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Genuis SK, Luth W, Magnussen C, Vande Velde C, Taylor D, Johnston WS. Patient engagement in research: lessons learned from CAPTURE ALS, a longitudinal observational ALS study. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-10. [PMID: 38519870 DOI: 10.1080/21678421.2024.2328599] [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: 12/06/2023] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
Objective: There are compelling ethical and practical reasons for patient engagement in research (PEIR), however, evidence for best practices remains limited. We investigated PEIR as implemented in CAPTURE ALS, a longitudinal observational study, from study inception through the first 2.5 years of operations. Methods: Data were drawn from three engagement initiatives: a community-led letter-writing campaign; consultation with patient and caregiver focus groups; and a study-embedded 'participant partner advisory council' (PPAC). Data were derived retrospectively from study documentation. We used the International Association of Public Participation (IAP2) participation spectrum as a framework for investigation. Results: 2401 letters from community members to the Canadian government affirmed study objectives and advocated for funding. Feedback from focus group consultation influenced study design and supported the study's data-sharing plan. PPAC collaboration shaped all aspects of the study. Contributions included: co-creation of governance documents, input on study protocols and public-facing communication, and development of engagement webinars for study participants and feedback surveys. Effective communication practices fostered collaboration and helped avoid tokenistic engagement. CAPTURE ALS encompassed all IAP2 participation levels. Conclusions: CAPTURE ALS was shaped by meaningful engagement initiatives over the course of the study. Lessons learned included: begin early and embed PEIR within research; build relationships and foster mutual learning; be flexible, open to adaptation, and seek diversity. Primary challenges included funding for early implementation, time needed to maintain relationships, and attrition due to disease progression. All IAP2 participation levels contributed to meaningful PEIR. 'Empowerment' was demonstrated through advocacy.
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Affiliation(s)
- Shelagh K Genuis
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Westerly Luth
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Claire Magnussen
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
| | | | | | - Wendy S Johnston
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Kjellström S, Sarre S, Masterson D. The complexity of leadership in coproduction practices: a guiding framework based on a systematic literature review. BMC Health Serv Res 2024; 24:219. [PMID: 38368329 PMCID: PMC10873973 DOI: 10.1186/s12913-024-10549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/03/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND As coproduction in public services increases, understanding the role of leadership in this context is essential to the tasks of establishing relational partnerships and addressing power differentials among groups. The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices. METHODS A systematic review that synthesizes the evidence reported by 73 papers related to coproduction of health and welfare. RESULTS Despite the fact that models of coleadership and collective leadership exhibit a better fit with the relational character of coproduction, the majority of the articles included in this review employed a leader-centric underlying theory. The practice of coproduction leadership is a complex activity pertaining to interactions among people, encompassing nine essential practices: initiating, power-sharing, training, supporting, establishing trust, communicating, networking, orchestration, and implementation. CONCLUSIONS This paper proposes a novel framework for coproduction leadership practices based on a systematic review of the literature and a set of reflective questions. This framework aims to help coproduction leaders and participants understand the complexity, diversity, and flexibility of coproduction leadership and to challenge and enhance their capacity to collaborate effectively.
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Affiliation(s)
- Sofia Kjellström
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Barnarpsgatan 39, Jönköping, Sweden.
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Daniel Masterson
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Barnarpsgatan 39, Jönköping, Sweden
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Blackburn S, Clinch M, de Wit M, Moser A, Primdahl J, van Vliet E, Walker C, Stevenson F. Series: Public engagement with research. Part 1: The fundamentals of public engagement with research. Eur J Gen Pract 2023; 29:2232111. [PMID: 37578421 PMCID: PMC10431741 DOI: 10.1080/13814788.2023.2232111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND In the first of a four-part series, we describe the fundamentals of public engagement in primary care research. OBJECTIVES The article's purpose is to encourage, inform and improve the researcher's awareness about public engagement in research. For a growing number of researchers, funders and patient organisations in Europe, public engagement is a moral and ethical imperative for conducting high-quality research. DISCUSSION Starting with an explanation of the role of public engagement in research, we highlight its diversity and benefits to research, researchers and the public members involved. We summarise principles of good practice and provide valuable resources for researchers to use in their public engagement activities. Finally, we discuss some of the issues encountered when researchers collaborate with members of the public and provide practical steps to address them. Case studies of real-life situations are used to illustrate and aid understanding. CONCLUSION We hope this article and the other papers in this series will encourage researchers to better consider the role and practice of public engagement and the potential added value to research that collaborating with the public could provide.
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Affiliation(s)
- Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Megan Clinch
- Centre for Public Health & Policy, Queen Mary University of London, London, UK
| | - Maarten de Wit
- Patient Research Partner Stichting Tools, Amsterdam, the Netherlands
| | - Albine Moser
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, the Netherlands
| | - Christine Walker
- Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Fiona Stevenson
- Primary Care and Population Health, University College London, London, UK
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Engelmann P, Eilerskov N, Thilsing T, Bernardini F, Rasmussen S, Löwe B, Herrmann-Lingen C, Gostoli S, Andréasson F, Rafanelli C, Pedersen SS, Jaarsma T, Kohlmann S. Needs of multimorbid heart failure patients and their carers: a qualitative interview study and the creation of personas as a basis for a blended collaborative care intervention. Front Cardiovasc Med 2023; 10:1186390. [PMID: 38028443 PMCID: PMC10667702 DOI: 10.3389/fcvm.2023.1186390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Involving patients and carers in the development of blended collaborative care (BCC) interventions for multimorbid heart failure (HF) patients is recommended but rarely practised, and research on the patient perspective is scarce. The aim of this study is to investigate patients' and carers' care-related needs and preferences to better customize a novel international BCC intervention. Methods A qualitative study design using framework analysis was employed. The study was performed in accordance with the EQUATOR standards for reporting qualitative research (SRQR). Patients aged at least 65 years with HF and at least two other physical diseases as well as their carers completed semistructured interviews in Germany, Italy, and Denmark. Based on these interviews, personas (prototype profiles of patients and carers) were created. Results Data from interviews with 25 patients and 17 carers were analysed. Initially, seven country-specific personas were identified, which were iteratively narrowed down to a final set of 3 personas: (a) the one who needs and wants support, (b) the one who has accepted their situation with HF and reaches out when necessary, and (c) the one who feels neglected by the health care system. Carers identifying with the last persona showed high levels of psychological stress and a high need for support. Discussion This is the first international qualitative study on patients' and carers' needs regarding a BCC intervention using the creation of personas. Across three European countries, data from interviews were used to develop three contrasting personas. Instead of providing "one size fits all" interventions, the results indicate that BCC interventions should offer different approaches based on the needs of individual patients and carers. The personas will serve as a basis for the development of a novel BCC intervention as part of the EU project ESCAPE (Evaluation of a patient-centred biopSychosocial blended collaborative CAre Pathway for the treatment of multimorbid Elderly patients).
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Affiliation(s)
- Petra Engelmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natasja Eilerskov
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Trine Thilsing
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Francesco Bernardini
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Sanne Rasmussen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sara Gostoli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Frida Andréasson
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Susanne S. Pedersen
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gonzato O, Schuster K. The role of patient advocates and sarcoma community initiatives in musculoskeletal oncology. Moving towards Evidence-Based Advocacy to empower Evidence-Based Medicine. J Cancer Policy 2023; 36:100413. [PMID: 36806641 DOI: 10.1016/j.jcpo.2023.100413] [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: 07/20/2022] [Revised: 01/29/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Musculoskeletal sarcomas are rare cancers that as the whole family of sarcomas pose several challenges at different levels, ranging from medical knowledge to clinical research and policymaking. Addressing these challenges, necessarily calls for the inclusion of patient perspective inside the decision-making processes of every area that contributes to treatment improvement, from the provision of high-quality services by healthcare organisations to research issues. Without patient-provided inputs to inform decisions, the current paradigm of patient-centred care makes no sense and sounds at the least irrational if not unethical. Putting PROMs on "centre stage" in cancer research and care, could allow to build a truly Evidence Based Advocacy (EBA) and therefore to empower Evidence Based Medicine (EBM).
