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Gafari O, Bahrami-Hessari M, Norton J, Parmar R, Hudson M, Ndegwa L, Agyapong-Badu S, Asante KP, Alwan NA, McDonough S, Tully MA, Calder PC, Barker M, Stokes M. Building trust and increasing inclusion in public health research: co-produced strategies for engaging UK ethnic minority communities in research. Public Health 2024; 233:90-99. [PMID: 38865828 DOI: 10.1016/j.puhe.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 06/14/2024]
Abstract
Patient and public involvement and engagement (PPIE) is essential for improved research outcomes and reduced research waste. To be effective, PPIE should provide opportunities for diverse groups to contribute to all research stages. However, UK ethnic minority communities remain underrepresented in research. This article describes strategies adopted in a public health research project that were effective in building trust and increasing inclusion of ethnic minority communities. The study team of researchers and PPIE partners reflects lessons learnt during the project and describe six main strategies that built meaningful levels of trust and inclusion: 1) early start to recruitment of PPIE partners; 2) relationship-focused engagement; 3) co-production and consultation activities; 4) open communication and iterative feedback; 5) co-production of project closure activities, and; 6) diverse research team. Meaningful outcomes for the community included the involvement of people from ethnic minorities as research participants and PPIE partners, community wellbeing, co-production of public health recommendations co-presented at the UK Houses of Parliament, and consortium-wide impact evidenced by the enrolment of 51 active PPIE partners. PPIE partners reflect on their research involvement, offering advice to researchers and encouraging people from ethnic minority communities to take part in research. An important message from PPIE partners is that involvement should not be restricted to projects specific to ethnic minorities but become a routine part of general population research, recognising ethnic minorities as an integral part of UK society. In conclusion, this article demonstrates that with appropriate strategies, inclusion and diversity can be achieved in public health research. We recommend researchers, practitioners and policy makers adopt these strategies when planning their public health projects.
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Affiliation(s)
- O Gafari
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
| | - M Bahrami-Hessari
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; NIHR Southampton Clinical Research Facility, University of Southampton and University Hospitals Southampton NHS Foundation Trust, UK
| | - J Norton
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - R Parmar
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - M Hudson
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - L Ndegwa
- Patient and Public Involvement Partner, School of Health Sciences, University of Southampton, UK
| | - S Agyapong-Badu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - K P Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Ghana
| | - N A Alwan
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S McDonough
- Royal College of Surgeons Ireland, Dublin, Ireland
| | - M A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - P C Calder
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Barker
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK; School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M Stokes
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
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Nollett C, Eberl M, Fitzgibbon J, Joseph-Williams N, Hatch S. Public involvement and engagement in scientific research and higher education: the only way is ethics? RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:50. [PMID: 38822417 PMCID: PMC11140937 DOI: 10.1186/s40900-024-00587-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/24/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Involving and engaging the public in scientific research and higher education is slowly becoming the norm for academic institutions in the United Kingdom and elsewhere. Driven by a wide range of stakeholders including regulators, funders, research policymakers and charities public involvement and public engagement are increasingly seen as essential in delivering open and transparent activity that is relevant and positively impacts on our society. It is obvious that any activities involving and engaging members of the public should be conducted safely and ethically. However, it is not clear whether conducting activities ethically means they require ethical approval from a research ethics committee. MAIN BODY Although there is some guidance available from government organisations (e.g. the UK Health Research Authority) to suggest ethical approval is not required for such activities, requests from funders and publishers to have ethical approval in place is commonplace in the authors' experience. We explore this using case studies from our own institution. CONCLUSION We conclude that any public-facing activity with the purpose to systemically investigate knowledge, attitudes and experiences of members of the public as research and as human participants requires prior approval from an ethics committee. In contrast, engaging and involving members of the public and drawing on lived experience to inform aspects of research and teaching does not. However, lack of clarity around this distinction often results in the academic community seeking ethical approval 'just in case', leading to wasted time and resources and erecting unnecessary barriers for public involvement and public engagement. Instead, ethical issues and risks should be appropriately considered and mitigated by the relevant staff within their professional roles, be it academic or a professional service. Often this can involve following published guidelines and conducting an activity risk assessment, or similar. Moving forward, it is critical that academic funders and publishers acknowledge the distinction and agree on an accepted approach to avoid further exacerbating the problem.
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Affiliation(s)
- Claire Nollett
- Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park Campus, Cardiff, UK.
| | - Matthias Eberl
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
- Systems Immunity Research Institute, Cardiff University, Cardiff, UK
| | - Jim Fitzgibbon
- School of Medicine, Lead Public Contributor, Cardiff University, Cardiff, UK
| | - Natalie Joseph-Williams
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
- Health and Care Research Wales Evidence Centre, Cardiff, UK
| | - Sarah Hatch
- Public Involvement and Engagement Team, School of Medicine, Cardiff University, Cardiff, UK.
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Pomey MP, Le Roux E, Nadon N, Perron J, Barry A, Bémeur C, Poder TG, Duford F, Laviolette L, Tétrault-Lassonde J, Vialaron C, Escalona MJ, Normandin L, Huard G, Girardin C, Rose C, Malas K, Ouellet D, Vincent C. Telehealth-Delivered Program and Accompanying Patients to Enhance the Clinical Condition of Patients Throughout a Liver Transplant: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e54440. [PMID: 38517464 PMCID: PMC10998179 DOI: 10.2196/54440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Liver transplantation (LT) is indicated in patients with severe acute or chronic liver failure for which no other therapy is available. With the increasing number of LTs in recent years, liver centers worldwide must manage their patients according to their clinical situation and the expected waiting time for transplantation. The LT clinic at the Centre hospitalier de l'Université de Montréal (CHUM) is developing a new health care model across the entire continuum of pre-, peri-, and posttransplant care that features patient monitoring by an interdisciplinary team, including an accompanying patient; a digital platform to host a clinical plan; a learning program; and data collection from connected objects. OBJECTIVE This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention's cost-effectiveness. METHODS Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study. RESULTS In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited. CONCLUSIONS The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54440.
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Affiliation(s)
- Marie-Pascale Pomey
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
| | - Enora Le Roux
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France
- AP-HP.Nord-Université Paris Cité, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nathalie Nadon
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Jessie Perron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Regroupement cardio-vasculaire, hépatologie et transplantation, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Angèle Barry
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Réseau transplantation et cliniques externes de transplantation et d'hépatologie, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Chantal Bémeur
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thomas G Poder
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada
| | - Fernand Duford
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Louise Laviolette
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Johanne Tétrault-Lassonde
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Cécile Vialaron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Manuel J Escalona
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Normandin
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Geneviève Huard
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Catherine Girardin
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Christopher Rose
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Denis Ouellet
- Direction de la biovigilance et de la biologie médicale, Ministère de la Santé et des Services sociaux du Québec, Montreal, QC, Canada
| | - Catherine Vincent
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
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Tönnies J, Graue L, Ayoub-Schreifeldt M, Wensing M, Szecsenyi J, Friederich HC, Haun MW. [Integrated Care for Patients with Somatic Symptom Disorder in Primary Care - A Qualitative Participatory Evaluation of a Randomised Feasibility Trial]. Psychother Psychosom Med Psychol 2023; 73:465-472. [PMID: 37487506 DOI: 10.1055/a-2105-3402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE The VISION intervention is a manualized short-term treatment for people with somatic symptom disorder, integrated into the primary care and delivered by psychotherapists via video consultations. As an innovative technology-based approach, the intervention was most recently piloted in a randomized feasibility trial. During the qualitative accompanying study presented here, the intervention was evaluated and optimised from the user perspective of patients who participated in the feasibility study. METHODS We interviewed a total of N=10 patients included in the intervention group in three semi structured focus group discussions focusing on how they (1) assess the intervention in terms of acceptance and individual benefit and (2) which adjustments are necessary from the user perspective for further optimization of the intervention. We performed a qualitative content analysis using MAXQDA Plus 2022. RESULTS Respondents reported initial reservations on their part regarding care via video consultation. After a brief period of habituation, the intervention was universally accepted. Main suggestions for improvement included a stronger focus on supporting patients find follow-up psychotherapy (if indicated) more flexible settings (e. g., location of video consultation), and a stronger integration of treatment into primary care. DISCUSSION AND CONCLUSION The study provides systematically elaborated comprehensive findings on participants' practical experiences with the intervention. The model is appropriate for treating people with somatic symptom disorder. Before implementation, important suggestions for improvement should be thoroughly considered with continued patient and public involvement.
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Affiliation(s)
- Justus Tönnies
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
| | - Leike Graue
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
| | - Marayah Ayoub-Schreifeldt
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
| | - Michel Wensing
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Deutschland
| | - Joachim Szecsenyi
- Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Deutschland
| | - Hans-Christoph Friederich
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
| | - Markus W Haun
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg, Deutschland
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Gilfoyle M, Melro C, Koskinas E, Salsberg J. Recruitment of patients, carers and members of the public to advisory boards, groups and panels in public and patient involved health research: a scoping review. BMJ Open 2023; 13:e072918. [PMID: 37832980 PMCID: PMC10582988 DOI: 10.1136/bmjopen-2023-072918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES The objectives of this scoping review are to: (1) identify the distribution of and context of the recruitment strategies used, (2) explore the facilitators, benefits, barriers and ethical issues of the identified recruitment strategies, (3) distinguish the varying terminology for involvement (ie, panels, boards, individual) and (4) determine if the individual recruitment strategies used were to address issues of representation or bias. DESIGN A scoping review. SETTING This scoping review follows the framework by Peters et al. Seven electronic databases were explored including Scopus, Medline, PubMed, Web of Science, CINAHL, Cochrane Library and PsycINFO (conducted July 2021). The search strategy was codeveloped among the research team, PPI research experts and a faculty librarian. Two independent reviewers screened articles by title and abstract and then at full text based on predetermined criteria. PRIMARY AND SECONDARY OUTCOME MEASURES Explore recruitment strategies used, facilitators, benefits, barriers and ethical issues of the identified recruitment strategies. Identify terminology for involvement. Explore recruitment strategies used to address issues of representation or bias. RESULTS The final sample was from 51 sources. A large portion of the extracted empirical literature had a clinical focus (37%, n=13) but was not a randomised control trial. The most common recruitment strategies used were human networks (78%, n=40), such as word of mouth, foundation affiliation, existing networks, clinics or personal contacts. Within the reviewed literature, there was a lack of discussion pertaining to facilitators, benefits, barriers and ethical considerations of recruitment strategies was apparent. Finally, 41% (n=21) of studies employed or proposed recruitment strategies or considerations to address issues of representation or bias. CONCLUSION We conclude with four key recommendations that researchers can use to better understand appropriate routes to meaningfully involve patients, carers and members of the public to cocreate the evidence informing their care.
