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Sagnol G, Haesebaert J, Termoz A, Michel P, Schott AM, Potinet V, Pomey MP, Tazarourte K, Douplat M. Assessing patient partnership among emergency departments in France: a cross-sectional study. BMC Health Serv Res 2023; 23:897. [PMID: 37612727 PMCID: PMC10463322 DOI: 10.1186/s12913-023-09905-7] [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: 01/29/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES This study aims to describe the use of patient partnership, as defined by the Montreal Model, in emergency departments (EDs) in France and report the perception of patient partnership from both the practitioner and patient perspectives. METHODS This cross-sectional study was conducted between July 2020 and October 2020. First, a survey was sent to 146 heads of EDs in both teaching hospitals and non-teaching hospitals in France to assess the current practices in terms of patient partnership in service organization, research, and teaching. The perceived barriers and facilitators of the implementation of such an approach were also recorded. Then, semi-structured telephone interviews were carried out with patients involved in a service re-organization project. RESULTS A total of 48 answers (response rate 32.9%) to the survey were received; 33.3% of respondents involved patients in projects relating to service re-organization, 20.8% involved patients in teaching projects, and 4.2% in research projects. Overall, 60.4% of the respondents were willing to involve patients in re-organization or teaching projects. The main barriers mentioned for establishing patient partnership were difficulties regarding patient recruitment and lack of time. The main advantages mentioned were the improvement in patient/caregiver relationship and new ideas to improve healthcare. When interviewed, patients mentioned the desire to improve healthcare and the necessity to involve people with different profiles and backgrounds. A too important personal commitment was the most frequently raised barrier to their engagement. All the patients recognized their positive role, and more generally, the positive role of patient engagement in service re-organization. CONCLUSION Although this preliminary study indicates a rather positive perception of patient partnership among heads of EDs in France and partner patients, this approach is still not widely applied in practice.
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Affiliation(s)
- Geoffrey Sagnol
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Julie Haesebaert
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Anne Termoz
- Pôle de Santé Publique, service de recherche et d’épidémiologie cliniques, Hospices Civils de Lyon, Lyon, France
| | - Philipe Michel
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices civils de Lyon, Lyon, 69002 France
| | - Anne-Marie Schott
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
| | - Véronique Potinet
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
| | - Marie-Pascale Pomey
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montreal, Montreal, QC Canada
| | - Karim Tazarourte
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Edouard Herriot, 5 place d’Arsonval, Lyon, F-69003 France
| | - Marion Douplat
- Hospices Civils de Lyon, Service d’Accueil des urgences, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, Pierre Bénite, F-69495 France
- University Claude Bernard Lyon , U1290 Reshape, Lyon (Rhône), France
- UMR 7268 ADéS, Aix-Marseille Université / EFS / CNRS, Espace éthique méditerranéen, Hôpital Adultes La Timone, 264 rue Saint Pierre, Marseille cedex 05, France
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Muir R, Carlini J, Crilly J, Ranse J. Patient and public involvement in emergency care research: a scoping review of the literature. Emerg Med J 2023; 40:596-605. [PMID: 37280045 DOI: 10.1136/emermed-2022-212514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/13/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Establishing the benefits of patient and public involvement (PPI) in emergency care research is important to improve the quality and relevance of research. Little is known about the extent of PPI in emergency care research, its methodological and reporting quality. This scoping review aimed to establish the extent of PPI in emergency care research, identify PPI strategies and processes and assess the quality of reporting on PPI in emergency care research. METHODS Keyword searches of five databases (OVID MEDLINE, Elsevier EMBASE, EBSCO CINAHL, PsychInfo, Cochrane Central Register of Controlled trials); hand searches of 12 specialist journals and citation searches of the included journal articles were performed. A patient representative contributed to research design and co-authored this review. RESULTS A total of 28 studies reporting PPI from the USA, Canada, UK, Australia and Ghana were included. The quality of reporting was variable, with only seven studies satisfying all Guidance for Reporting Involvement of Patients and the Public short form reporting criteria. None of the included studies adequately described all the key aspects of reporting the impact of PPI. CONCLUSION Relatively few emergency care studies comprehensively describe PPI. Opportunity exists to improve the consistency and quality of reporting of PPI in emergency care research. Further research is required to better understand the specific challenges for implementing PPI in emergency care research, and to determine whether emergency care researchers have adequate resources, education and funding to undertake and report involvement.