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Affiliation(s)
- Ornella Gonzato
- Fondazione Paola Gonzato-Rete Sarcoma ETS, Italy; Sarcoma Patient Advocacy Global Network (SPAGN), Germany.
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Mascher A, Pelzer F, Duncan LJ, Martin DD, Baumgartner S, Berger B. The Introspective Patient Experience of Mistletoe Therapy in Cancer: A Qualitative Study. Integr Cancer Ther 2023; 22:15347354231198474. [PMID: 37731253 PMCID: PMC10515602 DOI: 10.1177/15347354231198474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The introspective experience of cancer patients using mistletoe therapy has received little scientific interest, although it is crucial for a holistic understanding of this therapy. This study contributes to patient-centered research and treatment by documenting the subjective experiences of individuals undergoing mistletoe therapy. METHODS In this qualitative, explorative study, 20 outpatients with a history of various cancer types were recruited from Arlesheim Hospital (Arlesheim, Switzerland). All patients received subcutaneous mistletoe therapy for at least 2 years (median 7.5 years). Data was collected through 2 semi-structured, in-depth interviews per patient. Qualitative content analysis was applied to examine the data. The individual experience of mistletoe therapy was analyzed in relation to 6 predefined levels of human experience: physical, vital, emotional, mental, spiritual and social. In addition, 3 further aspects, considered as cross-dimensional perspectives, emerged out of the material: warmth, immune strengthening, and general wellbeing. RESULTS Data analysis revealed considerable heterogeneity among patients' experiences with mistletoe therapy. The importance of specific aspects became apparent, such as increased vitality to manage daily life, greater emotional and mental stability, warmth as a multidimensional phenomenon, feelings of safety and protection through mistletoe therapy, heightened self-awareness and improved self-care, as well as sensations of spiritual connectedness. CONCLUSIONS Prior to this study it had not been shown that cancer patients using mistletoe therapy do have observations on different levels of experience. These results may lead to a deeper understanding of patients receiving mistletoe therapy, enabling them to be supported in a more holistic way both during mistletoe treatment and on their life path. Further investigations into the effects of mistletoe therapy on the emotional, mental, and spiritual level are warranted.
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Affiliation(s)
- Annika Mascher
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
- Klinik Arlesheim, Arlesheim, Switzerland
| | - Florian Pelzer
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
| | | | | | - Stephan Baumgartner
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
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Lewis D, Salmi L, Staley A, Harlow J. From Individuals to Systems and Contributions to Creations: Novel Framework for Mapping the Efforts of Individuals by Convening The Center of Health and Health Care. J Particip Med 2022; 14:e39339. [DOI: 10.2196/39339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background
People with lived health care experiences (often referred to as “patients”) are increasingly contributing to health care and are most effective when they are involved as partners who can contribute complementary knowledge alongside other stakeholders in health care.
Objective
Convening The Center aimed to bring together “people known as patients”—the center of health care—to address priorities as they defined them.
Methods
According to the original project design, an in-person gathering was to be conducted; however, as a result of the COVID-19 pandemic, the in-person gathering was transformed into a series of digital gatherings, including an in-depth interview phase, small-group gatherings, and a collective convening of 25 participants (22 women and 3 men from the United States, India, Costa Rica, Sweden, and Pakistan). Each participant was interviewed on Zoom (Zoom Video Communications Inc), and the interview data were thematically analyzed to design a subsequent small group and then full cohort Zoom sessions. Visual note-taking was used to reinforce a shared understanding of each individual- and group-level conversation.
Results
The interviews and gatherings for Convening The Center offered unique perspectives on patient activities in research, health innovation, and problem-solving. This project further developed a novel, two-spectrum framework for assessing different experiences that patients may have or seek to gain, based on what patients actually do, and different levels of patients’ involvement, ranging from individual to community to systemic involvement.
Conclusions
The descriptors of patients in academic literature typically focus on what health care providers think patients “are” rather than on what patients “do.” The primary result of this project is a framework for mapping what patients “do” and “where” they do their work along two spectra: from creating their own projects to contributing to work initiated by others and from working at levels ranging from individual to community to systems. A better understanding of these spectra may enable researchers to more effectively engage and leverage patient expertise in health care research and innovation.
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Charalambous M, Kountouri A, Phylactou P, Triantafyllidou I, Annoni JM, Kambanaros M. The views of people living with chronic stroke and aphasia on their potential involvement as research partners: a thematic analysis. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:48. [PMID: 36064623 PMCID: PMC9446531 DOI: 10.1186/s40900-022-00379-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Patient and Public Involvement (PPI) is the active partnership between researchers, patients and laypeople in the process of creating research. PPI in stroke aphasia research aims to ensure equal opportunities for informed decision-making and guarantee democratic representation of patient partners within the research team. Yet, little is known about the factors that hinder and/or promote the autonomous involvement of people with aphasia in stroke and aphasia PPI projects. This study aimed to explore the views and perspectives of people who live with chronic stroke, with and without aphasia, with experience in research prior to stroke, on their potential involvement as research partners. METHODS The research team included a PPI partner with chronic stroke-induced aphasia. Semi-structured interviews were conducted online with people with chronic stroke (n = 8), four with aphasia and four without. Interviews were subject to thematic analysis. RESULTS Inductive thematic analysis generated four themes: (1) the kinds of Restrictions that make involvement in research difficult, (2) the preferred levels and ways of Involvement during the research process, (3) the Support required for active and collaborative involvement, and (4) the Impact of their involvement and how it benefits the study's outcomes. CONCLUSION People experiencing chronic stroke and aphasia are willing to be involved as PPI partners if the research team provides the necessary support. Recommendations for researchers to consider before commencing co-produced research with people with stroke and aphasia are provided.
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Affiliation(s)
- Marina Charalambous
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Alexia Kountouri
- Solidarity Network Nicosia In Action” (NicInAct), Multifunctional Foundation, Nicosia Municipality, Eptanisou 11, 1016 Nicosia, Cyprus
| | - Phivos Phylactou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Ioanna Triantafyllidou
- Department of Rehabilitation Sciences, Cyprus University of Technology, 30 Arch. Kyprianos Str. 3036, Limassol, Cyprus
| | - Jean-Marie Annoni
- Laboratory of Cognitive and Neurological Sciences, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée 8, 1700 Fribourg, Switzerland
| | - Maria Kambanaros
- Allied Health and Human Performance, University of South Australia, Adelaide, SA Australia
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The ‘Rippling’ Waves of Wellbeing: A Mixed Methods Evaluation of a Surf-Therapy Intervention on Patients with Acquired Brain Injury. SUSTAINABILITY 2022. [DOI: 10.3390/su14159605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dominant psychological models of wellbeing neglect the role that nature connection and other key factors, such as positive health behaviours and behaviour change, play in determining wellbeing. The present mixed-methods evaluation explores the impact of ”Surf-Ability”, an adapted surf therapy intervention delivered in collaboration with a UK neurorehabilitation service, on individuals with acquired brain injury (ABI) as part of an effort to design interventions based on advances in wellbeing science. Following five surf-therapy sessions, within-subjects analysis (n= 15) revealed significant improvements on the Warwick–Edinburgh mental wellbeing scale (t (15) = −2.164, p = 0.048), as well as in anxiety and happiness as measured via a brief visual analogue. No significant changes occurred in the Hospital Anxiety and Depression Scale (HADS) or resting heart rate variability (HRV). A ripple effects mapping (REM) session at 6–10 months follow-up (n = 6) revealed that the physical and psychological experience of a nature-based challenge initiated a mindset shift in participants, which ultimately led to them adopting wellbeing-promoting long-term behaviour changes. These changes occurred at the scale of (1) individual wellbeing—increased mindfulness and physical activity; (2) collective wellbeing—improved relationships, community participation and contribution to organisations; and (3) planetary wellbeing—connection to nature. These findings align with the GENIAL theoretical framework, which defines wellbeing from a biopsychosocial ecological perspective across multiple levels of scale. The findings support the need for healthcare providers—including neurorehabilitation services—to enhance interventions for patients by incorporating novel factors that improve wellbeing, such as nature-connection.