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Affiliation(s)
- Meghan Gilfoyle
- School of Medicine, University of Limerick, Limerick, Ireland
- McMaster University, Hamilton, Ontario, Canada
| | | | - Elena Koskinas
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- School of Medicine, University of Limerick, Limerick, Ireland
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Marcu A, McGregor F, Egan B, Hill K, Cook T, Arber A. Developing sustainable patient and public involvement in mesothelioma research: multi-method exploration with researchers, patients, carers, and patient organisations. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:15. [PMID: 36966347 PMCID: PMC10039679 DOI: 10.1186/s40900-023-00426-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Rare diseases where prognosis is poor provide limited scope for patient and public involvement (PPI). One such disease is mesothelioma, a cancer of the lung pleura or of the peritoneum caused by exposure to asbestos, where PPI is poorly documented. We undertook to explore how PPI could be facilitated in mesothelioma research. METHODS An online survey with mesothelioma researchers (n = 23) assessed the perceived benefits and challenges of PPI in mesothelioma. Six online workshops and thirteen in-depth interviews with patients and the public explored their views on how PPI could be increased in mesothelioma and their motivations to become PPI representatives in the future. The survey data were analysed using descriptive statistics and the interviews, using Thematic Analysis. RESULTS In the survey, 26% (n = 6) of the researchers did not include PPI in their research, while 74% (n = 17) did, finding it most beneficial at the stages of applying for funding and dissemination. The main perceived benefits of PPI were clarifying the research question and outcome measures, making research more credible and relevant to patients' needs, and increasing its impact. The main perceived challenges to PPI were the general poor prognosis in mesothelioma, and funding timescales which hindered timely recruitment of PPI representatives. The analysis of the interviews with the patients and public revealed three main themes: "Motivations to become a PPI representative in the future", "Understanding the nature of PPI during the project", and "Perceived challenges to PPI in mesothelioma". Altruism and the need for hope were the main reasons to wish to become involved in PPI in the future. For many participants, the project proved to be a journey of understanding the nature of PPI, a concept that was not easy to grasp from the start. The participants perceived certain barriers to PPI such as high symptom burden in mesothelioma, the abstract concept of PPI, and the use of scientific language. CONCLUSIONS The present research provides a detailed picture of the benefits and challenges of PPI in mesothelioma. We recommend long-term engagement with mesothelioma support groups so that researchers achieve meaningful and sustainable PPI in mesothelioma research.
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Affiliation(s)
- Afrodita Marcu
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK.
| | - Fiona McGregor
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
| | - Bernadette Egan
- School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kate Hill
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7YH, UK
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Power S, Rowley N, Duncan M, Broom D. "I Was Having My Midlife Fat Crisis": Exploring the Experiences and Preferences of Home-Based Exercise Programmes for Adults Living with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12831. [PMID: 36232130 PMCID: PMC9566702 DOI: 10.3390/ijerph191912831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
The involvement of people with lived experience in the design of exercise programmes is more likely to lead to a more needs-sensitive and population-specific intervention. There is limited evidence of the integration of people with lived experience, particularly regarding home-based exercise programmes for adults living with overweight and obesity, despite this being a population that would significantly benefit from a suitably tailored programme. Semi-structured interviews were virtually conducted to explore 20 participants' experiences of exercising at home and their preferences for the design of future home-based exercise programmes. Codes were generated through thematic analysis, highlighting considerations such as comfort within a home-based environment, a desire for social connection, and the integration of technology. Four corresponding themes were generated, encapsulating participants' choice reasoning for home-based exercise, difficulties of engaging in home-based exercise, undertaking and adhering to home-based exercise, and factors that constitute the perfect programme. Although the involvement of people with lived experience in research can be time-consuming, this process is fundamental to the design of an effective and efficacious programme. These findings will inform the design and development of a home-based exercise programme for adults living with overweight and obesity.
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Lessard D, Engler K, Ma Y, Rodriguez Cruz A, Vicente S, Kronfli N, Barkati S, Brouillette MJ, Cox J, Kildea J, Hijal T, Pomey MP, Bartlett SJ, Asselah J, Lebouché B. Remote Follow-up of Self-isolating Patients With COVID-19 Using a Patient Portal: Protocol for a Mixed Methods Pilot Study (Opal-COVID Study). JMIR Res Protoc 2022; 11:e35760. [PMID: 35820054 PMCID: PMC9390833 DOI: 10.2196/35760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background People with COVID-19 are instructed to self-isolate at home. During self-isolation, they may experience anxiety and insufficient care. Patient portals can allow patients to self-monitor and remotely share their health status with health care professionals, but little data are available on their feasibility. Objective This paper presents the protocol of the Opal-COVID Study. Its objectives are to assess the implementation of the Opal patient portal for distance monitoring of self-isolating patients with COVID-19, identify influences on the intervention’s implementation, and describe service and patient outcomes of this intervention. Methods This mixed methods pilot study aims to recruit 50 patient participants with COVID-19 tested at the McGill University Health Centre (Montreal, Canada) for 14 days of follow-up. With access to an existing patient portal through a smartphone app, patients will complete a daily self-assessment of symptoms, vital signs, and mental health monitored by a nurse, and receive teleconsultations as needed. Study questionnaires will be administered to collect data on sociodemographic characteristics, medical background, implementation outcomes (acceptability, usability, and respondent burden), and patient satisfaction. Coordinator logbook entries will inform on feasibility outcomes, namely, on recruitment, retention, and fidelity, as well as on the frequency and nature of contacts with health care professionals. The statistical analyses for objectives 1 (implementation outcomes), 3 (service outcomes), and 4 (patient outcomes) will evaluate the effects of time and sociodemographic characteristics on the outcomes. For objectives 1 (implementation outcomes) and 4 (patient outcomes), the statistical analyses will also examine the attainment of predefined success thresholds. As for the qualitative analyses, for objective 2 (influences on implementation), semistructured qualitative interviews will be conducted with 4 groups of stakeholders (ie, patient participants, health care professionals, technology developers, and study administrators) and submitted for content analysis, guided by the Consolidated Framework for Implementation Research to help identify barriers to and facilitators of implementation. For objective 3 (service outcomes), reasons for contacting health care professionals through Opal will also be submitted for content analysis. Results Between December 2020 and March 2021, a total of 51 patient participants were recruited. Qualitative interviews were conducted with 39 stakeholders from April to September 2021. Delays were experienced owing to measures taken at the McGill University Health Centre to address COVID-19. The quantitative and qualitative analyses began in May 2022. As of June 2022, a total of 2 manuscripts (on the implementation and the patient outcomes) were being prepared, and 3 conference presentations had been given on the study’s methods. Conclusions This protocol is designed to generate multidisciplinary knowledge on the implementation of a patient portal–based COVID-19 care intervention and will lead to a comprehensive understanding of feasibility, stakeholder experience, and influences on implementation that may prove useful for scaling up similar interventions. Trial Registration ClinicalTrials.gov NCT04978233; https://clinicaltrials.gov/ct2/show/NCT04978233 International Registered Report Identifier (IRRID) DERR1-10.2196/35760
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Affiliation(s)
- David Lessard
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Kim Engler
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments,
| | - Yuanchao Ma
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, QC, Canada
| | - Adriana Rodriguez Cruz
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Serge Vicente
- See Acknowledgments, .,Department of Mathematics and Statistics, Université de Montréal, Montreal, QC, Canada
| | | | - Nadine Kronfli
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - Marie-Josée Brouillette
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Psychiatry Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Joseph Cox
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Tarek Hijal
- Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Susan J Bartlett
- Department of Medicine, Divisions of Experimental Medicine, Clinical Epidemiology, Respiratory Medicine, and Rheumatology, McGill University, Montreal, QC, Canada
| | - Jamil Asselah
- Department of Medicine, Division of Medical Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Bertrand Lebouché
- Research Institute of the McGill University Health Centre, Centre for Outcomes Research & Evaluation, Montreal, QC, Canada.,See Acknowledgments, .,Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Iqbal H, West J, McEachan RRC, Haith‐Cooper M. Developing an obesity research agenda with British Pakistani women living in deprived areas with involvement from multisectoral stakeholders: Research priority setting with a seldom heard group. Health Expect 2022; 25:1619-1632. [PMID: 35484840 PMCID: PMC9327852 DOI: 10.1111/hex.13504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION British Pakistani women have exceptionally high rates of obesity and yet are seldom heard in a research priority setting concerning weight management. The objectives of this study were (i) to ascertain what multisectoral professionals perceive to be the most pressing unmet obesity needs or topic areas that need more research in relation to Pakistani women living in deprived areas of Bradford and (ii) to determine the top 10 obesity health priorities for this group to develop an obesity research agenda. METHODS A two-step process was adopted using the following: (i) a survey of a wide range of multisectoral professional stakeholders (n = 159) and (ii) a ranking exercise involving Pakistani women living in deprived areas of Bradford (n = 32) to select and prioritize their top 10 obesity health concerns and unmet needs from a list of 31 statements identified in the survey and previous research. Survey data were analysed using inductive content analysis and themes were identified. Themes were translated into statements to be ranked by Pakistani women. The ranking exercise was conducted by telephone either via voice or video call. Data were analysed using a reverse scoring system. RESULTS Survey responses were grouped into statements reflecting the following three categories: education needs; healthy behaviour barriers and mental well-being. The highest rankings were given by Pakistani women to statements on mental health and the need for education. The top 10 prioritized statements were developed with members of the public into an obesity research agenda that reflected the target population. CONCLUSION Actively engaging British Pakistani women in setting research priorities provided a unique opportunity to understand the key areas they think are important for future research. The culminating research agenda can be used by researchers to advance the field of obesity research in Pakistani communities, thus producing research outputs that are relevant to and have impact in this population. PATIENT OR PUBLIC CONTRIBUTION Participants in the ranking exercise collected data. Public contributors were involved in developing the prioritized statements into a research agenda.
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Affiliation(s)
- Halima Iqbal
- Born in BradfordBradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation TrustBradfordUK,Faculty of Health StudiesUniversity of BradfordBradfordUK
| | - Jane West
- Faculty of Health StudiesUniversity of BradfordBradfordUK
| | | | - Melanie Haith‐Cooper
- Born in BradfordBradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation TrustBradfordUK
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10
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Koskinas E, Gilfoyle M, Salsberg J. Exploring how patients, carers and members of the public are recruited to advisory boards, groups and panels as partners in public and patient involved health research: a scoping review protocol. BMJ Open 2022; 12:e059048. [PMID: 35450910 PMCID: PMC9024234 DOI: 10.1136/bmjopen-2021-059048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Engaging patients, carers and members of the public in health research has become widely recognised as an important approach for bridging the gap between research, and health and social care by increasing the relevance of research for those who benefit from its findings. Specific approaches to engagement vary, but commonly include advisory boards, groups or patient panels that are active throughout all stages of research. The breadth of and optimal strategies for recruiting patients, carers and members of the public to such boards, groups or panels remains unclear. The objective of this manuscript is to identify the breadth of and optimal strategies used to recruit patients, carers and members of the public to advisory boards, groups or panels, within public and patient involvement (PPI) research. METHODS AND ANALYSIS This review follows the scoping review framework by Peters et al, an elaboration on the framework by Arksey and O'Malley. The search strategy was co-developed among the research team, PPI research experts and a faculty librarian. The review will take place between July 2021 and June 2022. In July and August 2021, eight electronic databases, MEDLINE (PubMed), MEDLINE (OVID), Embase, CINAHL, PsychINFO, Scopus, Web of Science and Cochrane Library, will be explored to capture all available literature. Two independent reviewers will screen articles by title and abstract and then at full text based on predetermined criteria. The data will be presented in a tabular format with a narrative summary discussing how the research findings relate to the overarching research question. A thematic analysis will also be completed using qualitative description, identifying key themes and gaps in the literature. ETHICS AND DISSEMINATION Ethics is not required for this review. We aim to disseminate the information gathered through presentations at academic conferences, peer-reviewed publications and consultations with lay audiences.
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Affiliation(s)
- Elena Koskinas
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Meghan Gilfoyle
- Public and Patient Involvement Research Unit, School of Medicine and Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine and Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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11
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Murphy M, Wong G, Scott A, Wilson V, Salisbury C. The person-based development and realist evaluation of a summary report for GP consultations. NIHR OPEN RESEARCH 2022; 2:20. [PMID: 35935674 PMCID: PMC7613240 DOI: 10.3310/nihropenres.13258.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Use of telephone, video and e-consultations is increasing. These can make consultations more transactional. This study aimed to develop a complex intervention to address patients’ concerns more comprehensively in general practice and test the feasibility of this in a cluster-randomised framework. The complex intervention used two technologies: a patient-completed pre-consultation form used at consultation opening and a doctor-provided summary report provided at consultation closure. This paper reports on the development and realist evaluation of the summary report. Methods A person-based approach was used to develop the summary report. An electronic protocol was designed to automatically generate the report after GPs complete a clinical template in the patient record. This was tested with 45 patients in 3 rounds each, with iterative adjustments made based on feedback after each round. Subsequently, an intervention incorporating the pre-consultation form with the summary report was then tested in a cluster-randomised framework with 30 patients per practice in six practices: four randomised to intervention, and two to control. An embedded realist evaluation was carried out. The main feasibility study results are reported elsewhere. Results Conclusions The person-based approach was successful. The summary report creates clarity, empowerment and reassurance in certain consultations and patients. As it takes a few minutes per patient, GPs prefer to select patients who will benefit most.