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Affiliation(s)
- Rachel Muir
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Joan Carlini
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Consumer Advisory Group, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
- Department of Marketing, Griffith University, Gold Coast, Queensland, Australia
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
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Krishnan JA, Margellos-Anast H, Kumar R, Africk JJ, Berbaum M, Bracken N, Chen YF, DeLisa J, Erwin K, Ignoffo S, Illendula SD, Kim H, Lohff C, MacTavish T, Martin MA, Mosnaim GS, Nguyen H, Norell S, Nyenhuis SM, Paik SM, Pittsenbarger Z, Press VG, Sculley J, Thompson TM, Zun L, Gerald LB, McDermott M. Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100100. [PMID: 37641662 PMCID: PMC10461791 DOI: 10.1016/j.jacig.2023.100100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Background Evidence-based strategies to improve outcomes in minority children with uncontrolled asthma discharged from the emergency department (ED) are needed. Objectives This multicenter pragmatic clinical trial was designed to compare an ED-only intervention (decision support tool), an ED-only intervention and home visits by community health workers for 6 months (ED-plus-home), and enhanced usual care (UC). Methods Children aged 5 to 11 years with uncontrolled asthma were enrolled. The change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers were the primary outcomes. The secondary outcomes included guideline-recommended ED discharge care and self-management. Results Recruitment was significantly lower than expected (373 vs 640 expected). Of the 373 children (64% Black and 31% Latino children), only 63% completed the 6-month follow-up visit. In multivariable analyses that accounted for missing data, the adjusted odds ratios and 98% CIs for differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, guideline-recommended ED discharge care was significantly improved in the intervention groups versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups. Conclusions The ED-based interventions did not significantly improve the primary clinical outcomes, although the study was likely underpowered. Although guideline-recommended ED discharge care and self-management did improve, their effect on clinical outcomes needs further study.
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Affiliation(s)
- Jerry A. Krishnan
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago
- Department of Medicine, University of Illinois Chicago
| | | | - Rajesh Kumar
- Department of Pediatrics, Northwestern University and Ann and Robert H. Lurie Children’s Hospital of Chicago
| | | | - Michael Berbaum
- Center for Clinical and Translational Science, University of Illinois Chicago
| | - Nina Bracken
- Department of Medicine, University of Illinois Chicago
| | - Yi-Fan Chen
- Center for Clinical and Translational Science, University of Illinois Chicago
| | - Julie DeLisa
- Department of Medicine, University of Illinois Chicago
| | - Kim Erwin
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago
| | - Stacy Ignoffo
- Sinai Urban Health Institute, Sinai Health System, Chicago
| | | | - Hajwa Kim
- Center for Clinical and Translational Science, University of Illinois Chicago
| | | | - Tom MacTavish
- Institute of Design, Illinois Institute of Technology, Chicago
| | | | | | - Hannah Nguyen
- Department of Medicine, University of Illinois Chicago
| | - Sarah Norell
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago
| | | | - S. Margaret Paik
- Department of Pediatrics, University of Chicago Medicine Comer Children’s Hospital
| | - Zachary Pittsenbarger
- Department of Pediatrics, Northwestern University and Ann and Robert H. Lurie Children’s Hospital of Chicago
| | - Valerie G. Press
- Department of Pediatrics, University of Chicago Medicine Comer Children’s Hospital
- Department of Medicine, University of Chicago Medicine
| | - Jennifer Sculley
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago
| | - Trevonne M. Thompson
- Department of Emergency Medicine, Cook County Health and Hospitals System, Chicago
- Department of Emergency Medicine, University of Illinois Chicago
| | - Leslie Zun
- Department of Emergency Medicine and Psychiatry, Rosalind Franklin University of Medicine and Science, Chicago Medical School
| | - Lynn B. Gerald
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago
- Department of Medicine, University of Illinois Chicago