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Snowball E, Fernandez Loughlin R, Eagleson H, Barnett KM, McLellan E, O'Connor D, Kelly C, Thelker C, McGilton KS, Bethell J. Engagement of people with lived experience of dementia advisory group and cross-cutting program: reflections on the first year. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:28. [PMID: 35752841 PMCID: PMC9233803 DOI: 10.1186/s40900-022-00359-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The objective of this paper is to describe the activities, challenges and mitigation strategies, lessons learned and reflections on the importance of engagement from the first year of the Canadian Consortium on Neurodegeneration in Aging (CCNA) Engagement of People with Lived Experience of Dementia (EPLED) Advisory Group and cross-cutting program. EPLED was created to support persons with dementia and care partners to be actively involved in the CCNA research process. MAIN BODY The Advisory Group was formed to work with CCNA researchers and programs to develop new ways to further collaborate and advance the methods of patient engagement in research on dementia. A role profile and recruitment poster were developed and, after interviews, 17 people were invited to join the Advisory Group. We planned three online EPLED meetings to take place between July-August of 2020, with one in-person meeting to be held in Canada. Due to COVID-19, we moved all of these meetings online. In the first year, EPLED and the Advisory Group met seven times formally, four times informally, developed a website, engaged with CCNA research projects, participated in CCNA "Central" activities and formulated an evaluation plan. For researchers and people with lived experience of dementia, motivations for patient engagement included challenging stigma, making meaning from their experience (such as building relationships and having their voices heard) and contributing to research. Common challenges to engagement were related to navigating the impact of COVID-19, such as difficulty in getting to know each other and technical issues with video-conference software. We learned that developing trusting relationships, providing education, offering support, being flexible and acknowledging tensions between research, practice and lived experience, were vital to the success of the Advisory Group. CONCLUSION The first year of the EPLED Advisory Group demonstrated the potential contributions of people with lived experience of dementia as partners in research. Building these collaborations with individuals and communities-people living with dementia, care partners, researchers and research institutions-has the potential for positive impact across these groups and, ultimately, improve the lives of people living with dementia and their care partners.
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Affiliation(s)
- Ellen Snowball
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada.
| | - Rosette Fernandez Loughlin
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Heather Eagleson
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Karen Myers Barnett
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Emily McLellan
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Denis O'Connor
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Catherine Kelly
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Christine Thelker
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
| | - Katherine S McGilton
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
- Engagement of People with Lived Experience of Dementia Advisory Group and Cross-Cutting Program, Canadian Consortium on Neurodegeneration in Aging, Montreal, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
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Tong A, Scholes-Robertson N, Hawley C, Viecelli AK, Carter SA, Levin A, Hemmelgarn BR, Harris T, Craig JC. Patient-centred clinical trial design. Nat Rev Nephrol 2022; 18:514-523. [PMID: 35668231 DOI: 10.1038/s41581-022-00585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/09/2022]
Abstract
Patient involvement in clinical trial design can facilitate the recruitment and retention of participants as well as potentially increase the uptake of the tested intervention and the impact of the findings on patient outcomes. Despite these benefits, patients still have very limited involvement in designing and conducting trials in nephrology. Many trials do not address research questions and outcomes that are important to patients, including patient-reported outcomes that reflect how patients feel and function. This limitation can undermine the relevance, reliability and value of trial-based evidence for decision-making in clinical practice and health policy. However, efforts to involve patients with kidney disease are increasing across all stages of the trial process from priority setting, to study design (including selection of outcomes and approaches to improve participant recruitment and retention) and dissemination and implementation of the findings. Harnessing the patient voice in designing trials can ensure that efforts and resources are directed towards patient-centred trials that address the needs, concerns and priorities of patients living with kidney disease with the aim of achieving transformative improvements in care and outcomes.
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Affiliation(s)
- Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. .,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Carmel Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia
| | - Simon A Carter
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Adeera Levin
- Division of Nephrology, University of British Columbia, Vancouver, BC, Canada
| | - Brenda R Hemmelgarn
- Faculty of Medicine and Dentistry at University of Alberta, Edmonton, AB, Canada
| | | | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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McKenzie A, Bowden J, Zalcberg JR, Conroy K, Fallon-Ferguson J, Jesudason S, Ansell J, Anderst A, Straiton N. A snapshot of consumer engagement in clinical trials in Australia: results of a national survey of clinical trial networks and research organisations. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:3. [PMID: 35123586 PMCID: PMC8817464 DOI: 10.1186/s40900-022-00338-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/20/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Little is known about the extent, perceptions or experiences of consumers involved in clinical trials across Australia. The purpose of this National study was to better understand the activity and perceptions of clinical trial networks (CTNs), research co-ordinating centres and their consumers, around consumer involvement in clinical trials. METHODS CTNs and research co-ordinating centres who were members of the Australian Clinical Trials Alliance (ACTA), and consumers involved in the activities of these organisations, were invited to participate in online surveys. Surveys were completed between April and September 2018. RESULTS 80 respondents completed the surveys in full: 25 of 34 CTNs, 5 from 15 research co-ordinating centres, and included research investigators of 13 active trials, 10 completed trials. There were 27 consumer respondents. Consumers were involved in clinical trial activities across 19/25 (76%) of CTNs and 3/5 (60%) of research co-ordinating centres. Consumers were involved at all stages of the trial cycle. Despite this, only 8/30 (27%) of research organisations provided specific training to their employees or members on consumer involvement in research, and most did not have a specific policy or process relating to conducting consumer involvement in clinical trials. At the organisation level, barriers to consumer involvement in clinical trials included being unsure how to involve consumers effectively and systematically, difficulty in accessing consumers or lack of infrastructure and resources. At the consumer level, barriers included limited understanding of their roles, a lack of resources and training. Enablers included education, training and funding for both the research sector and for consumers. Almost all consumer respondents (25/27; 92%) would recommend the consumer role to other potential consumers, stating it was a valuable experience that led to knowledge exchange and learning about the research process. CONCLUSIONS Over the last few years, consumer involvement in clinical trials has increased in Australia, but the scope of involvement varies across different research organisations, and therapeutic areas. Consumer involvement in clinical trials is valued by most that do it, however, there are opportunities to further foster and strengthen ongoing partnerships, for example by providing practical advice for researchers on how to best engage and involve consumers.
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Affiliation(s)
- Anne McKenzie
- Consumer Engagement, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, 6009, Australia
| | | | - John R Zalcberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, 3004, Australia
| | - Karena Conroy
- Consumer & Community Involvement Program, The George Institute for Global Health, Newtown, NSW, 2042, Australia
- Sydney Research, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Julia Fallon-Ferguson
- School of Population Health, Curtin University, Perth, WA, 6845, Australia
- Australian and New Zealand Alliance for Cardiovascular Trials, Perth, WA, 6845, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service, Adelaide, SA, 5000, Australia
- Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, 5000, Australia
| | - James Ansell
- Consumers Health Forum of Australia, Deakin, ACT, 2600, Australia
| | - Ania Anderst
- The George Institute for Global Health, Newton, NSW, 2042, Australia
| | - Nicola Straiton
- Australian Clinical Trials Alliance, Melbourne, VIC, 3205, Australia.
- University of Sydney, Sydney, NSW, 2006, Australia.