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12
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Transferable learning about patient and public involvement and engagement in gambling support services from health and social care: findings from a narrative review and workshop with people with lived experience. JOURNAL OF INTEGRATED CARE 2022. [DOI: 10.1108/jica-06-2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe involvement of patients or members of the public within public health, health and social care and addictions services is growing in the UK and internationally but is less common in gambling support services. The purpose of this study was to explore Patient and Public Involvement (PPI) infrastructures and engagement channels used in health and care services and debate their transferability to the gambling support sector (including research, education and treatment).Design/methodology/approachA narrative review examined data from six English language electronic databases, NHS evidence and grey literature covering the period 2007–2019. We identified 130 relevant items from UK literature. A workshop was held in London, England, with people with lived experience of gambling harm to seek their views on and applicability of the review findings to gambling services.FindingsSynthesis of literature and workshop data was undertaken. Main themes addressed “What works” in relation to: building infrastructures and organising involvement of people with lived experience; what people want to be involved in; widening participation and sustaining involvement and respecting people with lived experience.Practical implicationsExamination of the literature about involvement and engagement of patients, service users and the public in public health, health and social care and addiction services provides potentially useful examples of good practice which may be adopted by gambling services.Originality/valueThe involvement of people with lived experience of gambling harms in gambling support services is under-explored, with little published evidence of what constitutes good practice amongst self-organising groups/networks/grassroots organisations or rights-based/empowerment-based approaches.
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13
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Goodwin L, Skrybant M, Kenyon S. Involving and engaging pregnant women in maternity-related research: reflections on an innovative approach. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:90. [PMID: 34915935 PMCID: PMC8679964 DOI: 10.1186/s40900-021-00332-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/07/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Meaningful public involvement in maternity research remains challenging, partly due to the transient nature of pregnancy. This paper reflects on the development, implementation and simple evaluation of an innovative and inclusive approach to engaging and involving pregnant and early postnatal women in research. METHODS Between January and February 2018, a Research Fellow in Maternity Care, a Professor of Evidence Based Maternity Care, and a Patient and Public Involvement Lead convened for a number of meetings to discuss how public involvement and engagement might be improved for pregnancy-related research. A stakeholder group was created, including a local community matron, a community engagement officer at a local children's centre, public contributors, and senior members of the Maternal and Child Health theme of the West Midlands Collaboration for Leadership in Applied Health Research and Care (CLAHRC WM). The team worked together to develop a format for Yoga for Bump sessions: a free 90-min session, offered weekly, which included research involvement/engagement, pregnancy yoga, and a 'question and answer' session with a midwife. RESULTS A total of 67 women from two local communities in Birmingham attended Yoga for Bump sessions, which ran between May and December of 2018. Evaluation of the sessions suggested benefits to both women and researchers: it created mutually beneficial relationships between contributors and researchers, provided opportunities for women to engage and get involved in research that was directly relevant to them, and provided a convenient and efficient way for researchers to involve and engage pregnant women from diverse backgrounds in their research. Unintended benefits included self-reported improvements in women's health and wellbeing. CONCLUSIONS Yoga for Bump demonstrates an innovative approach to engaging and involving pregnant and early postnatal women; combining a free exercise class with healthcare advice and opportunities to engage with and be involved in research, and demonstrating mutual benefits for those involved. This model has the potential to be replicated elsewhere to support inclusive public involvement in pregnancy-related research. Further work is needed to design and evaluate similar approaches to involvement/engagement and explore potential funding avenues to enhance sustainability.
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Affiliation(s)
- Laura Goodwin
- School of Health and Social Wellbeing, University of the West of England, Glenside Campus, Bristol, BS16 1DD, UK.
| | - Magdalena Skrybant
- Institute of Applied Health Research, Murray Learning Centre, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sara Kenyon
- Institute of Applied Health Research, Murray Learning Centre, University of Birmingham, Birmingham, B15 2TT, UK
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14
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Tully L, Spyreli E, Allen-Walker V, Matvienko-Sikar K, McHugh S, Woodside J, McKinley MC, Kearney PM, Dean M, Hayes C, Heary C, Kelly C. Recruiting 'hard to reach' parents for health promotion research: experiences from a qualitative study. BMC Res Notes 2021; 14:276. [PMID: 34289873 PMCID: PMC8293495 DOI: 10.1186/s13104-021-05653-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022] Open
Abstract
Objective Marginalised populations are less likely to take part in health research, and are sometimes considered ‘easy to ignore’. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents. Results We approached 74 organisations of which 17 helped with recruitment. We recruited 86 parents/carers (one male) for 19 focus groups (15 urban/4 rural). Seventy two percent met at the eligibility criteria. Most participants were recruited through organisations (91%), and the remainder on social media (9%). Recruitment barriers included multiple steps, research fatigue, or uncertainty around expectations. Factors such as building rapport, simplifying the recruitment process and being flexible with procedures were facilitators. Despite comprehensive, multi-pronged approaches, the most marginalised parents may not have been reached. Further alternative recruitment strategies are required for recruiting fathers, rural populations, or those without the capacity or opportunity to engage with local services. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05653-1.
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Affiliation(s)
- Louise Tully
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland.
| | - Eleni Spyreli
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Virginia Allen-Walker
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | | | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Jayne Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - Michelle C McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | | | - Moira Dean
- School of Biological Sciences, Institute for Global Food Security, Queens University Belfast, Belfast, UK
| | | | - Caroline Heary
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
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15
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Golenya R, Chloros GD, Panteli M, Giannoudis PV, Howard A. How to improve diversity in patient and public involvement. Br J Hosp Med (Lond) 2021; 82:1-8. [PMID: 34191561 DOI: 10.12968/hmed.2021.0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patient and public involvement involves ascertaining the opinions of and collaborating with patients and members of the public to holistically improve the quality of research. Patient and public involvement provides patients with a platform to use and share their lived experiences. This allows healthcare professionals to gain a deeper appreciation of the patient's perspective, which enables future research to be more patient centred and tailored to patients' requirements. Patient and public involvement aims to broadly encapsulate the opinions of the public, so ensuring diversity is recommended. This article provides a practical framework to increase diversity and engage hard-to-reach demographics in patient and public involvement. It highlights some common barriers to participation and methods for overcoming this, describes sampling frameworks and provides examples of how these have been adopted in practice.
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Affiliation(s)
- Rebecca Golenya
- Department of Medicine, St James Hospital, Leeds, UK.,School of Medicine, University of Leeds, Leeds, UK
| | - George D Chloros
- School of Medicine, University of Leeds, Leeds, UK.,Academic Department of Trauma and Orthopaedics, Leeds, UK
| | - Michalis Panteli
- School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, Leeds, UK.,Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK
| | - Anthony Howard
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds University, Leeds, UK.,Leeds Orthopaedic Trauma Sciences, Leeds University, Leeds, UK.,Department of Trauma and Orthopaedics, Leeds General Infirmary, Leeds, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK
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16
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Saini P, Hassan SM, Morasae EK, Goodall M, Giebel C, Ahmed S, Pearson A, Harper LM, Cloke J, Irvine J, Gabbay M. The value of involving patients and public in health services research and evaluation: a qualitative study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:49. [PMID: 34187590 PMCID: PMC8244227 DOI: 10.1186/s40900-021-00289-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/30/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Public and Patient Involvement, Engagement and Participation research encompasses working with patients/service users (people with a medical condition receiving health service treatment), public members, caregivers and communities (who use services or care for patients). The Partner Priority Programme (PPP) was developed by the National Health Service [NHS] and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care [NIHR CLAHRC] NWC to share information and experience on evaluating new services being offered to patients that were seeking to reduce health inequalities, improve people's health and wellbeing and reduce emergency hospital admissions. This paper seeks to explore an approach developed for involving the public as equal partners within the evaluation and decision-making processes of health and social care services research. The aim of this study was to identify how public advisors were included, the impact of their involvement, and how change occurred within the organisations following their involvement. METHODS A qualitative approach using focus group discussions was adopted to explore the experiences of two cohorts of participants involved in PPP project teams. Focus groups were held with public advisors (n = 9), interns (n = 9; staff or public who received a funded internship for a PPP project), NHS and Local Authority initiative leads (n = 10), and academic facilitators (n = 14). These were transcribed verbatim and analysed using a thematic approach. RESULTS Thirty-two public advisors were recruited to support 25 PPP projects across the Collaboration for Leadership in Applied Health Research and CLAHRC North West Coast [NWC] partner organisations. Three inter-related themes were conceptualised: 1)"Where it all started - involving public advisors" identified the varying journeys to recruitment and experiences of becoming a public advisor; 2)"Steps toward active involvement and engagement" related to public advisors becoming core team members; and 3) "Collaborative working to enhance public and patient involvement" relayed how projects identified the benefits of working jointly with the public advisors, particularly for those who had not experienced this style of working before. CONCLUSIONS The findings indicate that the PPP model is effective for embedding Public and Patient Involvement [PPI] within health services research, and recommends that PPI is integrated at the earliest opportunity within research projects and service evaluations through the use of support-led and facilitative programmes.
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Affiliation(s)
- Pooja Saini
- School of Psychology, Tom Reilly Building, Liverpool John Moores University, Liverpool, L3 3AF, UK.
| | | | | | - Mark Goodall
- University of Liverpool, NIHR ARC NWC, Liverpool, UK
| | | | | | - Anna Pearson
- North West Boroughs Healthcare NHS Foundation Trust, Winwick, UK
| | | | - Jane Cloke
- University of Liverpool, NIHR ARC NWC, Liverpool, UK
| | - Jenny Irvine
- Lancaster University, NIHR CLAHRC NWC, Lancaster, UK
| | - Mark Gabbay
- University of Liverpool, NIHR ARC NWC, Liverpool, UK
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17
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Gheduzzi E, Masella C, Morelli N, Graffigna G. How to prevent and avoid barriers in co-production with family carers living in rural and remote area: an Italian case study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:16. [PMID: 33731217 PMCID: PMC7968224 DOI: 10.1186/s40900-021-00259-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted. METHODS To investigate this topic, we undertook a single case study - a longitudinal project (Place4Carers (Graffigna et al., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process. RESULTS The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants' inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers' satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production. CONCLUSIONS Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together.
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Affiliation(s)
| | | | - Niccolò Morelli
- School of Management, Politecnico di Milano, Milan, Italy
- Department of Psychology, EngageMinds Hub Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore (Milano), Milan, Italy
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds Hub Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore (Milano), Milan, Italy
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18
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Neill RD, Best P, Lloyd K, Williamson J, Allen J, Badham J, Tully MA. Engaging Teachers and School Leaders in Participatory Data Analysis for the Development of a School-Based Mental Health Intervention. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09418-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractThe success of school-based mental health interventions is often inconsistent, in part due to lack of input from teachers and students in the programme design. Therefore, the involvement and engagement of teachers in the co-production of an intervention, especially within data analysis, can create more innovative and effective solutions. This paper presents a teacher-led qualitative data analysis using a new approach within the field, participation theme elicitation. This approach will be used to gather information relevant to the initial development of a school-based mental health intervention. Teachers identified the following themes: (1) physical activity as a stress reliever, (2) programme facilitation, (3) exam pressure and (4) solutions to improve negative mental health. Results from the teacher-led analysis are broadly similar to previous research in the field. Our findings demonstrate that teachers can have a valuable input into research findings which should help address the development of a school-based mental health intervention. In summary, the findings suggest that the use of participatory theme elicitation is a valid and effective method to address the gaps and limitations of participatory qualitative data analysis.