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Dy T, Hamilton WJ, Kramer CB, Apter A, Krishnan JA, Stout JW, Teach SJ, Federman A, Elder J, Bryant-Stephens T, Bruhl RJ, Jackson S, Sumino K. Stakeholder engagement in eight comparative effectiveness trials in African Americans and Latinos with asthma. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:63. [PMID: 36434672 PMCID: PMC9694541 DOI: 10.1186/s40900-022-00399-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The effects of stakeholder engagement, particularly in comparative effectiveness trials, have not been widely reported. In 2014, eight comparative effectiveness studies targeting African Americans and Hispanics/Latinos with uncontrolled asthma were funded by the Patient-Centered Outcomes Research Institute (PCORI) as part of its Addressing Disparities Program. Awardees were required to meaningfully involve patients and other stakeholders. Using specific examples, we describe how these stakeholders substantially changed the research protocols and in other ways participated meaningfully as full partners in the development and conduct of the eight studies. METHODS Using the method content analysis of cases, we identified themes regarding the types of stakeholders, methods of engagement, input from the stakeholders, changes made to the research protocols and processes, and perceived benefits and challenges of the engagement process. We used summaries from meetings of the eight teams, results from an engagement survey, and the final research reports as our data source to obtain detailed information. The descriptive data were assessed by multiple reviewers using inductive and deductive qualitative methods and discussed in the context of engagement literature. RESULTS Stakeholders participated in the planning, conduct, and dissemination phases of all eight asthma studies. All the studies included clinicians and community representatives as stakeholders. Other stakeholders included patients with asthma, their caregivers, advocacy organizations, and health-system representatives. Engagement was primarily by participation in advisory boards, although six of the eight studies (75%) also utilized focus groups and one-on-one interviews. Difficulty finding a time and location to meet was the most reported challenge to engagement, noted by four of the eight teams (50%). Other reported challenges and barriers to engagement included recruitment of stakeholders, varying levels of enthusiasm among stakeholders, controlling power dynamics, and ensuring that stakeholder involvement was reflected and had true influence on the project. CONCLUSION Engagement-driven modifications led to specific changes in study design and conduct that were felt to have increased enrollment and the general level of trust and support of the targeted communities. The level of interaction described, between investigators and stakeholders in each study and between investigator-stakeholder groups, is-we believe-unprecedented and may provide useful guidance for other studies seeking to improve the effectiveness of community-driven research.
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Affiliation(s)
- Tiffany Dy
- Division of Allergy and Immunology, Department of Internal Medicine, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave, CB 8122, St. Louis, MO, 63110, USA.
| | - Winifred J Hamilton
- Environmental Health Service, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Andrea Apter
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois Chicago and Population Health Sciences Program, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - James W Stout
- Department of Pediatrics and Health Services, University of Washington, Seattle, WA, USA
| | - Stephen J Teach
- Division of Emergency Medicine and the Department of Pediatrics, Children's National Hospital, Washington, DC, USA
| | - Alex Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Elder
- Institute for Behavioral and Community Health, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Tyra Bryant-Stephens
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca J Bruhl
- Environmental Health Service, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Shawni Jackson
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kaharu Sumino
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Lowe D, Ryan R, Schonfeld L, Merner B, Walsh L, Graham-Wisener L, Hill S. Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. Cochrane Database Syst Rev 2021; 9:CD013373. [PMID: 34523117 PMCID: PMC8440158 DOI: 10.1002/14651858.cd013373.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person-centred and so better able to meet the needs of and provide care for individuals. Globally, governments recommend consumer involvement in healthcare decision-making at the systems level, as a strategy for promoting person-centred health services. However, the effects of this 'working in partnership' approach to healthcare decision-making are unclear. Working in partnership is defined here as collaborative relationships between at least one consumer and health provider, meeting jointly and regularly in formal group formats, to equally contribute to and collaborate on health service-related decision-making in real time. In this review, the terms 'consumer' and 'health provider' refer to partnership participants, and 'health service user' and 'health service provider' refer to trial participants. This review of effects of partnership interventions was undertaken concurrently with a Cochrane Qualitative Evidence Synthesis (QES) entitled Consumers and health providers working in partnership for the promotion of person-centred health services: a co-produced qualitative evidence