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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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Nguyen VT, Ravaud P, Tran VT, Young B, Boutron I. Patients' Perspectives on Transforming Clinical Trial Participation: Large Online Vignette-based Survey. J Med Internet Res 2022; 24:e29691. [PMID: 35103603 PMCID: PMC8848233 DOI: 10.2196/29691] [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: 04/16/2021] [Revised: 06/04/2021] [Accepted: 11/21/2021] [Indexed: 12/01/2022] Open
Abstract
Background Patients’ participation is crucial to the success of randomized controlled trials (RCTs). However, recruiting and retaining patients in trials remain a challenge. Objective This study aims to describe patients’ preferences for the organization of RCTs (visits on- site or remotely) and evaluate the potential impact of fulfilling preferences on their willingness to participate in a clinical trial. Methods This was a vignette-based survey. Vignettes were case scenarios of real clinical trials assessing pharmacological treatments. These RCTs evaluated 6 prevalent chronic diseases (ie, osteoporosis, osteoarthritis, asthma, cardiovascular diseases, diabetes, and endometriosis). Each vignette described (1) the RCT and characteristics of the treatment tested (ie, doses, administration routes) and (2) the trial procedures and different options (on-site or remotely) for how the trial was organized for informed consent, follow-up visits, and communication of results when the trial was completed. We recruited 628 participants from ComPaRe (www.compare.aphp.fr), a French e-cohort of patients with chronic diseases. The outcomes were the participants’ preferences for the way the trial was organized (on-site or remotely) and their willingness to participate in the trial. Results Of the 628 participants who answered the vignettes, 491 (78.2%) were female (median age 55 years), with different chronic diseases ranging from endometriosis in 59 of 491 (12%) patients to asthma in 133 of 628 (21.2%) patients. In addition, 38 (6.1%) participants wanted to provide informed consent and all trial visits on-site, 176 (28%) wished to participate in the trial entirely remotely, and 414 (65.9%) wanted to combine remote-based and hospital-based visits. Considering the trial as a whole, when the trial was organized in a way that the patients preferred, the median (Q1-Q3) likelihood of participation in the trial was 90% (80-100) versus 60% (30-80) if the trial followed the patients’ nonpreferred model. Furthermore, 256 (40.8%) patients responded to open-ended questions expressing their experience with trial participation and visits to the hospital and providing suggestions for improvement. The patients emphasized the need to personalize the way a trial is organized according to each patient’s needs and conditions. Conclusions There was a significant diversity in the participants’ preferences. Most participants preferred hybrid organization involving both on-site and remote visits. Participants were more likely to participate in a trial organized according to their preferences.
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Affiliation(s)
- Van Thu Nguyen
- Université de Paris, Centre of Research Epidemiology and Statistics, Inserm, Paris, France.,Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Philippe Ravaud
- Université de Paris, Centre of Research Epidemiology and Statistics, Inserm, Paris, France.,Cochrane France, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Viet Thi Tran
- Université de Paris, Centre of Research Epidemiology and Statistics, Inserm, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Bridget Young
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics, Inserm, Paris, France.,Cochrane France, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
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15
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Yun S, Takashima R, Yoshida K, Sawamura D, Inoue T, Sakai S. Differences of expected intervention effects between participant-led and facilitator-led preventive care services in Japan. Hong Kong J Occup Ther 2022; 34:83-93. [PMID: 34987346 PMCID: PMC8721582 DOI: 10.1177/15691861211022986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the effect of different management methods on the effectiveness of care preventive programmes for community-dwelling older adults. Methods This study comprised two facilitator-led (FL) and one participant-led (PL) preventive care classes in Japan. All participants received the intervention for approximately 12 weeks. Functional assessments, occupational dysfunctions, and subjective health were measured before and after the interventions. A two-way mixed design analysis of covariance (ANCOVA) was adopted to examine the effect of the interventions, adjusted for previous experiences with preventive care services. The level of significance was set at P < 0.05. Results Fourteen participants in the PL group (76.64 ± 6.48 years, 92.9% women) and 29 participants in the FL group (76.55 ± 5.75 years, 75.9% women) were included in the statistical analysis. ANCOVA showed significant group × time interaction effects in the Five Times Sit-to-Stand Test (FTSST), the Timed Up & Go (TUG), occupational deprivation of the Classification and Assessment of Occupational Dysfunction Scale, and self-rated health. Simple main effect tests showed that the TUG decreased significantly in the PL group, while occupational deprivation and self-rated health scores improved significantly. In contrast, FTSST scores significantly improved in the FL group. Conclusion PL-type management may be more appropriate for preventing social isolation and withdrawal, while FL-type management may be more appropriate for preventing physical frailty. Selecting not only adequate programmes but also an appropriate management type that matches the service purpose can help provide more effective care preventive services.
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Affiliation(s)
- Shan Yun
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Risa Takashima
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kazuki Yoshida
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Daisuke Sawamura
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takao Inoue
- Department of Rehabilitation, Osaka Kawasaki Rehabilitation University
| | - Shinya Sakai
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
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16
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Aguayo GA, Goetzinger C, Scibilia R, Fischer A, Seuring T, Tran VT, Ravaud P, Bereczky T, Huiart L, Fagherazzi G. Methods to Generate Innovative Research Ideas and Improve Patient and Public Involvement in Modern Epidemiological Research: Review, Patient Viewpoint, and Guidelines for Implementation of a Digital Cohort Study. J Med Internet Res 2021; 23:e25743. [PMID: 34941554 PMCID: PMC8738987 DOI: 10.2196/25743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/16/2021] [Accepted: 10/08/2021] [Indexed: 01/20/2023] Open
Abstract
Background Patient and public involvement (PPI) in research aims to increase the quality and relevance of research by incorporating the perspective of those ultimately affected by the research. Despite these potential benefits, PPI is rarely included in epidemiology protocols. Objective The aim of this study is to provide an overview of methods used for PPI and offer practical recommendations for its efficient implementation in epidemiological research. Methods We conducted a review on PPI methods. We mirrored it with a patient advocate’s viewpoint about PPI. We then identified key steps to optimize PPI in epidemiological research based on our review and the viewpoint of the patient advocate, taking into account the identification of barriers to, and facilitators of, PPI. From these, we provided practical recommendations to launch a patient-centered cohort study. We used the implementation of a new digital cohort study as an exemplary use case. Results We analyzed data from 97 studies, of which 58 (60%) were performed in the United Kingdom. The most common methods were workshops (47/97, 48%); surveys (33/97, 34%); meetings, events, or conferences (28/97, 29%); focus groups (25/97, 26%); interviews (23/97, 24%); consensus techniques (8/97, 8%); James Lind Alliance consensus technique (7/97, 7%); social media analysis (6/97, 6%); and experience-based co-design (3/97, 3%). The viewpoint of a patient advocate showed a strong interest in participating in research. The most usual PPI modalities were research ideas (60/97, 62%), co-design (42/97, 43%), defining priorities (31/97, 32%), and participation in data analysis (25/97, 26%). We identified 9 general recommendations and 32 key PPI-related steps that can serve as guidelines to increase the relevance of epidemiological studies. Conclusions PPI is a project within a project that contributes to improving knowledge and increasing the relevance of research. PPI methods are mainly used for idea generation. On the basis of our review and case study, we recommend that PPI be included at an early stage and throughout the research cycle and that methods be combined for generation of new ideas. For e-cohorts, the use of digital tools is essential to scale up PPI. We encourage investigators to rely on our practical recommendations to extend PPI in future epidemiological studies.