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19
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Tierney S, Dawson S, Boylan AM, Richards G, Park S, Turk A, Babatunde O. Broadening diversity through creative involvement to identify research priorities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:3. [PMID: 33407929 PMCID: PMC7787225 DOI: 10.1186/s40900-020-00244-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/07/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Patient and public involvement (PPI) can help with steering and shaping research prioritisation and execution. However, some groups of people may not be encouraged to take part and their voices may be seldom listened to in the production of research. This is important to consider because they may have poorer healthcare experiences. We tried using art as a vehicle for including individuals not necessarily invited to be part of research priority setting. METHODS We contacted existing groups and organisations to reach people not routinely supported to be part of PPI. We targeted individuals: a) with dementia, b) with a mental and physical health condition, c) of South Asian heritage. We ran a workshop with each group at which individuals shared their experiences of healthcare. A young amateur artist also attended, who produced a piece of artwork afterwards that reflected the research priorities raised. We held a Twitter chat to discuss these pieces of art and the processes involved in their generation. RESULTS From each workshop, we produced a list of research priorities. These included: a) improving coordination of care for people with dementia, b) information needs and anxiety/guilt around accessing care for people with physical and mental health conditions, c) supporting discussion of women's health issues in South Asian communities. These priorities were reflected in three pieces of art, which can be viewed online. Feedback from those at workshops suggested that the artwork helped them to feel that their voice had been heard and triggered their interest in how research is developed. Those involved in the Twitter chat commented that art was one means through which researchers could connect with a range of groups in a PPI context when preparing and producing a study. CONCLUSIONS We found the medium of art to be an effective way of including a range of people in research prioritisation setting. This approach could be useful for future PPI, building on what we have learnt from the project described in this paper.
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Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gillian Richards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sophie Park
- Department of Primary care and Population Health, UCL, London, UK
| | - Amadea Turk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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20
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Reynolds J, Ogden M, Beresford R. Conceptualising and constructing 'diversity' through experiences of public and patient involvement in health research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:53. [PMID: 34294162 PMCID: PMC8295976 DOI: 10.1186/s40900-021-00296-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/05/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Increasing the accessibility of public and patient involvement (PPI) in health research for people from diverse backgrounds is important for ensuring all voices are heard and represented. Critiques of PPI being dominated by 'the usual suspects' reflect concerns over the barriers to involvement in PPI faced by people from minority groups or non-professional backgrounds. Yet, what has received less attention is how undertaking PPI work might produce diverse experiences, potentially shaping the motivation and capacity of people from different backgrounds to continue in PPI. METHODS We conducted qualitative research to explore experiences of the health research PPI field in the UK and to understand how these might shape the accessibility of PPI for people of diverse backgrounds. We conducted in-depth and follow-up interviews with five PPI contributors with experience of multiple health research projects, and a focus group with nine people in professional roles relating to PPI. Interview data were analysed using a narrative approach, and then combined with the focus group data for thematic analysis. RESULTS The structure, organisation and relationships of health research in the UK all shape PPI experiences in ways that can intersect the different backgrounds and identities of contributors, and can pose barriers to involvement and motivation for some. Navigating processes for claiming expenses can be frustrating particularly for people from lower-income backgrounds or with additional needs, and short-term research can undermine relationships of trust between contributors and professionals. Pressure on PPI coordinators to find 'more diverse' contributors can also undermine ongoing relationships with contributors, and how their inputs are valued. CONCLUSIONS To increase diversity within PPI, and to ensure that people of different backgrounds are supported and motivated to continue in PPI, changes are needed in the wider health research infrastructure in the UK. More resources are required to support relationships of trust over time between contributors and professionals, and to ensure the unique circumstances of each contributor are accommodated within and across PPI roles. Finally, critical reflection on the pressure in PPI to seek 'more diverse' contributors is needed, to understand the impacts of this on those already involved.
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Affiliation(s)
- Joanna Reynolds
- Department of Psychology, Sociology & Politics, Sheffield Hallam University, Heart of the Campus, Collegiate Crescent, Sheffield, S10 2BP, UK.
| | | | - Ruth Beresford
- Department of Psychology, Sociology & Politics, Sheffield Hallam University, Heart of the Campus, Collegiate Crescent, Sheffield, S10 2BP, UK
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21
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Rai T, Morton K, Roman C, Doogue R, Rice C, Williams M, Schwartz C, Velardo C, Tarassenko L, Yardley L, McManus RJ, Hinton L. Optimizing a digital intervention for managing blood pressure in stroke patients using a diverse sample: Integrating the person-based approach and patient and public involvement. Health Expect 2020; 24:327-340. [PMID: 33316120 PMCID: PMC8077154 DOI: 10.1111/hex.13173] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/12/2023] Open
Abstract
Background Having a stroke or transient ischaemic attack increases the risk of a subsequent one, especially with high blood pressure (BP). Home‐based BP management can be effective at maintaining optimal BP. Objective To describe the optimization of a digital intervention for stroke patients and the value of participant diversity, using the person‐based approach (PBA) and integral patient and public involvement (PPI). Setting and participants Stroke patients recruited from primary care and community settings, and health‐care professionals in primary care, in England and Ireland. Design Three linked qualitative studies conducted iteratively to develop an intervention using the PBA, with integral PPI. Intervention The BP: Together intervention, adapted from existing BP self‐monitoring interventions, is delivered via mobile phone or web interface to support self‐monitoring of BP at home. It alerts patients and their clinicians when a change in antihypertensive medication is needed. Findings Feedback from a diverse range of participants identified potential barriers, which were addressed to improve the intervention accessibility, feasibility and persuasiveness. Easy‐to‐read materials were developed to improve usability for patients with aphasia and lower literacy. The importance of including family members who support patient care was also highlighted. Feedback messages regarding medication change were refined to ensure usefulness for patients and clinicians. Discussion Input from PPI alongside qualitative research with a diverse study sample allowed the creation of a simple and equitable BP management intervention for stroke patients. Patient involvement Two PPI co‐investigators contributed to design, conduct of study, data interpretation and manuscript preparation; community PPI sessions informed early planning. Study participants were stroke patients and family members.
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Affiliation(s)
- Tanvi Rai
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kate Morton
- School of Psychology, University of Southampton, Southampton, UK
| | - Cristian Roman
- Department of Engineering Science, University of Oxford, UK
| | - Roisin Doogue
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Cathy Rice
- Public and Patient Involvement (PPI) Contributor, Bristol, UK
| | - Marney Williams
- Public and Patient Involvement (PPI) Contributor, Bristol, UK
| | - Claire Schwartz
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, UK.,Department of Experimental Psychology, Institute of Biomedical Engineering, University of Bristol, Bristol, UK
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
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22
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Conneely M, Boland P, O'Neill A, Byrne D, Cronin S, Quinn D, Trépel D, Leahy S, Salsberg J, Galvin R, Robinson K. A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research. HRB Open Res 2020; 3:1. [PMID: 32760878 PMCID: PMC7374807 DOI: 10.12688/hrbopenres.12979.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 01/10/2023] Open
Abstract
Background: There has been a policy shift towards public and patient involvement (PPI) in population health and health services research in Ireland and internationally. Despite growing evidence that PPI can have positive impacts on the quality and appropriateness of health research, little is known about the involvement and impact of older adults as research partners. The aim of this study is to 1) describe the process of establishing a PPI panel of older adults, family carers and ageing research academics and 2) to evaluate the impact of this research partnership on all research partners. Methods: A partnership-focused framework will guide the recruitment and establishment of a PPI panel of older adults, family carers and academic researchers. Eight to ten older adults and four to six family carers with experience of using health services will be recruited through gatekeepers in a range of non-governmental, voluntary, and community organisations in the Mid-West region of Ireland. Academic researchers will be recruited through the Ageing Research Centre at the University of Limerick. To evaluating the impact of the research partnership on all members of the PPI panel we propose to record an activity log, maintain a record of all meeting, panel discussions and conduct individual interviews with all members of the research team at key time points. The final plan for evaluation will be negotiated and agreed with all members of the PPI panel. Data will be transcribed, managed in NVivo and analysed using an inductive approach to thematic analysis. Dissemination of research findings will be facilitated by the research partnership team of academics and older adults. Discussion: This study will identify learning about the process of establishing a PPI panel guided by a partnership-focused framework and will evaluate the impact of participation in a PPI panel for all members of the research team.
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Affiliation(s)
- Mairéad Conneely
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Pauline Boland
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Aoife O'Neill
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - David Byrne
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Sinéad Cronin
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Quinn
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Trépel
- Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin 2, Ireland, DO2 PN40, Ireland
| | - Siobhán Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Jon Salsberg
- Graduate Entry Medical School Ireland, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
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23
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Shields GE, Brown L, Wells A, Capobianco L, Vass C. Utilising Patient and Public Involvement in Stated Preference Research in Health: Learning from the Existing Literature and a Case Study. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:399-412. [PMID: 32748242 PMCID: PMC8205869 DOI: 10.1007/s40271-020-00439-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Publications reporting discrete choice experiments of healthcare interventions rarely discuss whether patient and public involvement (PPI) activities have been conducted. This paper presents examples from the existing literature and a detailed case study from the National Institute for Health Research-funded PATHWAY programme that comprehensively included PPI activities at multiple stages of preference research. Reflecting on these examples, as well as the wider PPI literature, we describe the different stages at which it is possible to effectively incorporate PPI across preference research, including the design, recruitment and dissemination of projects. Benefits of PPI activities include gaining practical insights from a wider perspective, which can positively impact experiment design as well as survey materials. Further benefits included advice around recruitment and reaching a greater audience with dissemination activities, amongst others. There are challenges associated with PPI activities; examples include time, cost and outlining expectations. Overall, although we acknowledge practical difficulties associated with PPI, this work highlights that it is possible for preference researchers to implement PPI across preference research. Further research systematically comparing methods related to PPI in preference research and their associated impact on the methods and results of studies would strengthen the literature.
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Affiliation(s)
- Gemma E Shields
- Manchester Centre for Health Economics, Division of Population Health, The University of Manchester, 4.307 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | | | - Adrian Wells
- Faculty of Biology, Medicine and Health, School of Psychological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Research & Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Lora Capobianco
- Research & Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Caroline Vass
- Manchester Centre for Health Economics, Division of Population Health, The University of Manchester, 4.307 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.,RTI Health Solutions, Manchester, UK
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24
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Conneely M, Boland P, O'Neill A, Byrne D, Cronin S, Quinn D, Trépel D, Leahy S, Salsberg J, Galvin R, Robinson K. A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research. HRB Open Res 2020; 3:1. [PMID: 32760878 PMCID: PMC7374807 DOI: 10.12688/hrbopenres.12979.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 10/15/2023] Open
Abstract
Background: There has been a policy shift towards public and patient involvement (PPI) in population health and health services research in Ireland and internationally. Despite growing evidence that PPI can have positive impacts on the quality and appropriateness of health research, little is known about the involvement and impact of older adults as research partners. The aim of this study is to 1) describe the process of establishing a PPI panel of older adults, family carers and ageing research academics and 2) to evaluate the impact of this research partnership on all research partners. Methods: A partnership-focused framework will guide the recruitment and establishment of a PPI panel of older adults, family carers and academic researchers. Eight to ten older adults and four to six family carers with experience of using health services will be recruited through gatekeepers in a range of non-governmental, voluntary, and community organisations in the Mid-West region of Ireland. Academic researchers will be recruited through the Ageing Research Centre at the University of Limerick. To evaluating the impact of the research partnership on all members of the PPI panel we propose to record an activity log, maintain a record of all meeting, panel discussions and conduct individual interviews with all members of the research team at key time points. The final plan for evaluation will be negotiated and agreed with all members of the PPI panel. Data will be transcribed, managed in NVivo and analysed using an inductive approach to thematic analysis. Dissemination of research findings will be facilitated by the research partnership team of academics and older adults. Discussion: This study will identify learning about the process of establishing a PPI panel guided by a partnership-focused framework and will evaluate the impact of participation in a PPI panel for all members of the research team.