synthesis. OBJECTIVES To assess the effects of consumers and health providers working in partnership, as an intervention to promote person-centred health services. SEARCH METHODS We searched the CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL databases from 2000 to April 2019; PROQUEST Dissertations and Theses Global from 2016 to April 2019; and grey literature and online trial registries from 2000 until September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs of 'working in partnership' interventions meeting these three criteria: both consumer and provider participants meet; they meet jointly and regularly in formal group formats; and they make actual decisions that relate to the person-centredness of health service(s). DATA COLLECTION AND ANALYSIS Two review authors independently screened most titles and abstracts. One review author screened a subset of titles and abstracts (i.e. those identified through clinical trials registries searches, those classified by the Cochrane RCT Classifier as unlikely to be an RCT, and those identified through other sources). Two review authors independently screened all full texts of potentially eligible articles for inclusion. In case of disagreement, they consulted a third review author to reach consensus. One review author extracted data and assessed risk of bias for all included studies and a second review author independently cross-checked all data and assessments. Any discrepancies were resolved by discussion, or by consulting a third review author to reach consensus. Meta-analysis was not possible due to the small number of included trials and their heterogeneity; we synthesised results descriptively by comparison and outcome. We reported the following outcomes in GRADE 'Summary of findings' tables: health service alterations; the degree to which changed service reflects health service user priorities; health service users' ratings of health service performance; health service users' health service utilisation patterns; resources associated with the decision-making process; resources associated with implementing decisions; and adverse events. MAIN RESULTS We included five trials (one RCT and four cluster-RCTs), with 16,257 health service users and more than 469 health service providers as trial participants. For two trials, the aims of the partnerships were to directly improve the person-centredness of health services (via health service planning, and discharge co-ordination). In the remaining trials, the aims were indirect (training first-year medical doctors on patient safety) or broader in focus (which could include person-centredness of health services that targeted the public/community, households or health service delivery to improve maternal and neonatal mortality). Three trials were conducted in high income-countries, one was in a middle-income country and one was in a low-income country. Two studies evaluated working in partnership interventions, compared to usual practice without partnership (Comparison 1); and three studies evaluated working in partnership as part of a multi-component intervention, compared to the same intervention without partnership (Comparison 2). No studies evaluated one form of working in partnership compared to another (Comparison 3). The effects of consumers and health providers working in partnership compared to usual practice without partnership are uncertain: only one of the two studies that assessed this comparison measured health service alteration outcomes, and data were not usable, as only intervention group data were reported. Additionally, none of the included studies evaluating this comparison measured the other primary or secondary outcomes we sought for the 'Summary of findings' table. We are also unsure about the effects of consumers and health providers working in partnership as part of a multi-component intervention compared to the same intervention without partnership. Very low-certainty evidence indicated there may be little or no difference on health service alterations or health service user health service performance ratings (two studies); or on health service user health service utilisation patterns and adverse events (one study each). No studies evaluating this comparison reported the degree to which health service alterations reflect health service user priorities, or resource use. Overall, our confidence in the findings about the effects of working in partnership interventions was very low due to indirectness, imprecision and publication bias, and serious concerns about risk of selection bias; performance bias, detection bias and reporting bias in most studies. AUTHORS' CONCLUSIONS The effects of consumers and providers working in partnership as an intervention, or as part of a multi-component intervention, are uncertain, due to a lack of high-quality evidence and/or due to a lack of studies. Further well-designed RCTs with a clear focus on assessing outcomes directly related to partnerships for patient-centred health services are needed in this area, which may also benefit from mixed-methods and qualitative research to build the evidence base.