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Affiliation(s)
- Gloria A Aguayo
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Catherine Goetzinger
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Renza Scibilia
- Diabetes Australia, Melbourne, Australia.,Diabetogenic, Melbourne, Australia
| | - Aurélie Fischer
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Till Seuring
- Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Viet-Thi Tran
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tamás Bereczky
- European Patients' Academy on Therapeutic Innovation, Brussels, Belgium
| | - Laetitia Huiart
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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Walsh J, Cave J, Griffiths F. Spontaneously Generated Online Patient Experience of Modafinil: A Qualitative and NLP Analysis. Front Digit Health 2021; 3:598431. [PMID: 34713085 PMCID: PMC8521895 DOI: 10.3389/fdgth.2021.598431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: To compare the findings from a qualitative and a natural language processing (NLP) based analysis of online patient experience posts on patient experience of the effectiveness and impact of the drug Modafinil. Methods: Posts (n = 260) from 5 online social media platforms where posts were publicly available formed the dataset/corpus. Three platforms asked posters to give a numerical rating of Modafinil. Thematic analysis: data was coded and themes generated. Data were categorized into PreModafinil, Acquisition, Dosage, and PostModafinil and compared to identify each poster's own view of whether taking Modafinil was linked to an identifiable outcome. We classified this as positive, mixed, negative, or neutral and compared this with numerical ratings. NLP: Corpus text was speech tagged and keywords and key terms extracted. We identified the following entities: drug names, condition names, symptoms, actions, and side-effects. We searched for simple relationships, collocations, and co-occurrences of entities. To identify causal text, we split the corpus into PreModafinil and PostModafinil and used n-gram analysis. To evaluate sentiment, we calculated the polarity of each post between −1 (negative) and +1 (positive). NLP results were mapped to qualitative results. Results: Posters had used Modafinil for 33 different primary conditions. Eight themes were identified: the reason for taking (condition or symptom), impact of symptoms, acquisition, dosage, side effects, other interventions tried or compared to, effectiveness of Modafinil, and quality of life outcomes. Posters reported perceived effectiveness as follows: 68% positive, 12% mixed, 18% negative. Our classification was consistent with poster ratings. Of the most frequent 100 keywords/keyterms identified by term extraction 88/100 keywords and 84/100 keyterms mapped directly to the eight themes. Seven keyterms indicated negation and temporal states. Sentiment was as follows 72% positive sentiment 4% neutral 24% negative. Matching of sentiment between the qualitative and NLP methods was accurate in 64.2% of posts. If we allow for one category difference matching was accurate in 85% of posts. Conclusions: User generated patient experience is a rich resource for evaluating real world effectiveness, understanding patient perspectives, and identifying research gaps. Both methods successfully identified the entities and topics contained in the posts. In contrast to current evidence, posters with a wide range of other conditions found Modafinil effective. Perceived causality and effectiveness were identified by both methods demonstrating the potential to augment existing knowledge.
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Affiliation(s)
- Julia Walsh
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jonathan Cave
- Department of Economics, University of Warwick, Coventry, United Kingdom
| | - Frances Griffiths
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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18
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Roberts A. From artmaking to changemaking: Conceptualizing the PATCH (Palliative care patient-led change) programme. PROGRESS IN PALLIATIVE CARE 2021. [DOI: 10.1080/09699260.2021.1962669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Owyang D, Bakhsh A, Brewer D, Boughton OR, Cobb JP. Patient and Public Involvement Within Orthopaedic Research: A Systematic Review. J Bone Joint Surg Am 2021; 103:e51. [PMID: 34228669 DOI: 10.2106/jbjs.20.01573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND We performed a systematic review of patient and public involvement in randomized controlled trials (RCTs) in the field of orthopaedic surgery. We assessed the prevalence, extent, and quality of patient and public involvement (PPI) in current academic orthopaedic practice. METHODS A literature search of the Cochrane, MEDLINE, and Embase databases was performed; we identified RCTs that were published between 2013 and 2020 in the 10 orthopaedic surgery journals with the highest impact factors. Inclusion of studies was based on set criteria, and they were analyzed for their validity. The results were assessed for the rate and the quality of PPI reporting. The Wright and Foster guidelines and the GRIPP2-SF (Guidance for Reporting Involvement of Patients and the Public-2 short form) checklist were used to assess PPI reporting. This review was reported in line with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. RESULTS An initial 2,107 results were identified. After the screening process, 475 full-text articles were identified and reviewed. Two papers that described PPI were included in this review. One paper used PPI to inform the research question, the choice of primary outcome, the oversight of the study schedule, and the dissemination of the results. The second article used PPI to design the study protocol. Both articles poorly reported the impact of PPI on the research. CONCLUSIONS To our knowledge, this systematic review is the first to describe the prevalence, extent, and quality of PPI reporting in orthopaedic RCTs. Barriers to adequate PPI reporting are multifactorial and stem from a lack of systematic uptake of PPI guidelines and a lack of compulsory PPI reporting from publishing bodies. CLINICAL RELEVANCE PPI can improve the quality of clinical trials by focusing on the clinical questions and outcomes that are most important to patients. This article assesses the prevalence of PPI reporting in orthopaedic RCTs.
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Affiliation(s)
- Dean Owyang
- Patient and Public Involvement Group, The MSk Lab (D.B.), Department of Surgery and Cancer (D.O., A.B., O.R.B., and J.P.C.), Faculty of Medicine, Imperial College London, United Kingdom
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20
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Neubauer NA, Liu L. Dissemination and implementation of strategy adoption guidelines for persons with dementia at risk of getting lost. Aging Ment Health 2021; 25:528-534. [PMID: 31830801 DOI: 10.1080/13607863.2019.1699017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To address risks associated with critical dementia-related wandering, three guidelines were developed for use by persons living with dementia, their care partners, and professional staff, to choose wander-management strategies. This evidence-based research incorporates knowledge mobilization approaches that directly involve the three types of stakeholders in using the guidelines in the real world. The purpose of this project was to evaluate the knowledge translation of three guidelines on wander-management strategies, and to further deploy these guidelines to organizations across Canada. METHODS Steering committees across Canada were established for consultation. Guidelines were then shared among these organizations via Google slides. Health professionals, caregivers, community organizations and persons living with dementia completed an online survey (via Google) or paper-based survey to provide feedback on the guidelines. The guidelines were then translated from English to French using a forward-translation method. RESULTS The guidelines were adopted across ten organizations in four Canadian provinces. Adoption included introduction and formal training to staff. It took 22 months from the development of the guidelines to the dissemination and launch of the guidelines to the organizations. Participants (n = 73) were very satisfied with the developed guidelines and agreed they were easy to navigate, easy to understand, and the information provided was useful. CONCLUSIONS A stakeholder-driven approach used for guideline development and dissemination were successful methods for minimizing the time for this work to become practice. This in addition to the use of online platforms can replace conventional methods which take longer and become quickly outdated.
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Affiliation(s)
- N A Neubauer
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - L Liu
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, Canada.,Faculty of Applied Health Sciences, School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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21
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Assessing the engagement of children and families in selecting patient-reported outcomes (PROs) and developing their measures: a systematic review. Qual Life Res 2020; 30:983-995. [DOI: 10.1007/s11136-020-02690-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/14/2023]
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Grayson S, Doerr M, Yu JH. Developing pathways for community-led research with big data: a content analysis of stakeholder interviews. Health Res Policy Syst 2020; 18:76. [PMID: 32641140 PMCID: PMC7346420 DOI: 10.1186/s12961-020-00589-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/14/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Big data (BD) informs nearly every aspect of our lives and, in health research, is the foundation for basic discovery and its tailored translation into healthcare. Yet, as new data resources and citizen/patient-led science movements offer sites of innovation, segments of the population with the lowest health status are least likely to engage in BD research either as intentional data contributors or as 'citizen/community scientists'. Progress is being made to include a more diverse spectrum of research participants in datasets and to encourage inclusive and collaborative engagement in research through community-based participatory research approaches, citizen/patient-led research pilots and incremental research policy changes. However, additional evidence-based policies are needed at the organisational, community and national levels to strengthen capacity-building and widespread adoption of these approaches to ensure that the translation of research is effectively used to improve health and health equity. The aims of this study are to capture uses of BD ('use cases') from the perspectives of community leaders and to identify needs and barriers for enabling community-led BD science. METHODS We conducted a qualitative content analysis of semi-structured key informant interviews with 16 community leaders. RESULTS Based on our analysis findings, we developed a BD Engagement Model illustrating the pathways and various forces for and against community engagement in BD research. CONCLUSIONS The goal of our Model is to promote concrete, transparent dialogue between communities and researchers about barriers and facilitators of authentic community-engaged BD research. Findings from this study will inform the subsequent phases of a multi-phased project with the ultimate aims of organising fundable frameworks and identifying policy options to support BD projects within community settings.