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Affiliation(s)
- Mairéad Conneely
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Pauline Boland
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Aoife O'Neill
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - David Byrne
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Sinéad Cronin
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Quinn
- HRB Centre for Primary Care Research, Mercer Building, Royal College of Surgeons in Ireland, Dublin 2, Ireland, DO2 YN72, Ireland
| | - Dominic Trépel
- Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin 2, Ireland, DO2 PN40, Ireland
| | - Siobhán Leahy
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Jon Salsberg
- Graduate Entry Medical School Ireland, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 T9PX, Ireland
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25
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Coupe N, Mathieson A. Patient and public involvement in doctoral research: Impact, resources and recommendations. Health Expect 2020; 23:125-136. [PMID: 31613049 PMCID: PMC6978853 DOI: 10.1111/hex.12976] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND AIM Patient and public involvement (PPI) has potential to enhance health-care research and is increasingly an expectation, particularly for many funding bodies. However, PPI can be tokenistic, which may limit this potential. Furthermore, few studies report PPI processes and impact, particularly in doctoral research studies, which are seldom reported in peer-reviewed papers. The aim of this paper was to explore the impact of PPI on two health-related doctoral research studies and identify how PPI could be used meaningfully at this level. METHOD The PPI processes included (a) involvement of two 'Research Buddies' who informed the research design and ensured implementation of a booklet intervention was feasible for family carers, (b) data analysis workshops with 'Research Buddies' to identify emerging themes from practitioner interviews, (c) public and stakeholder involvement who informed data collection tool design, and the design of an intervention to help people with obesity who attend weight loss groups. FINDINGS The application of PPI enhanced both doctoral studies by assisting data analysis; problem solving and improving recruitment rates; improving the usability and appeal of data collection tools and interventions; and developing implementation strategies. Patient and public involvement was considered a rewarding experience for both researchers and PPI contributors. CONCLUSION This paper demonstrates the value of PPI in doctoral research in relation to its impact on research processes, researchers and contributors. We also present recommendations on how PPI could be incorporated into future doctoral research, including resources required, planning PPI processes and involving PPI contributors in all stages of research.
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Affiliation(s)
- Nia Coupe
- Manchester Centre for Health PsychologySchool of Health SciencesThe University of ManchesterManchesterUK
| | - Amy Mathieson
- Division of Nursing, Midwifery and Social WorkThe University of ManchesterManchesterUK
- Present address:
Department of Health Services ResearchUniversity of LiverpoolLiverpoolUK
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26
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Carlton J, Peasgood T, Khan S, Barber R, Bostock J, Keetharuth AD. An emerging framework for fully incorporating public involvement (PI) into patient-reported outcome measures (PROMs). J Patient Rep Outcomes 2020; 4:4. [PMID: 31933005 PMCID: PMC6957651 DOI: 10.1186/s41687-019-0172-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 12/23/2019] [Indexed: 01/28/2023] Open
Abstract
Patient-reported outcome measures (PROMs) are widely used in the United Kingdom (UK) and internationally to report and monitor patients’ subjective assessments of their symptoms and functional status and also their quality of life. Whilst the importance of involving the public in PROM development to increase the quality of the developed PROM has been highlighted this practice is not widespread. There is a lack of guidance on how public involvement (PI) could be embedded in the development of PROMs, where the roles can be more complex than in other types of research. This paper provides a timely review and sets out an emerging framework for fully incorporating PI into PROM development.
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Affiliation(s)
- J Carlton
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - T Peasgood
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - S Khan
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - R Barber
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - J Bostock
- University of Cambridge, Cambridge, UK.,University of Oxford, Oxford, UK.,Kings College London, London, UK
| | - A D Keetharuth
- University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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27
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Muller I, Santer M, Morrison L, Morton K, Roberts A, Rice C, Williams M, Yardley L. Combining qualitative research with PPI: reflections on using the person-based approach for developing behavioural interventions. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:34. [PMID: 31807316 PMCID: PMC6857167 DOI: 10.1186/s40900-019-0169-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/16/2019] [Indexed: 06/01/2023]
Abstract
BACKGROUND The value and importance of qualitative research and Patient and Public Involvement (PPI) for developing complex health interventions is widely recognised. However, there is often confusion between the two, with researchers relying on just one of these approaches, rather than using the two alongside one another. METHODS The Person-Based Approach (PBA) to developing health-related behaviour change interventions adapts and integrates methods from user-centred design and qualitative research. The PBA involves qualitative research at multiple stages of interventions to ensure they are acceptable, feasible, meaningful, and optimally engaging to the people who will use them. The qualitative research is carried out with research participants from a target population, who have no prior or continuing involvement in the wider research process and see the intervention from a fresh perspective. This enables in-depth understanding of the views and experiences of a wide range of target users and the contexts within which they engage with behavioural change.PPI in research is carried out with or by members of the public and is a key part of the research process. PPI contributors are involved at all stages of research design and interpretation. PPI provides input into interventions as members of the research team alongside other stakeholders, such as health professionals and behaviour change experts. RESULTS We advocate using qualitative research alongside PPI at all stages of intervention planning, development, and evaluation. We illustrate this with examples from recent projects developing complex health interventions, highlighting examples where PPI and PBA have pulled in different directions and how we have approached this, how PPI have helped optimise interventions based on PBA feedback, and how we have engaged PPI in community settings. CONCLUSIONS PPI provides a valuable alternative to the traditional researcher-led approaches, which can be poorly matched to the needs of target users. Combining PPI with the PBA can help to create optimally engaging interventions by incorporating a greater diversity of feedback than would have been possible to achieve through PPI or qualitative approaches alone.
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Affiliation(s)
- Ingrid Muller
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Miriam Santer
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Leanne Morrison
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Kate Morton
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | | | - Cathy Rice
- Patient and Public Contributor, Southampton, UK
| | | | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Southampton, UK
- School of Experimental Psychology, University of Bristol, Bristol, UK
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28
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Liabo K, Boddy K, Burchmore H, Cockcroft E, Britten N. Clarifying the roles of patients in research. Br J Sports Med 2019; 53:1324. [PMID: 31582520 DOI: 10.1136/bjsports-2018-k1463rep] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Kristin Liabo
- NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Kate Boddy
- NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Helen Burchmore
- AccEPT Clinic, Mood Disorders Centre, University of Exeter, Exeter, UK
| | - Emma Cockcroft
- NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Nicky Britten
- NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
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29
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McInnes RJ, Gillespie N, Crossland N, Hall Moran V, Hoddinott P. Women's views about a free breast pump service: Online survey informing intervention development. MATERNAL & CHILD NUTRITION 2019; 15:e12745. [PMID: 30381867 PMCID: PMC7198920 DOI: 10.1111/mcn.12745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/10/2018] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
Abstract
Improving breastfeeding outcomes is a global priority; however, in the United Kingdom, continuation of breastfeeding remains low. Growing empirical evidence suggests a free breast pump service might be an acceptable and feasible incentive intervention to improve breastfeeding outcomes and reduce heath inequalities. To inform intervention development, we conducted an online survey with women recruited via social media using snowball sampling. Data were analysed descriptively (closed questions) with qualitative thematic analysis (free text). The survey was completed by 666 women, most of whom had recently breastfed and used a breast pump. Participants agreed that free pump hire (rental/loan; 567 women; 85.1%) or a free pump to keep (408; 61.3%) should be provided. Free text comments provided by 408 women (free pump) and 309 women (free hire) highlighted potential benefits: helping women to continue breastfeeding; express milk; overcome difficulties; and pump choice. Concerns are possible effect on breast milk supply, reduced breastfeeding, pumps replacing good support for breastfeeding, and pump hire hygiene. Personal and societal costs are important issues. Some suggested a pump service should be for low-income mothers, those with feeding difficulties or sick/preterm infants. A one-size service would not suit all and vouchers were proposed. Some suggested fees and deposits to prevent waste. To our knowledge, this is the first study reporting views about the acceptability of providing a free breast pump hire service. Mothers support and wish to have a say in breast pump service development. Future evaluations should address impact on feeding outcomes, professional support, hygiene for hired pumps, and costs.
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Affiliation(s)
- Rhona J. McInnes
- Associate Professor in Maternal Health & Consultant Midwife for NHS Lothian, School of Health and Social CareEdinburgh Napier University (ENU)EdinburghScotland
| | - Nicola Gillespie
- Research Midwife, Nursing Midwifery Allied Health Professions Research UnitGlasgow Caledonian UniversityGlasgowScotland
| | - Nicola Crossland
- Research Associate, Maternal and Infant Nutrition and Nurture Unit, College of Health and WellbeingUniversity of Central LancashirePrestonUK
| | - Victoria Hall Moran
- Associate Professor, Maternal and Infant Nutrition and Nurture Unit, College of Health and WellbeingUniversity of Central LancashirePrestonUK
| | - Pat Hoddinott
- Chair in Primary Care, Nursing Midwifery and Allied Health Professions Research UnitUniversity of StirlingStirlingUK
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30
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Curwen A, Fernandes J, Howison R, Binfield P, Rohricht F, Giacco D. Exploring experiences of people participation activities in a British national health service trust: a service user-led research project. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:5. [PMID: 30723548 PMCID: PMC6350336 DOI: 10.1186/s40900-019-0140-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/20/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND People participation teams are being established in many British NHS Trusts. They support active service user involvement in staff recruitment interviews, in evaluations of care and in programmes to improve services. No studies exploring experience of people involved in these activities are available in published mental health literature. In this project we explored benefits experienced and suggestions for improvement provided by service users. METHODS The design, materials and methods of the project were developed in workshops including N = 15 service users. Three service user researchers were trained to carry out research interviews and qualitative analysis of the data. They were responsible for the management of the project on a day-to-day basis with weekly supervision by academic researchers and authored this paper. The service user researchers interviewed people with at least 1 year of experience of being involved in a People Participation team activities. Interviews were based on a topic guide, which was developed in workshops with a larger number of service users (N = 15) and explored reasons for joining the group, how participation helped recovery and suggestions for service improvement. RESULTS Fifteen service users were recruited and interviewed. Reasons for joining the group were identified: to "give back" to the service, to influence service change, curiosity, desire to meet like-minded people and to structure the day. Benefits reported included: sharing experiences, improving self-confidence, feeling valued, having a better understanding of services, overcoming personal fears, and developing better coping mechanisms for psychological difficulties. Being involved in People Participation activities helped to gain or refresh listening and interpersonal skills, communication skills, public speaking and creative skills and to develop better ways to cope with conflict. Suggestions for improvement were focused on changing staff attitudes, further promoting participation (e.g. through websites), simplifying payment procedures and establishing a moving-on support system to help people to access regular employment and gain full social inclusion. CONCLUSIONS Our findings showed that People Participation initiatives can have benefits at least for some patients and help their recovery through a positive effect on self-confidence, providing room for feeling valued and for obtaining or refreshing personal skills. This provides support for the development and refinement of People Participation Teams and for larger scale research to test their effects.
