(s)
- Belén Marco-Crespo
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, 333 Irvine Hall, Athens, OH, United States; Communications and Development Program, Center for International Studies, Ohio University, Athens, OH 45701, United States.
| | - Sharon Casapulla
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, 333 Irvine Hall, Athens, OH, United States; Department of Family Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States; Office of Rural and Underserved Programs, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States.
| | - Claudia Nieto-Sanchez
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, 333 Irvine Hall, Athens, OH, United States.
| | - J Guillermo Gómez Urrego
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, 333 Irvine Hall, Athens, OH, United States.
| | - Mario J Grijalva
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, 333 Irvine Hall, Athens, OH, United States; Center for Health Research in Latin America, School of Biological Sciences, Pontifical Catholic University of Ecuador, Quito, Ecuador.
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Greer AM, Amlani A, Pauly B, Burmeister C, Buxton JA. Participant, peer and PEEP: considerations and strategies for involving people who have used illicit substances as assistants and advisors in research. BMC Public Health 2018; 18:834. [PMID: 29976169 PMCID: PMC6034321 DOI: 10.1186/s12889-018-5765-2] [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] [Received: 03/07/2018] [Accepted: 06/26/2018] [Indexed: 01/07/2023] Open
Abstract
Background The Peer Engagement and Evaluation Project (PEEP) aimed to engage, inspire, and learn from peer leaders who represented voices of people who use or have used illicit substances, through active membership on the ‘Peeps’ research team. Given the lack of critical reflection in the literature about the process of engaging people who have used illicit substances in participatory and community-based research processes, we provide a detailed description of how one project, PEEP, engaged peers in a province-wide research project. Methods By applying the Peer Engagement Process Evaluation Framework, we critically analyze the intentions, strategies employed, and outcomes of the process utilized in the PEEP project and discuss the implications for capacity building and empowerment among the peer researchers. This process included: the formation of the PEEP team; capacity building; peer-facilitated data collection; collaborative data analysis; and, strengths-based approach to outputs. Results Several lessons were learned from applying the Peer Engagement Process Evaluation Framework to the PEEP process. These lessons fall into themes of: recruiting and hiring; fair compensation; role and project expectations; communication; connection and collaboration; mentorship; and peer-facilitated research. Conclusion This project offers a unique approach to engaging people who use illicit substances and demonstrates how participation is an important endeavor that improves the relevance, capacity, and quality of research. Lessons learned in this project can be applied to future community-based research with people who use illicit substances or other marginalized groups and/or participatory settings.
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Affiliation(s)
- Alissa M Greer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada. .,BC Centre for Disease Control, University of British Columbia, Vancouver, Canada.
| | - Ashraf Amlani
- BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
| | - Bernadette Pauly
- School of Nursing, Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Charlene Burmeister
- BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
| | - Jane A Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,BC Centre for Disease Control, University of British Columbia, Vancouver, Canada
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Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people's perceptions of the BC take home naloxone program. Harm Reduct J 2017; 14:34. [PMID: 28592287 PMCID: PMC5463299 DOI: 10.1186/s12954-017-0160-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships with staff after THN training. However, we found a dearth of literature exploring the experiences of young adults with THN programs. This study set out to address this gap and identify suggestions from the young adults for program improvement. The primary research question was “How do street-involved young people experience the THN Program in Vancouver, BC?” Methods The study was undertaken at the ICY Program. Two peer researchers with lived experience of THN were recruited from ICY and were involved in all phases of the study. The peer researchers and a graduate student facilitated two focus groups and five individual interviews with ICY program participants using a semi-structured interview guide. Audio recordings were transcribed verbatim. The cut-up-and-put-in-folders approach was used to identify emerging themes. Results The themes that emerged were perceptions of risk, altruism, strengthening relationship with staff, access to training, empowerment, and confidence in ability to respond, and suggestions for youth-friendly training. These themes were then situated within the framework of the health belief model to provide additional context. Participants viewed themselves as vulnerable to overdose and spoke of the importance of expanding access to THN training. Following training, participants reported an increase in internal locus of control, an improved sense of safety among the community of people who use drugs, improved self-esteem, and strengthened relationships with ICY staff. Overall, participants found THN training engaging, which appeared to enhance participation in other ICY programming. Conclusions Young people perceived THN training as a positive experience that improved relationships with staff. Participant recommendations for quality improvement were implemented within the provincial program. Electronic supplementary material The online version of this article (doi:10.1186/s12954-017-0160-3) contains supplementary material, which is available to authorized users.
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Damon W, Callon C, Wiebe L, Small W, Kerr T, McNeil R. Community-based participatory research in a heavily researched inner city neighbourhood: Perspectives of people who use drugs on their experiences as peer researchers. Soc Sci Med 2017; 176:85-92. [PMID: 28135693 DOI: 10.1016/j.socscimed.2017.01.027] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 12/16/2022]
Abstract
Community-based participatory research (CBPR) has become an increasingly common approach to research involving people who use(d) drugs (PWUD), who are often employed as peer researchers on these projects. This paper seeks to understand the impact of CBPR on PWUD, particularly those living in heavily researched and stigmatized neighbourhoods where CBPR projects are often located. This study draws on 14 in-depth interviews with PWUD who had previous experience as both peer researchers and research participants in CBPR projects conducted between July 2010 and February 2011. The study employed a CBPR approach in its study design, recruitment, interviewing, and analysis. Our analysis indicates that participants were supportive of CBPR in principle and described the ways in which it helped contest stigmatizing assumptions and researcher bias. Participants also reported positive personal gains from participation in CBPR projects. However, many participants had negative experiences with CBPR projects, especially when CBPR principles were implemented in a superficial or incomplete manner. Participants emphasized the importance of inclusiveness and active deconstruction of hierarchy between researchers and community members to successful CBPR among drug using populations. CBPR has been widely adopted as a research approach within marginalized communities but has often been implemented inconsistently. Still, CBPR can empower communities to contest forms of social stigma that are often reproduced through academic research on marginalized communities. Our findings describe how the benefits of CBPR are maximized when CBPR principles are consistently applied and when community-based researchers are supported in ways that reduce power hierarchies. This suggests a need for capacity building within affected communities to develop independent support, training, and grievance processes for peer researchers.