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Affiliation(s)
- Shira Grayson
- Sage Bionetworks, 2901 Third Avenue, Seattle, WA, 98121, United States of America
- Institute for Public Health Genetics, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, United States of America
| | - Megan Doerr
- Sage Bionetworks, 2901 Third Avenue, Seattle, WA, 98121, United States of America.
| | - Joon-Ho Yu
- Institute for Public Health Genetics, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, United States of America
- Department of Pediatrics, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, United States of America
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, 1900 9th Ave, Seattle, WA, 98101, United States of America
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Bedlack R, Pogemiller A, Shefner J, Cudkowicz M, Heiman-Patterson T. ALS clinical research learning institutes (ALS-CRLI): empowering people with ALS to be research ambassadors. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:216-221. [PMID: 32458763 DOI: 10.1080/21678421.2019.1690519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: Patient engagement in research is increasingly recognized as important across many countries and fields. In 2008, we conducted surveys that suggested a need for improved patient engagement in ALS research. We decided to create an ALS Clinical Research Learning Institute (ALS-CRLI) to facilitate direct interactions between researchers and people with ALS and their caregivers, toward ultimately improving engagement. Methods: Initially modeled after a similar program in Parkinson's disease, our ALS-CRLI is a multi-day collection of formal courses for people with ALS and their caregivers, moderated by clinicians, scientists and patient advocates. Previous graduates (called ALS Research Ambassadors) engage with the current class participants before, during and after the courses. Prior to the courses, Research Ambassadors serve as "mentors" to the participants, offering guidance and setting expectations. Feedback during the courses is used to change the way researchers design and advertise studies, and feedback after the courses is used to improve the agenda for subsequent ALS-CRLIs. Funding is provided by patient advocacy groups including the ALS Association and ALS Hope Foundation. Research Ambassadors are provided with ongoing mentoring and notifications about opportunities for engagement via regular teleconferences with the Northeast ALS Consortium's Patient Education and Advocacy Committee and their own Facebook page. Engagement and advocacy efforts are tracked using a tool on the Northeast ALS Consortium's website. Results and Conclusions: We have now held 15 ALS-CRLIs at various locations within the United States, resulting in over 320 graduated ALS Research Ambassadors. From these engagements, researchers have been prompted to formally include patients in the design process, to design more patient-centric trials and to create new ways to help patients find trials. Research ambassadors are improving awareness and clearing up misconceptions about participation in research, improving research availability, and helping to create more patient-centric trial designs. In addition, we are now creating an ALS-CRLI Toolkit that will facilitate ALS-CRLIs throughout the world. This will be housed on the Northeast ALS Consortium website.
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Affiliation(s)
| | | | - Jeremy Shefner
- Departments of Neurology, Barrow Neurological Institute, University of Arizona College of Medicine, Creighton University, Phoenix, AZ, USA
| | - Merit Cudkowicz
- Sean M Healey & AMG Center for ALS, Mass General Hospital, Boston, MA, USA, and
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Seeralan T, Härter M, Koschnitzke C, Scholl M, Kohlmann S, Lehmann M, Eisele M, Braunschneider LE, Marx G, Scherer M, Löwe B, Magaard JL, Brütt AL. Patient involvement in developing a patient-targeted feedback intervention after depression screening in primary care within the randomized controlled trial GET.FEEDBACK.GP. Health Expect 2020; 24 Suppl 1:95-112. [PMID: 32286005 PMCID: PMC8137500 DOI: 10.1111/hex.13039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background Patient and public involvement (PPI) is increasingly required in mental health services research. To empower patients to actively address depression, the GET.FEEDBACK.GP study evaluates a patient‐targeted feedback intervention after depression screening using the Patient Health Questionnaire (PHQ‐9). Objective To refine the patient‐targeted feedback from a previous study within a participatory research team (PRT) by conducting workshops to investigate patients' needs and preferences for feedback. To evaluate the process and outcome of PPI. Design Patient and public involvement was carried out on the levels of collaboration and consultation. A PRT of patient partners and researchers planned and conducted three workshops with patients. Patients' needs were investigated using a focus group. Participants prioritized needs, discussed feedback drafts and evaluated two drafts using cognitive debriefings. Researchers of the PRT communicated the results at project level. PPI was evaluated using the Public and Patient Engagement Evaluation Tools (PPEET). Setting and Participants A purposeful sampling of N = 12 patients with experiences of depression participated in at least one workshop. Results Relevant content‐related needs about feedback (eg no distinction between severe and moderate symptoms), recommendations for action and patient‐relevant information were considered. Needs for comprehensible, valuing, nonstigmatizing language and design elements (eg dimensional bar) were implemented. Workshops and PRT were positively evaluated. Discussion and Conclusions Patient and public involvement influenced the content, wording and design of the feedback. Strengths include two levels of PPI, methodical diversity and purposeful sampling. Limitations include the lack of inclusion of patients who are unaware of their depression. The evaluated PPI concept can be useful for future studies.
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Affiliation(s)
- Tharanya Seeralan
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michael Scholl
- Member of the Participatory Research Team, Hamburg, Germany
| | - Sebastian Kohlmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lea-Elena Braunschneider
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriella Marx
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, Center for Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Luise Magaard
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany
| | - Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Member of the Participatory Research Team, Hamburg, Germany.,Department for Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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25
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El-Damanawi R, Lee M, Harris T, Cowley LB, Bond S, Pavey H, Sandford RN, Wilkinson IB, Karet Frankl FE, Hiemstra TF. High water vs. ad libitum water intake for autosomal dominant polycystic kidney disease: a randomized controlled feasibility trial. QJM 2020; 113:258-265. [PMID: 31665476 PMCID: PMC7133783 DOI: 10.1093/qjmed/hcz278] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vasopressin stimulates cyst growth in autosomal dominant polycystic kidney disease (ADPKD) and is a key therapeutic target. Evaluation of high water intake as an alternative to pharmacological vasopressin blockade is supported by patients. However feasibility, safety and adherence-promoting strategies required to deliver this remain unknown. AIMS Assess the feasibility of a definitive randomized high water intake trial in ADPKD. METHODS In this prospective open-label randomized trial, adult ADPKD patients with eGFR ≥ 20 ml/min/1.73 m2 were randomized to prescribed high water (HW) intake targeting urine osmolality (UOsm) ≤270 mOsm/kg, or ad libitum (AW) intake (UOsm >300 mOsm/kg). Self-management strategies including home-monitoring of urine-specific gravity (USG) were employed to promote adherence. RESULTS We enrolled 42 participants, baseline median eGFR (HW 68.4 [interquartile range (IQR) 35.9-107.2] vs. AW 75.8 [IQR 59.0-111.0 ml/min/1.73 m2, P = 0.22) and UOsm (HW 353 [IQR 190-438] vs. AW 350 [IQR 240-452] mOsm/kg, P = 0.71) were similar between groups. After 8 weeks, 67% in the HW vs. 24% in AW group achieved UOsm ≤270 mOsm/kg, P = 0.001. HW group achieved lower UOsm (194 [IQR 190-438] vs. 379 [IQR 235-503] mOsm/kg, P = 0.01) and higher urine volumes (3155 [IQR 2270-4295] vs. 1920 [IQR 1670-2960] ml/day, P = 0.02). Two cases of hyponatraemia occurred in HW group. No acute GFR effects were detected. In total 79% (519/672) of USG were submitted and 90% (468/519) were within target. Overall, 17% withdrew during the study. CONCLUSION DRINK demonstrated successful recruitment and adherence leading to separation between treatment arms in primary outcomes. These findings suggest a definitive trial assessing the impact of high water on kidney disease progression in ADPKD is feasible.