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Affiliation(s)
- Adrian Curwen
- East London NHS Foundation Trust, People Participation Team, London, E1 8DE UK
| | - Jane Fernandes
- East London NHS Foundation Trust, People Participation Team, London, E1 8DE UK
| | - Rachael Howison
- East London NHS Foundation Trust, People Participation Team, London, E1 8DE UK
| | - Paul Binfield
- East London NHS Foundation Trust, People Participation Team, London, E1 8DE UK
| | | | - Domenico Giacco
- East London NHS Foundation Trust, London, E1 8DE UK
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, London, E1 4NS UK
- Unit for Social and Community Psychiatry, Newham Centre for Mental Health, Glen Road, London, E13 8SP UK
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Taylor RM, Whelan JS, Gibson F, Morgan S, Fern LA. Involving young people in BRIGHTLIGHT from study inception to secondary data analysis: insights from 10 years of user involvement. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:50. [PMID: 30607259 PMCID: PMC6307198 DOI: 10.1186/s40900-018-0135-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/29/2018] [Indexed: 05/28/2023]
Abstract
PLAIN ENGLISH SUMMARY Young people with cancer are often described as 'hard to reach', 'difficult to engage' and/or 'vulnerable'. Consequently, they are often over looked for patient and public involvement activities. We set out to involve young people with cancer to work as co-researchers in the design of the largest ever study of young people with cancer, called BRIGHTLIGHT. In the 10 years since the BRIGHTLIGHT feasibility work began we have involved more than 1200 young people as co-researchers, collaborators, consultants and dissemination partners. We chronicle the key points of this 10-year journey, sharing our success, describing our challenges and the solutions we put in place; sharing also what worked and did not work. Here we share some of these experiences of involving young people in this research and offer some practical advice for those looking to do the same. ABSTRACT Background Young people with cancer, broadly those aged 13-24 years at diagnosis, warrant special attention; physiological and psychological growth creates complex psychosocial needs which neither adult nor child systems are suitably designed to deal with. Resulting from these needs, they are often described as 'vulnerable', 'hard to reach' and 'difficult to engage', and consequently are often over looked for patient and public involvement/engagement (PPIE) roles. In our study 'BRIGHTLIGHT', we set out to evaluate whether specialist care for young people adds value, ensuring young people were central to our PPIE activities. We believe that BRIGHTLIGHT is unique as a very large study of young people with cancer which has successfully overcome the challenges of including young people in the research process so we are confident that they have influenced every aspect of study design, conduct and dissemination. Methods We chronicle a period of 10 years, over which we describe our approach and our methods to involving young people in PPIE activities in BRIGHTLIGHT. We describe the feasibility work, study set up, conduct and dissemination of our findings, and weave through our story of PPIE to illustrate its benefits. Through the narration of our experience we highlight significant points that both influenced and changed our direction of travel. We reflect on our experiences and offer some practical advice for those looking to do the same. Results In the 10 years since the BRIGHTLIGHT feasibility work began we have involved more than 1200 young people. Their contributions have been isolated and mapped over a 10-year period. We begin at an early step of identifying what research questions to prioritize, we then plot PPIE activities for one of these research priorities, place of care, which evolved into BRIGHTLIGHT. We document steps along the way to evidence the impact of this involvement. Conclusions Young people can make a valuable contribution to healthcare research given adequate support from the research team. Although some challenges exist, we propose that the benefits to young people, researchers and the study considerably outweigh these challenges and PPIE with young people should be integrated in all similar research studies.
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Affiliation(s)
- Rachel M. Taylor
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jeremy S. Whelan
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Faith Gibson
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH UK
- Centre for Outcomes and Experience Research in Children’s Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sue Morgan
- Teenage Cancer Trust Unit, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - Lorna A. Fern
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
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Lessard D, Engler K, Toupin I, Routy JP, Lebouché B. Evaluation of a project to engage patients in the development of a patient-reported measure for HIV care (the I-Score Study). Health Expect 2018; 22:209-225. [PMID: 30375111 PMCID: PMC6433311 DOI: 10.1111/hex.12845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 10/01/2018] [Accepted: 10/10/2018] [Indexed: 01/12/2023] Open
Abstract
Background Patient engagement (PE), patients’ meaningful involvement in research through partnerships and sensitivity to their expertise, is receiving attention. However, PE initiatives are poorly reported and little is known about patients’ perspective on PE. Objective To document and evaluate the first phase (22 months) of a PE Project for the I‐Score Study which is developing a patient‐reported measure of HIV treatment adherence barriers, we describe the nature of PE conducted, determine the level of PE achieved and present its impacts from the engaged patients’ perspective. Setting and participants A Montreal‐based committee of ten people with HIV was recruited from community and clinical settings and participated in: I‐Score study decision making, knowledge dissemination, research on the experience of people with HIV and the PE project's evaluation. Methods The evaluation followed a convergent parallel mixed‐methods design. Data collection included participant observation, a satisfaction survey and meeting minutes/transcriptions. Analysis entailed reporting PE activities, generating descriptive statistics and thematically analysing qualitative material. Results PE consisted of twelve meetings, including two focus groups (needs assessment), in addition to four knowledge dissemination activities. PE levels showed an increase: the first four regular meetings entailed information/consultation, while subsequent meetings reached implication/collaboration. Regarding impacts, patients indicated high and stable satisfaction rates (M = 4.4/5; SD = 0.76). Furthermore, thematic analysis identified “positive interactions,” “co‐learning,” “self‐determination,” and “the collective management of confidentiality” as important PE impacts for engaged patients. Conclusion This PE Project evaluation highlighted growing engagement levels, high satisfaction rates and the importance of a patient‐centric approach to PE.
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Affiliation(s)
- David Lessard
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.,Royal Victoria Hospital, Chronic and Viral Illness Service (MUHC), Montreal, Quebec, Canada.,SPOR Mentorship Chair in Innovative Clinical Trials of the CIHR, Montreal, Quebec, Canada
| | - Kim Engler
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.,Royal Victoria Hospital, Chronic and Viral Illness Service (MUHC), Montreal, Quebec, Canada.,SPOR Mentorship Chair in Innovative Clinical Trials of the CIHR, Montreal, Quebec, Canada
| | - Isabelle Toupin
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.,Royal Victoria Hospital, Chronic and Viral Illness Service (MUHC), Montreal, Quebec, Canada.,SPOR Mentorship Chair in Innovative Clinical Trials of the CIHR, Montreal, Quebec, Canada
| | | | - Jean-Pierre Routy
- Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.,Royal Victoria Hospital, Chronic and Viral Illness Service (MUHC), Montreal, Quebec, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.,Royal Victoria Hospital, Chronic and Viral Illness Service (MUHC), Montreal, Quebec, Canada.,SPOR Mentorship Chair in Innovative Clinical Trials of the CIHR, Montreal, Quebec, Canada
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Pezaro S, Pearce G, Bailey E. Childbearing women's experiences of midwives' workplace distress: Patient and public involvement. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.10.659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sally Pezaro
- Midwife, researcher and lecturer, School of Nursing, Midwifery and Health, Coventry University
| | - Gemma Pearce
- Senior research assistant, Centre for Advances in Behavioural Science, Coventry University
| | - Elizabeth Bailey
- Research Fellow, Faculty Research Centre for Innovative Research Across the Life Course
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Hoddinott P, Pollock A, O'Cathain A, Boyer I, Taylor J, MacDonald C, Oliver S, Donovan JL. How to incorporate patient and public perspectives into the design and conduct of research. F1000Res 2018; 7:752. [PMID: 30364075 PMCID: PMC6192439 DOI: 10.12688/f1000research.15162.1] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2018] [Indexed: 11/25/2022] Open
Abstract
International government guidance recommends patient and public involvement (PPI) to improve the relevance and quality of research. PPI is defined as research being carried out 'with' or 'by' patients and members of the public rather than 'to', 'about' or 'for' them ( http://www.invo.org.uk/). Patient involvement is different from collecting data from patients as participants. Ethical considerations also differ. PPI is about patients actively contributing through discussion to decisions about research design, acceptability, relevance, conduct and governance from study conception to dissemination. Occasionally patients lead or do research. The research methods of PPI range from informal discussions to partnership research approaches such as action research, co-production and co-learning. This article discusses how researchers can involve patients when they are applying for research funding and considers some opportunities and pitfalls. It reviews research funder requirements, draws on the literature and our collective experiences as clinicians, patients, academics and members of UK funding panels.
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Affiliation(s)
- Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, G4 0BA, UK
| | - Alicia O'Cathain
- Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
| | - Isabel Boyer
- PPI member of NIHR/HTA General Board, NIHR Evaluation, Trials and Studies Coordinating Centre, Southampton, SO16 7NS, UK
| | - Jane Taylor
- Chair of Patient Insight Group, Arthritis Research UK, Chesterfield, S41 7TD, UK
| | - Chris MacDonald
- Research Involvement Manager, Arthritis Research UK, Chesterfield, S41 7TD, UK
| | - Sandy Oliver
- Department of Social Science, Social Science Research Unit, UCL Institute of Education, University College London, London, WC1H 0AL, UK
| | - Jenny L. Donovan
- School of Social and Community Medicin, University of Bristol, Bristol, BS8 2PS, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
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Hamilton FL, Hornby J, Sheringham J, Linke S, Ashton C, Moore K, Stevenson F, Murray E. DIAMOND (DIgital Alcohol Management ON Demand): a feasibility RCT and embedded process evaluation of a digital health intervention to reduce hazardous and harmful alcohol use recruiting in hospital emergency departments and online. Pilot Feasibility Stud 2018; 4:114. [PMID: 29946479 PMCID: PMC6003139 DOI: 10.1186/s40814-018-0303-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/25/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The harmful use of alcohol is a causal factor in more than 200 disease and injury conditions and leads to over 3 million deaths every year worldwide. Relatively few problem alcohol users access treatment due to stigma and lack of services. Alcohol-specific digital health interventions (DHI) may help them, but trial data comparing DHI with face-to-face treatment are lacking. METHODS We conducted a feasibility RCT of an alcohol DHI, testing recruitment, online data-collection and randomisation processes, with an embedded process evaluation. Recruitment ran from October 2015 for 12 months. Participants were adults, drinking at hazardous and harmful levels, recruited from hospital emergency departments (ED) in London or recruited online. Participants were randomised to HeLP-Alcohol, a six module DHI with weekly reminder prompts (phone, email or text message), or to face-to-face treatment as usual (TAU). Participants were invited to take part in qualitative interviews after the trial. RESULTS The trial website was accessed 1074 times: 420 people completed online eligibility questionnaires; 350 did not meet eligibility criteria, 51 declined to participate, and 19 were recruited and randomised. Follow-up data were collected from three participants (retention 3/19), and four agreed to be interviewed for the process evaluation. The main themes of the interviews were:Participants were not at equipoise. They wanted to try the website and were disappointed to be randomised to face-to-face, so they were less engaged and dropped out.Other reasons for drop out included not accepting that they had a drink problem; problem drinking interfering with their ability to take part in a trial or forgetting appointments; having a busy life and being randomised to TAU made it difficult to attend appointments. CONCLUSIONS This feasibility RCT aimed to test recruitment, randomisation, retention, and data collection methods, but recruited only 19 participants. This illustrates the importance of undertaking feasibility studies prior to fully powered RCTs. From the qualitative interviews we found that potential recruits were not at equipoise for recruitment. An alternative methodology, for example a preference RCT recruiting from multiple locations, needs to be explored in future trials. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number: ISRCTN31789096.