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Affiliation(s)
- Will Damon
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Cody Callon
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Lee Wiebe
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Will Small
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Thomas Kerr
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ryan McNeil
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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VanderKaay S, Moll SE, Gewurtz RE, Jindal P, Loyola-Sanchez A, Packham TL, Lim CY. Qualitative research in rehabilitation science: opportunities, challenges, and future directions. Disabil Rehabil 2016; 40:705-713. [PMID: 27973927 DOI: 10.1080/09638288.2016.1261414] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field. METHODS Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions. RESULTS Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research. CONCLUSION Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential. Implications for Rehabilitation Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner-client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting patients that are utilizing these services. Changes over time in how qualitative research is conceptualized, conducted, and utilized to advance rehabilitation science have resulted in a number of unique opportunities and challenges in using qualitative research that must be considered within this field. Advances in methodology and increased expectations for evaluation must be considered to ensure quality and credibility of qualitative rehabilitation research within rehabilitation. Improved quality and credibility may increase likelihood of research dissemination and use by clinicians intervening within the rehabilitation process in order to improve clinical practice. In order to maximize opportunities and mitigate challenges there are two principal future directions for rehabilitation scientists to consider: (1) advancing training in qualitative methods to adequately prepare future rehabilitation scientists and (2) engaging qualitative communities of research.
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Affiliation(s)
- Sandra VanderKaay
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Sandra E Moll
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Rebecca E Gewurtz
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | - Pranay Jindal
- a School of Rehabilitation Science , McMaster University , Hamilton , Ontario , Canada
| | | | - Tara L Packham
- c Hamilton Health Sciences , Hand Therapy Clinic , Hamilton , Ontario , Canada
| | - Chun Y Lim
- d Department of Child Development , KK Women's And Children's Hospital , Singapore
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Gallagher A, Curtis K, Dunn M, Baillie L. Realising dignity in care home practice: an action research project. Int J Older People Nurs 2016; 12. [DOI: 10.1111/opn.12128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 06/21/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Ann Gallagher
- Ethics and Care; International Care Ethics Observatory; School of Health Sciences; University of Surrey; Surrey UK
| | - Katherine Curtis
- Department Nursing and Clinical Sciences; Faculty of Health and Social Sciences; Bournemouth University
| | - Michael Dunn
- Health and Social Care Ethics; The Ethox Centre; Nuffield Department of Population Health University of Oxford; Oxford UK
| | - Lesley Baillie
- Florence Nightingale Foundation; Clinical Nursing Practice; School of Health and Social Care; London South Bank University; London
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Tozer K, Tzemis D, Amlani A, Coser L, Taylor D, Van Borek N, Saewyc E, Buxton JA. Reorienting risk to resilience: street-involved youth perspectives on preventing the transition to injection drug use. BMC Public Health 2015; 15:800. [PMID: 26286577 PMCID: PMC4545775 DOI: 10.1186/s12889-015-2153-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 08/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Youth Injection Prevention (YIP) project aimed to identify factors associated with the prevention of transitioning to injection drug use (IDU) among street-involved youth (youth who had spent at least 3 consecutive nights without a fixed address or without their parents/caregivers in the previous six months) aged 16-24 years in Metro Vancouver, British Columbia. METHODS Ten focus groups were conducted by youth collaborators (peer-researchers) with street-involved youth (n = 47) from November 2009-April 2010. Audio recordings and focus group observational notes were transcribed verbatim and emergent themes identified by open coding and categorizing. RESULTS Through ongoing data analysis we identified that youth produced risk and deficiency rather than resiliency-based answers. This enabled the questioning guide to be reframed into a strengths-based guide in a timely manner. Factors youth identified that prevented them from IDU initiation were grouped into three domains loosely derived from the risk environment framework: Individual (fear and self-worth), Social Environment (stigma and group norms - including street-entrenched adults who actively discouraged youth from IDU, support/inclusion, family/friend drug use and responsibilities), and Physical/Economic Environment (safe/engaging spaces). Engaging youth collaborators in the research ensured relevance and validity of the study. CONCLUSION Participants emphasized having personal goals and ties to social networks, supportive family and role models, and the need for safe and stable housing as key to resiliency. Gaining the perspectives of street-involved youth on factors that prevent IDU provides a complementary perspective to risk-based studies and encourages strength-based approaches for coaching and care of at-risk youth and upon which prevention programs should be built.
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Affiliation(s)
- Kira Tozer
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada.
| | - Despina Tzemis
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada.
| | - Ashraf Amlani
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada.
| | - Larissa Coser
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
| | - Darlene Taylor
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada. .,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T1Z3, Canada.
| | - Natasha Van Borek
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada.
| | - Elizabeth Saewyc
- University of British Columbia School of Nursing, T201-2211 Westbrook Mall, Vancouver, BC, V6T2B5, Canada.
| | - Jane A Buxton
- British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z4R4, Canada. .,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T1Z3, Canada.
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