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Affiliation(s)
- R El-Damanawi
- Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - M Lee
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge
| | - T Harris
- PKD Charity, 91 Royal College, London
| | - L B Cowley
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
- Patient Led Research Hub, Cambridge NIHR Biomedical Research Centre, Cambridge
| | - S Bond
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - H Pavey
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - R N Sandford
- Department of Medical Genetics, University of Cambridge, Hills Road, Cambridge, UK
| | - I B Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - F E Karet Frankl
- Department of Medical Genetics, University of Cambridge, Hills Road, Cambridge, UK
| | - T F Hiemstra
- Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge
- Address correspondence to Dr T.F. Hiemstra, Cambridge Clinical Trials Unit, Box 401 Cambridge Biomedical Camp us, Hills Road, Cambridge CB2 0QQ, UK.
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26
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Issom DZ, Henriksen A, Woldaregay AZ, Rochat J, Lovis C, Hartvigsen G. Factors Influencing Motivation and Engagement in Mobile Health Among Patients With Sickle Cell Disease in Low-Prevalence, High-Income Countries: Qualitative Exploration of Patient Requirements. JMIR Hum Factors 2020; 7:e14599. [PMID: 32207692 PMCID: PMC7139429 DOI: 10.2196/14599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 12/29/2019] [Accepted: 01/24/2020] [Indexed: 12/20/2022] Open
Abstract
Background Sickle cell disease (SCD) is a hematological genetic disease affecting over 25 million people worldwide. The main clinical manifestations of SCD, hemolytic anemia and vaso-occlusion, lead to chronic pain and organ damages. With recent advances in childhood care, high-income countries have seen SCD drift from a disease of early childhood mortality to a neglected chronic disease of adulthood. In particular, coordinated, preventive, and comprehensive care for adults with SCD is largely underresourced. Consequently, patients are left to self-manage. Mobile health (mHealth) apps for chronic disease self-management are now flooding app stores. However, evidence remains unclear about their effectiveness, and the literature indicates low user engagement and poor adoption rates. Finally, few apps have been developed for people with SCD and none encompasses their numerous and complex self-care management needs. Objective This study aimed to identify factors that may influence the long-term engagement and user adoption of mHealth among the particularly isolated community of adult patients with SCD living in low-prevalence, high-income countries. Methods Semistructured interviews were conducted. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Analysis was informed by the Braun and Clarke framework and mapped to the COM-B model (capability, opportunity, motivation, and behavior). Results were classified into high-level functional requirements (FRs) and nonfunctional requirements (NFRs) to guide the development of future mHealth interventions. Results Overall, 6 males and 4 females were interviewed (aged between 21 and 55 years). Thirty FRs and 31 NFRs were extracted from the analysis. Most participants (8/10) were concerned about increasing their physical capabilities being able to stop pain symptoms quickly. Regarding the psychological capability aspects, all interviewees desired to receive trustworthy feedback on their self-care management practices. About their physical opportunities, most (7/10) expressed a strong desire to receive alerts when they would reach their own physiological limitations (ie, during physical activity). Concerning social opportunity, most (9/10) reported wanting to learn about the self-care practices of other patients. Relating to motivational aspects, many interviewees (6/10) stressed their need to learn how to avoid the symptoms and live as normal a life as possible. Finally, NFRs included inconspicuousness and customizability of user experience, automatic data collection, data shareability, and data privacy. Conclusions Our findings suggest that motivation and engagement with mHealth technologies among the studied population could be increased by providing features that clearly benefit them. Self-management support and self-care decision aid are patients’ major demands. As the complexity of SCD self-management requires a high cognitive load, pervasive health technologies such as wearable sensors, implantable devices, or inconspicuous conversational user interfaces should be explored to ease it. Some of the required technologies already exist but must be integrated, bundled, adapted, or improved to meet the specific needs of people with SCD.
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Affiliation(s)
- David-Zacharie Issom
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - André Henriksen
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | | | - Jessica Rochat
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gunnar Hartvigsen
- Department of Computer Science, UiT - The Arctic University of Norway, Norway, Tromsø, Norway
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27
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Hansen MB, Nørgaard LS, Hallgreen CE. How and Why to Involve Patients in Drug Development: Perspectives From the Pharmaceutical Industry, Regulatory Authorities, and Patient Organizations. Ther Innov Regul Sci 2019:2168479019864294. [PMID: 31390896 DOI: 10.1177/2168479019864294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Despite increasing interest and focus on patient-centric approaches to drug development, there might still be divergent views between key stakeholders in how to perceive patient involvement and how possibly divergent views influence the role of patients in the drug development process. The objective of this study is to explore how the perception of patient organizations, pharmaceutical companies, and regulatory agencies influence the role of patients in drug development. METHOD A qualitative interview study based on 12 semi-structured interviews with representatives from the 3 stakeholders. Interviews were transcribed, and data were analyzed using a social constructivist approach in the form of systematic text condensation. RESULTS Three main perceptions of patient involvement were identified: "a way to improve quality of life," "a way to avoid business failure," and "a way to foster a faster drug approval process." Transparency, trust, and clarification of expectations and roles were factors perceived as prerequisites for a valuable collaboration. Furthermore, a required cultural mindset change in the pharmaceutical industry, the lack of a common framework, patient organizations having limited resources available, and concerns about what to do with patient responsibility were perceived as the most important barriers for patient involvement. CONCLUSION Based on the findings, the pharmaceutical industry, patient organizations, and regulatory authorities were labeled as "pioneer/dominant," "unaware/quiet," and "hesitant," respectively. The 3 behavioural descriptors reflect a limited negotiation of the role patients have in drug development. Thus, the pharmaceutical industry appears to be the largest influencer with regard to patients' role in drug development.
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Affiliation(s)
- Marianne Botoft Hansen
- 1 Copenhagen Centre for Regulatory Science, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Stig Nørgaard
- 2 Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christine Erikstrup Hallgreen
- 1 Copenhagen Centre for Regulatory Science, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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28
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Greshake Tzovaras B, Angrist M, Arvai K, Dulaney M, Estrada-Galiñanes V, Gunderson B, Head T, Lewis D, Nov O, Shaer O, Tzovara A, Bobe J, Price Ball M. Open Humans: A platform for participant-centered research and personal data exploration. Gigascience 2019; 8:giz076. [PMID: 31241153 PMCID: PMC6593360 DOI: 10.1093/gigascience/giz076] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/02/2019] [Accepted: 06/03/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Many aspects of our lives are now digitized and connected to the internet. As a result, individuals are now creating and collecting more personal data than ever before. This offers an unprecedented chance for human-participant research ranging from the social sciences to precision medicine. With this potential wealth of data comes practical problems (e.g., how to merge data streams from various sources), as well as ethical problems (e.g., how best to balance risks and benefits when enabling personal data sharing by individuals). RESULTS To begin to address these problems in real time, we present Open Humans, a community-based platform that enables personal data collections across data streams, giving individuals more personal data access and control of sharing authorizations, and enabling academic research as well as patient-led projects. We showcase data streams that Open Humans combines (e.g., personal genetic data, wearable activity monitors, GPS location records, and continuous glucose monitor data), along with use cases of how the data facilitate various projects. CONCLUSIONS Open Humans highlights how a community-centric ecosystem can be used to aggregate personal data from various sources, as well as how these data can be used by academic and citizen scientists through practical, iterative approaches to sharing that strive to balance considerations with participant autonomy, inclusion, and privacy.