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Affiliation(s)
- Fiona L. Hamilton
- eHealth Unit, Department of Primary Care & Population Health, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Jo Hornby
- eHealth Unit, Department of Primary Care & Population Health, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | | | - Stuart Linke
- Camden and Islington NHS Foundation Trust, London, UK
| | | | - Kevin Moore
- Institute for Liver and Digestive Health, UCL, London, UK
| | - Fiona Stevenson
- eHealth Unit, Department of Primary Care & Population Health, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Elizabeth Murray
- eHealth Unit, Department of Primary Care & Population Health, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
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Smith H, Horobin A, Fackrell K, Colley V, Thacker B, Hall DA. Defining and evaluating novel procedures for involving patients in Core Outcome Set research: creating a meaningful long list of candidate outcome domains. RESEARCH INVOLVEMENT AND ENGAGEMENT 2018; 4:8. [PMID: 29507772 PMCID: PMC5833049 DOI: 10.1186/s40900-018-0091-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/08/2018] [Indexed: 06/08/2023]
Abstract
PLAIN ENGLISH SUMMARY Outcome domains are aspects of a condition that matter to patients and clinicians and can be measured to assess treatment effects. For tinnitus, examples include 'tinnitus loudness' and 'ability to concentrate'. This study focuses on the first stage of agreeing which outcome domains should be measured in all clinical trials of tinnitus. Crucially, it involves identifying outcome domains, prior to a voting process. This article describes how we effectively involved patients in that study design process, and reflects on the impact of their input.The study first compiled a long list of all possible outcome domains before asking interested parties, including patients, to vote which ones to include. Ensuring patients fully participate in this process holds unique challenges as it can be long, repetitive and its purpose far removed from their needs. These challenges may be addressed by involving patients in designing the research. There is evidence that other research teams are doing this, but its reporting is not detailed enough to guide others. Our paper seeks to address this.We describe how we involved patients (people living with tinnitus) in creating a long list of outcome domains that we included in our study. We also reflect on the benefits this brought. Two patients partnered with us in designing the survey. We also consulted an independent patient review panel. Involving patients reduced the list of domains included in the survey and made domain names and associated descriptions clearer. Our resulting survey performed well in recruiting and retaining patients as participants. ABSTRACT Background Tinnitus is a complex audiological condition affecting many different domains of everyday life. Clinical trials of tinnitus interventions measure and report those outcome domains inconsistently and this hinders direct comparison between study findings. To address this problem, an ongoing project is developing a Core Outcome Set; an agreed list of outcome domains to be measured and reported in all future trials. Part of this project uses a consensus methodology ('Delphi' survey), whereby all relevant stakeholders identify important and critical outcome domains from a long list of candidates. This article addresses a gap in the patient involvement literature by describing and reflecting on our involvement of patients to create a meaningful long list of candidate outcome domains.Methods Two Public Research Partners with lived experience of tinnitus reviewed an initial list of 124 outcome domains over two face-to-face workshops. With the Study Management Team, they interpreted each candidate outcome domain and generated a plain language description. Following this, the domain names and descriptions underwent an additional lay review by 14 patients and 5 clinical experts, via an online survey platform.Results Insights gained from the workshops and survey feedback prompted substantial, unforeseen modifications to the long list. These included the reduction of the number of outcome domains (from 124 to 66) via the exclusion of broad concepts and consolidation of equivalent domains or domains outside the scope of the study. Reviewers also applied their lived experience of tinnitus to bring clarity and relevance to domain names and plain language descriptions. Four impacts on the Delphi survey were observed: recruitment exceeded the target by 171%, there were equivalent numbers of patient and professional participants (n = 358 and n = 312, respectively), feedback was mostly positive, and retention was high (87%).Conclusions Patient involvement was an integral and transformative step of the study design process. Patient involvement was impactful because the online Delphi survey was successful in recruiting and retaining participants, and there were many comments about a positive participatory experience. Seven general methodological features are highlighted which fit with general principles of good patient involvement. These can benefit other Core Outcome Set developers.
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Affiliation(s)
- Harriet Smith
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Adele Horobin
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH UK
| | - Kathryn Fackrell
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Veronica Colley
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
| | - Brian Thacker
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
| | - Deborah A. Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH UK
| | - for the Core Outcome Measures in Tinnitus (COMiT) initiative
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH UK
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Liabo K, Ingold A, Roberts H. Co-production with "vulnerable" groups: Balancing protection and participation. Health Sci Rep 2018; 1:e19. [PMID: 30623060 PMCID: PMC6266358 DOI: 10.1002/hsr2.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/02/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIM This paper explores the tension between participation and protection at a time when professionals are encouraged to engage patients and citizens in both the "R" (research) and the "D" (development) of services. Concerns to protect groups perceived as "vulnerable" can mean that not everyone is afforded the same opportunity to participate. METHODS Our data draw on the literature and secondary analysis of a study designed to explore the experiences of young peoples' transitions from health and social care to adult services. In seeking ethics approval, tensions between protection and participation were evident, and once the study was concluded, we reviewed group and individual interview transcripts, team email correspondence, and research notes. We considered aspects of participation, co-production, involvement, and research design in relation to the ethics concerns raised. FINDINGS In terms of privacy and confidentiality, young people were skilled at setting their own boundaries. Whilst young people leaving foster and residential care are frequently perceived as vulnerable, those in our study asserted their agency and desire to be "visible." Some experienced conditions aimed at protecting their confidentiality or safety as oppressive. CONCLUSION The risk reduction strategies that often underpin ethics approval processes can also carry risks. Limiting opportunities to play a part in research for people who may already be excluded on age, health, language, or other grounds reduces the range of lay knowledge on which we can draw, limits generalisability, and potentially adds to damaging social exclusion. Learning how to participate effectively is a life skill.
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Affiliation(s)
- Kristin Liabo
- Institute for Health ResearchUniversity of Exeter Medical SchoolExeterUK
| | - Anne Ingold
- Freelance ResearcherSt AlbansHertfordshireUK
| | - Helen Roberts
- Population Policy & PracticeUCL Great Ormond Street Institute of Child HealthLondonUK
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Hind D, Parkin J, Whitworth V, Rex S, Young T, Hampson L, Sheehan J, Maguire C, Cantrill H, Scott E, Epps H, Main M, Geary M, McMurchie H, Pallant L, Woods D, Freeman J, Lee E, Eagle M, Willis T, Muntoni F, Baxter P. Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation. Health Technol Assess 2018. [PMID: 28627356 DOI: 10.3310/hta21270] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent. OBJECTIVES To assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work. DESIGN Parallel-group, single-blind, randomised pilot trial with nested qualitative research. SETTING Six paediatric neuromuscular units. PARTICIPANTS Children with DMD aged 7-16 years, established on corticosteroids, with a North Star Ambulatory Assessment (NSAA) score of 8-34 and able to complete a 10-m walk without aids/assistance. Exclusions: > 20% variation between baseline screens 4 weeks apart and contraindications. INTERVENTIONS Participants were allocated on a 1 : 1 ratio to (1) optimised, manualised LBT (prescribed by specialist neuromuscular physiotherapists) or (2) the same plus manualised AT (30 minutes, twice weekly for 6 months: active assisted and/or passive stretching regime; simulated or real functional activities; submaximal exercise). Semistructured interviews with participants, parents (n = 8) and professionals (n = 8) were analysed using Framework analysis. An independent rater reviewed patient records to determine the extent to which treatment was optimised. A cost-impact analysis was performed. Quantitative and qualitative data were mixed using a triangulation exercise. MAIN OUTCOME MEASURES Feasibility of recruiting 40 participants in 6 months, participant and therapist views on the acceptability of the intervention and research protocols, clinical outcomes including NSAA, independent assessment of treatment optimisation and intervention costs. RESULTS Over 6 months, 348 children were screened - most lived too far from centres or were enrolled in other trials. Twelve (30% of target) were randomised to AT (n = 8) or control (n = 4). People in the AT (n = 8) and control (n = 2: attrition because of parental report) arms contributed outcome data. The mean change in NSAA score at 6 months was -5.5 [standard deviation (SD) 7.8] for LBT and -2.8 (SD 4.1) in the AT arm. One boy suffered pain and fatigue after AT, which resolved the same day. Physiotherapists and parents valued AT and believed that it should be delivered in community settings. The independent rater considered AT optimised for three out of eight children, with other children given programmes that were too extensive and insufficiently focused. The estimated NHS costs of 6-month service were between £1970 and £2734 per patient. LIMITATIONS The focus on delivery in hospitals limits generalisability. CONCLUSIONS Neither a full-scale frequentist randomised controlled trial (RCT) recruiting in the UK alone nor a twice-weekly open-ended AT course delivered at tertiary centres is feasible. Further intervention development research is needed to identify how community-based pools can be accessed, and how families can link with each other and community physiotherapists to access tailored AT programmes guided by highly specialised physiotherapists. Bayesian RCTs may be feasible; otherwise, time series designs are recommended. TRIAL REGISTRATION Current Controlled Trials ISRCTN41002956. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 27. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Daniel Hind
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - James Parkin
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Victoria Whitworth
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Saleema Rex
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Tracey Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lisa Hampson
- Department of Mathematics and Statistics, University of Lancaster, Lancaster, UK
| | - Jennie Sheehan
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Chin Maguire
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Hannah Cantrill
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Elaine Scott
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Marion Main
- Dubowitz Neuromuscular Centre (DNC), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michelle Geary
- Children's Therapy Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Heather McMurchie
- Paediatric Physiotherapy, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Lindsey Pallant
- Regional Paediatric Neuromuscular Team, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Jennifer Freeman
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ellen Lee
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | | | - Tracey Willis
- The Oswestry Inherited Neuromuscular Service, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre (DNC), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Peter Baxter
- Paediatric Neurology, Sheffield Children's Hospital, Sheffield, UK
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Evans D, Bird E, Gibson A, Grier S, Chin TL, Stoddart M, MacGowan A. Extent, quality and impact of patient and public involvement in antimicrobial drug development research: A systematic review. Health Expect 2018; 21:75-81. [PMID: 28752577 PMCID: PMC5750755 DOI: 10.1111/hex.12587] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) is increasingly recognized as bringing a range of benefits to clinical and health services research. Recent systematic reviews have identified and synthesized many benefits (eg higher recruitment rates) and some costs (eg extra time need). Much of the literature focuses on PPI in long-term conditions rather than more acute health care in which the majority of microbiological research is undertaken. OBJECTIVES The aim was to identify the extent, quality and impact of PPI in antimicrobial drug development research. Objectives were to identify any relevant reporting of PPI in antimicrobial research; appraise the quality of reporting on PPI using recognized PPI reporting and critical appraisal tools; and extract and synthesize data on the impact of PPI. SEARCH STRATEGY A systematic review was undertaken with a search strategy based on four word groups (PPI, patients, antimicrobial drug development and outcomes). Eight online databases were searched. INCLUSION CRITERIA English language publication, publication between 1996 and 2016 and studies describing PPI in antimicrobial drug development research. MAIN RESULTS No studies were found through online searching that met the search strategy and inclusion criteria. One relevant protocol paper with a brief mention of PPI was identified through expert recommendation. Commentary papers recommending PPI were identified through website searching and expert opinion. DISCUSSION AND CONCLUSIONS Despite strong policy guidance encouraging PPI at the international and national levels, and anecdotal accounts of PPI taking place, evidence for the extent, quality and impact of PPI in antimicrobial drug development research has not yet appeared in the peer-reviewed literature.
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Affiliation(s)
- David Evans
- Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Emma Bird
- Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Andy Gibson
- Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Sally Grier
- Department of Infection SciencesSouthmead HospitalBristolUK
| | - Teh Li Chin
- Department of Infection SciencesSouthmead HospitalBristolUK
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Best P, Badham J, Corepal R, O’Neill RF, Tully MA, Kee F, Hunter RF. Network methods to support user involvement in qualitative data analyses: an introduction to Participatory Theme Elicitation. Trials 2017; 18:559. [PMID: 29169378 PMCID: PMC5701364 DOI: 10.1186/s13063-017-2289-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While Patient and Public Involvement (PPI) is encouraged throughout the research process, engagement is typically limited to intervention design and post-analysis stages. There are few approaches to participatory data analyses within complex health interventions. METHODS Using qualitative data from a feasibility randomised controlled trial (RCT), this proof-of-concept study tests the value of a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Forty excerpts were given to eight members of a youth advisory PPI panel to sort into piles based on their perception of related thematic content. Using algorithms to detect communities in networks, excerpts were then assigned to a thematic cluster that combined the panel members' perspectives. Network analysis techniques were also used to identify key excerpts in each grouping that were then further explored qualitatively. RESULTS While PTE analysis was, for the most part, consistent with the researcher-led analysis, young people also identified new emerging thematic content. CONCLUSIONS PTE appears promising for encouraging user led identification of themes arising from qualitative data collected during complex interventions. Further work is required to validate and extend this method. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT02455986 . Retrospectively Registered on 21 May 2015.