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Affiliation(s)
- Bastian Greshake Tzovaras
- Open Humans Foundation, 500 Westover Dr #10553, Sanford, NC, 27330, USA
- Lawrence Berkeley National Laboratory, One Cyclotron Road, Berkeley, CA 94720, USA
| | - Misha Angrist
- Social Science Research Institute, Duke University, 140 Science Drive, Durham, NC 27708, USA
| | | | - Mairi Dulaney
- Open Humans Foundation, 500 Westover Dr #10553, Sanford, NC, 27330, USA
| | - Vero Estrada-Galiñanes
- QoL Lab, Department of ComputerScience, University of Copenhagen, Sigurdsgade 41, DK-2200 Copenhagen, Denmark
- IDE, University of Stavanger, Kjell Arholmsgate 41, 4036 Stavanger, Norway
| | | | - Tim Head
- Wild Tree Tech, Froehlichstrasse 42 5200 Brugg Switzerland
| | | | - Oded Nov
- Tandon School of Engineering, New York University, 6 MetroTech Center, Brooklyn, NY 11201, USA
| | - Orit Shaer
- Wellesley College, 106 Central Street – Wellesley, MA 02481, USA
| | - Athina Tzovara
- Helen Wills Neuroscience Institute, University of California, Berkeley 174 Li Ka Shing Center, Berkeley, CA 94720, USA
- Institute of Computer Science, University of Bern, Neubrückstrasse 10, 3012 Bern, Switzerland
| | - Jason Bobe
- Institute for Next Generation Healthcare, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place New York, NY 10029-5674, USA
| | - Mad Price Ball
- Open Humans Foundation, 500 Westover Dr #10553, Sanford, NC, 27330, USA
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29
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Green G, Johns T. Exploring the Relationship (and Power Dynamic) Between Researchers and Public Partners Working Together in Applied Health Research Teams. FRONTIERS IN SOCIOLOGY 2019; 4:20. [PMID: 33869346 PMCID: PMC8022793 DOI: 10.3389/fsoc.2019.00020] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/01/2019] [Indexed: 05/05/2023]
Abstract
Public involvement in applied health research in the UK has become a pre-requisite for receiving funding from some bodies including the National Institute of Health Research. However, much of this involvement has been criticized as being tokenistic with an unequal power dynamic whereby the public voice is consulted but may be ignored. To redress this imbalance more participatory methods of involvement, such as co-production have emerged. This paper explores the relationship and power dynamic between researchers and public partners through the thematic analysis of interviews with fourteen researchers and six public contributors who were involved in projects that were identified as having many features associated with inclusive co-produced research. Public involvement was valued but the integration of scientific and lay knowledge on an equal basis was problematic. In practice, "co-opted relationships" were most common whereby public partners were slotted into a designated role created for them by the researcher/research team. There were though some examples of more equal partnerships being established to share power and decision-making including two cases where the research idea was initiated by the public partner. However, establishing an equal relationship and sharing power was constrained by the hierarchical nature of applied health research as well as issues around governance and accountability. Specifically, the positivist paradigm that predominates in applied health research and tends to privilege classically scientific ways of thinking, was a barrier to experiential knowledge being equally valued. This demonstrates the challenges inherent in establishing equal relationships and suggests that a transformation of research practices, culture and hierarchies is required for power sharing to become a reality. Specifically, the culture of applied health research needs to embrace more democratic participatory approaches, such as those used in research originating from the service user movement, as it is within these ways of working that public partners can more readily share power.
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Affiliation(s)
- Gill Green
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
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30
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Rice R, Nuzum D, O’Connell O, O’Donoghue K. Parents and clinicians: partners in perinatal bereavement research -experiences from the International Stillbirth Alliance Conference 2017. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:4. [PMID: 30774980 PMCID: PMC6357380 DOI: 10.1186/s40900-018-0137-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
In recent years, there has been a global call to reduce the numbers of preventable stillbirths and increase public awareness about the incidence and impact of pregnancy loss. The lived experiences of bereaved parents have much to contribute to developing the research agenda and clinical care in pregnancy loss. The multidisciplinary Pregnancy Loss Research Group (PLRG) based at the INFANT Centre at University College Cork and Cork University Maternity Hospital, has an established practice of active engagement and participation of patient members. This partnership provided the catalyst to model a similar collaborative approach between clinicians, researchers and bereaved parents when the PLRG was successful in their bid to host the International Stillbirth Alliance (ISA) annual conference in 2017. Over 400 hundred delegates from around the globe attended the conference, of which one quarter were bereaved parents. Establishing a culture of collaboration, support and mutual respect in the field of pregnancy loss, requires scientists, clinicians and parents to be brought together so each can be informed by the other in the efforts to prevent stillbirth and improve bereavement care. As part of ISA 2017 conference, a sub-committee of staff and parents was established to ensure that the voice of parents could contribute to the research agenda and developments in clinical and bereavement care. A creative workshop specifically for parents, followed by a parent assembly were organised to facilitate this. Remembrance activities, organised by the parent committee, were central to the conference and actively engaged in by parents, clinicians and researchers. This commentary, written collaboratively by a parent, a chaplain, a bereavement and loss specialist midwife and a consultant obstetrician, gives voice to this experience, identifying four key messages that arose from our reflection on the conference. These include; the value of active partnership between clinicians and patients, the use of creativity as a unifying expression of grief and as a means to facilitate learning, the value of collaboration with global stakeholders in raising awareness about stillbirth, and the importance of facilitating meaningful patient/public engagement in scientific research. The potential for education and learning opportunities are also explored, highlighting the connection between parents, researchers and clinicians as central stakeholders in the prevention of stillbirth and in improving bereavement care.
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Affiliation(s)
- Rachel Rice
- Pregnancy Loss Research Group, Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Daniel Nuzum
- Pregnancy Loss Research Group, Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland
- Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Orla O’Connell
- Pregnancy Loss Research Group, Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Keelin O’Donoghue
- Pregnancy Loss Research Group, Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland
- Cork University Maternity Hospital, Wilton, Cork, Ireland
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31
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Johnson L, Shapiro M, Mankoff J. Removing the Mask of Average Treatment Effects in Chronic Lyme Disease Research Using Big Data and Subgroup Analysis. Healthcare (Basel) 2018; 6:healthcare6040124. [PMID: 30322049 PMCID: PMC6316052 DOI: 10.3390/healthcare6040124] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 01/09/2023] Open
Abstract
Lyme disease is caused by the bacteria borrelia burgdorferi and is spread primarily through the bite of a tick. There is considerable uncertainty in the medical community regarding the best approach to treating patients with Lyme disease who do not respond fully to short-term antibiotic therapy. These patients have persistent Lyme disease symptoms resulting from lack of treatment, under-treatment, or lack of response to their antibiotic treatment protocol. In the past, treatment trials have used small restrictive samples and relied on average treatment effects as their measure of success and produced conflicting results. To provide individualized care, clinicians need information that reflects their patient population. Today, we have the ability to analyze large data bases, including patient registries, that reflect the broader range of patients more typically seen in clinical practice. This allows us to examine treatment variation within the sample and identify groups of patients that are most responsive to treatment. Using patient-reported outcome data from the MyLymeData online patient registry, we show that sub-group analysis techniques can unmask valuable information that is hidden if averages alone are used. In our analysis, this approach revealed treatment effectiveness for up to a third of patients with Lyme disease. This study is important because it can help open the door to more individualized patient care using patient-centered outcomes and real-world evidence.
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Affiliation(s)
| | - Mira Shapiro
- Analytic Designers LLC., Bethesda, MD 20817, USA.
| | - Jennifer Mankoff
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA.
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