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Affiliation(s)
- Paul Best
- School of Social Sciences, Education and Social Work, Queen’s University, Belfast, UK
| | - Jennifer Badham
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
| | - Rekesh Corepal
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
| | - Roisin F. O’Neill
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
| | - Mark A. Tully
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
| | - Frank Kee
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
| | - Ruth F. Hunter
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, UK
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Rayment J, Lanlehin R, McCourt C, Husain SM. Involving seldom-heard groups in a PPI process to inform the design of a proposed trial on the use of probiotics to prevent preterm birth: a case study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:11. [PMID: 29062536 PMCID: PMC5611657 DOI: 10.1186/s40900-017-0061-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/05/2017] [Indexed: 06/07/2023]
Abstract
PLAIN ENGLISH SUMMARY When designing clinical trials it is important to involve members of the public, who can provide a view on what may encourage or prevent people participating and on what matters to them. This is known as Public and Patient Involvement (PPI). People from minority ethnic groups are often less likely to take part in clinical trials, but it is important to ensure they are able to participate fully so that health research and its findings are relevant to a wide population. We are preparing to conduct a randomised controlled trial (RCT) to test whether taking probiotic capsules can play a role in preventing preterm birth. Women from some minority ethnic groups, for example women from West Africa, and those who are from low-income groups are more likely to suffer preterm births. Preterm birth can lead to extra costs to health services and psychosocial costs for families. In this article we describe how we engaged women in discussion about the design of the planned trial, and how we aim to use our findings to ensure the trial is workable and beneficial to women, as well as to further engage service users in the future development of the trial. Four socially and ethnically diverse groups of women in East London took part in discussions about the trial and contributed their ideas and concerns. These discussions have helped to inform and improve the design of a small practice or 'pilot' trial to test the recruitment in a 'real life' setting, as well as encourage further PPI involvement for the future full-scale trial. ABSTRACT Background Patient and public involvement (PPI) is an important tool in approaching research challenges. However, involvement of socially and ethnically diverse populations remains limited and practitioners need effective methods of involving a broad section of the population in planning and designing research. Methods In preparation for the development of a pilot randomised controlled trial (RCT) on the use of probiotics to prevent preterm birth, we conducted a public consultation exercise in a socially disadvantaged and ethnically diverse community. The consultation aimed to meet and engage local service users in considering the acceptability of the proposed protocol, and to encourage their participation in future and ongoing patient and public involvement activities. Four discussion groups were held in the community with mothers of young children within the proposed trial region, using an inclusive approach that incorporated a modified version of the Nominal Group Technique (NGT). Bringing the consultation to the community supported the involvement of often seldom-heard participants, such as those from minority ethnic groups. Results The women involved expressed a number of concerns about the proposed protocol, including adherence to the probiotic supplement regimen and randomisation. The proposal for the RCT in itself was perceived as confirmation that probiotic supplements had potentially beneficial effects, but also that they had potentially harmful side-effects. The complexity of the women's responses provided greater insights into the challenges of even quite simple trial designs and enabled the research team to take these concerns into account while planning the pilot trial. Conclusions The use of the NGT method allowed for a consultation of a population traditionally less likely to participate in medical research. A carefully facilitated PPI exercise can allow members to express unanticipated concerns that may not have been elicited by a survey method. Findings from such exercises can be utilised to improve clinical trial design, provide insight into the feasibility of trials, and enable engagement of often excluded population groups.
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Affiliation(s)
- Juliet Rayment
- School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW UK
| | - Rosemary Lanlehin
- School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW UK
| | - Christine McCourt
- School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW UK
| | - Shahid M. Husain
- Centre for Genomics and Child Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT UK
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Pandya-Wood R, Barron DS, Elliott J. A framework for public involvement at the design stage of NHS health and social care research: time to develop ethically conscious standards. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:6. [PMID: 29062531 PMCID: PMC5611655 DOI: 10.1186/s40900-017-0058-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/30/2017] [Indexed: 05/12/2023]
Abstract
PLAIN ENGLISH SUMMARY Researchers who conduct studies in health and social care are encouraged to involve the public as early as possible in the process of designing their studies. Before their studies are allowed to start researchers must seek approval from a Research Ethics Committee, which will assess whether the study is going to be safe and ethical for patients or healthy volunteers to take part in. The process of ethical review does not consider how researchers work with patients and the public early on to design their studies. Furthermore, there is no requirement for researchers to seek ethical approval for public involvement. However, in our work advising researchers about public involvement we have found that the ways in which researchers involve the public in the design of their studies are sometimes unintentionally unethical, and this is the focus of our paper. We have observed ten areas where ethical issues may arise because of the actions researchers may or may not take and which might consequently have a negative impact. Therefore, we have used these observations to develop a "framework" to help researchers and the public work together at the early design stage in ways that are ethical. Our intention for the framework is to help researchers be mindful of these ten areas and how easily ethical issues can arise. The framework suggests some ways to overcome the potential issues in each of the ten areas. The ten areas are: 1) Allocating sufficient time for public involvement; 2) Avoiding tokenism; 3) Registering research design stage public involvement work with NHS Research & Development Trust Office at earliest opportunity; 4) Communicating clearly from the outset; 5) Entitling public contributors to stop their involvement for any unstated reasons; 6) Operating fairness of opportunity; 7) Differentiating qualitative research methods and public involvement activities; 8) Working sensitively; 9) Being conscious of confidentiality and 10) Valuing, acknowledging and rewarding public involvement. We looked to see whether any other similar approaches to helping researchers address potential ethical issues when working with the public on designing studies have been published and to our knowledge none exist. Our framework is presented as a draft and believe that it would now benefit from input from researchers and the public to gauge how useful it is and whether there are any other possible situations that it might need to cover. ABSTRACT The current paper highlights real life examples of how ethical issues can arise during public involvement activities at the research design stage. We refer to "the research design stage" as the time between the generation of the research ideas and when formal permissions to start the work including ethical approval are granted. We argue that although most researchers work ethically at this early stage, some may still benefit from being informed about ethically conscious approaches to involving the public. The paper highlights 10 ethical issues that we have observed with involving the public at the research design stage. We provide examples of these observed scenarios to illustrate the issues and make suggestions for how they can be avoided to help researchers become more ethically conscious when involving the public at the research design stage. Currently the draft framework comprises: 1) Allocating sufficient time for public involvement; 2) Avoiding tokenism; 3) Registering research design stage public involvement work with NHS Research & Development Trust Office at earliest opportunity; 4) Communicating clearly from the outset; 5) Entitling public contributors to stop their involvement for any unstated reasons; 6) Operating fairness of opportunity; 7) Differentiating qualitative research methods and public involvement activities; 8) Working sensitively; 9) Being conscious of confidentiality and 10) Valuing, acknowledging and rewarding public involvement. The draft framework will help researchers to recognise the ethical issues when involving the public and is intended to be used voluntarily in a self-regulatory way. We believe that the draft framework requires further consultation and input from the wider research community and the public before endorsement by national UK bodies such as INVOLVE and the Health Research Authority (HRA).
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Affiliation(s)
- Raksha Pandya-Wood
- Faculty of Health and Life Sciences, De Montfort University, Hawthorn Building, The Gateway, Leicester, LE1 9BH UK
| | - Duncan S. Barron
- Senior Research Fellow and Public Involvement Lead for the NIHR RDS South East, University of Brighton, Centre for Health Research, Falmer, Brighton, BN1 9PH UK
| | - Jim Elliott
- Public Involvement Lead, Health Research Authority, Ground Floor, Skipton House, 80 London Road, London, SE1 6LH UK
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Furniss D, Iacovides I, Lyons I, Blandford A, Franklin BD. Patient and public involvement in patient safety research: a workshop to review patient information, minimise psychological risk and inform research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2016; 2:19. [PMID: 29062520 PMCID: PMC5611588 DOI: 10.1186/s40900-016-0035-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/11/2016] [Indexed: 06/07/2023]
Abstract
PLAIN ENGLISH SUMMARY Patient safety is a growing research area. However, although patients and the public are increasingly involved in clinical research, there is little guidance on how best to involve patients in patient safety research. Here we focus on how patients can contribute to the design of patient safety research. We conducted a workshop with patients as part of a project exploring errors and safety in the delivery of intravenous medication (medication given via a vein). The workshop was designed to explore how best to engage with hospital inpatients about these issues, to generate research topics, and to inform researchers about patients' experiences. Nine patients participated, each of whom had previously received intravenous medication. Participants advised against using terms such as 'error'; they also advocated caution when using terms such as 'safety' when describing the study to patients as this may worry some who had not thought about these issues before. We received thorough and useful feedback on our patient information sheets to ensure they were clear and understandable to patients. Patients also shared rich experiences with us about their treatment, which emphasised the need to extend our research focus to include a wider range of factors affecting quality and safety. ABSTRACT Background Patient safety has attracted increasing attention in recent years. This paper explores patients' contributions to informing patient safety research at an early stage, within a project on intravenous infusion errors. Currently, there is little or no guidance on how best to involve patients and the wider public in shaping patient safety research, and indeed, whether such efforts are worthwhile. Method We ran a 3-hour workshop involving nine patients with experience of intravenous therapy in the hospital setting. The first part explored patients' experiences of intravenous therapy. We derived research questions from the resulting discussion through qualitative analysis. In the second part, patients were asked for feedback on patient information sheets considering both content and clarity, and on two potential approaches to framing our patient information: one that focused on research on safety and error, the other on quality improvement. Results The workshop led to a thorough review of how we should engage with patients. Importantly, there was a clear steer away from terms such as 'error' and 'safety' that could worry patients. The experiences that patients revealed were also richer than we had anticipated, revealing different conceptions of how patients related to their treatment and care, their role in safety and use of medical devices, the different levels of information they preferred, and broader factors impacting perceptions of their care. Conclusion Involving patients at an early stage in patient safety research can be of great value. Our workshop highlighted sensitivities around potentially worrying patients about risks that they might not have considered previously, and how to address these. Patient representatives also emphasised a need to expand the focus of patient safety research beyond clinicians and error, to include factors affecting perceptions of quality and safety for patients more broadly.
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Affiliation(s)
- Dominic Furniss
- UCL Interaction Centre, University College London, Gower Street, London, UK
| | - Ioanna Iacovides
- UCL Interaction Centre, University College London, Gower Street, London, UK
| | - Imogen Lyons
- UCL Interaction Centre, University College London, Gower Street, London, UK
| | - Ann Blandford
- UCL Interaction Centre, University College London, Gower Street, London, UK
| | - Bryony Dean Franklin
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
- Research Department of Practice and Policy, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, UK
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Hoddinott P, Morgan H, MacLennan G, Sewel K, Thomson G, Bauld L, Yi D, Ludbrook A, Campbell MK. Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public. BMJ Open 2014; 4:e005524. [PMID: 25037645 PMCID: PMC4120368 DOI: 10.1136/bmjopen-2014-005524] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 06/22/2014] [Accepted: 06/24/2014] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design. DESIGN Cross-sectional survey. SETTING AND PARTICIPANTS British general public. METHODS Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models. RESULTS Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%). CONCLUSIONS Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions. TRIAL REGISTRATION NUMBER CRD42012001980.
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Affiliation(s)
- Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Heather Morgan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Linda Bauld
- Health Policy and Social Marketing, University of Stirling, Stirling, UK
| | - Deokhee Yi
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Anne Ludbrook
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
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