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Affiliation(s)
- Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Ostrach B. Human-Centered Design for a Women's Health Screening Tool: Participant Experiences. South Med J 2021; 113:469-474. [PMID: 33005959 DOI: 10.14423/smj.0000000000001157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Screening is a priority in primary care and women's health, and increasingly used for intimate partner violence. Integrating such routine screening into primary care screening may be challenging for clinicians. Human-centered design (HCD) is a participatory process emphasizing stakeholder input and is used increasingly in health care. A growing body of literature has examined the science of patient and community engagement in health research, yet few qualitative studies investigate how participants recruited to collaborate in designing screening tools perceive HCD processes. This study examined participants' perceptions of an HCD process used as an engagement tool to inform the development of a women's health screening tool. METHODS Qualitative study using data collected from community members and providers and staff recruited through a southern Appalachian medical education center and network of family medicine clinics and in the surrounding community. Using opportunistic and key informant sampling, study participants (some of whom were also intimate partner violence survivors) were part of an earlier HCD process undertaken to redesign a women's health/primary care screening tool and were invited to be interviewed about their perceptions of and experiences in the HCD process. Interviews were conducted using a semistructured guide. Interviews were audio-recorded, transcribed, hand-coded, and analyzed using modified grounded theory. RESULTS All of the participants reported that they valued the opportunity to be part of the HCD process; however, they reported divergent views of the process itself. Some found it easy to engage, whereas others found it confusing or embarrassing. All valued the opportunity to be part of determining the best process for screening, yet concerns were expressed about access to and full participation in the process. Community members reported more concerns; providers and staff reported fewer concerns about their own involvement and participation, although some expressed doubts about community members' full engagement. CONCLUSIONS Although a promising option and valuable process, the HCD process was not equally comfortable for or accessible to all participants. Community engagement beyond the clinical team is important for improving practices in health screening and health care, but it must be undertaken thoughtfully.
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Affiliation(s)
- Bayla Ostrach
- From the Department of Research, University of North Carolina Health Sciences at MAHEC, Asheville
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Erwin K, Fitzpatrick V, Norell S, Gilliam M. Development of a Framework and Tool to Facilitate Cost-of-Care Conversations With Patients During Prenatal Care. Ann Intern Med 2019; 170:S62-S69. [PMID: 31060059 DOI: 10.7326/m18-2207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Studies show that patients want to engage in cost-of-care conversations and factor costs into the formulation of care plans. Low-income patients are particularly likely to defer care because of costs, suggesting that cost-of-care conversations may be an important factor in health equity. Little guidance is available to clinicians and health systems for how to integrate effective cost-of-care conversations into clinical practice or to address specific cost needs of low-income patients. OBJECTIVE To develop a framework and tool to assist cost-of-care conversations with low-income patients during prenatal care. DESIGN A qualitative study using human-centered design methods. SETTING University medical center-based obstetrics-gynecology (ob-gyn) practice. PARTICIPANTS 20 pregnant or recently postpartum women, 16 clinicians, and 8 support and executive staff. RESULTS Pregnant women accumulate substantial indirect costs that interfere with treatment adherence and stress patients and their relationships. Frequency and duration of appointments are primary drivers of indirect costs; the burden is exacerbated by not knowing these costs in advance and disproportionately affects low-income patients. Working with ob-gyn clinicians, staff, and patients, a paper-based tool was developed to help patients forecast treatment demands and indirect costs, and to help clinicians introduce and standardize cost conversations. LIMITATIONS Data were collected from a small number of stakeholders in a single clinical setting that may not be generalizable to other settings. The tool has not been tested for effects on adherence or clinical outcomes. CONCLUSION A communication tool that helps pregnant patients understand their care plan and anticipate indirect costs can promote cost-of-care conversations between clinicians and low-income patients. PRIMARY FUNDING SOURCE Robert Wood Johnson Foundation.
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Affiliation(s)
- Kim Erwin
- University of Illinois at Chicago (K.E., S.N.)
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Martin MA, Kapheim MG, Erwin K, Ignoffo S, McMahon K, OʼRourke A, Gerald LB, Barrett M, Press VG, Darabi H, Krishnan JA. Childhood Asthma Disparities in Chicago: Developing Approaches to Health Inequities. FAMILY & COMMUNITY HEALTH 2018; 41:135-145. [PMID: 29781915 PMCID: PMC5965690 DOI: 10.1097/fch.0000000000000187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated. Cooperative, multidisciplinary efforts grounded in the community can target wicked problems such as asthma.
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Affiliation(s)
- Molly A Martin
- Department of Pediatrics (Dr Martin), College of Engineering (Dr Darabi), and University of Illinois Hospital & Health Sciences System Population Health Sciences Program (Dr Krishnan), University of Illinois at Chicago; Sinai Health System, Sinai Urban Health Institute, Chicago, Illinois (Ms Kapheim); Institute of Design, Illinois Institute of Technology, Chicago (Ms Erwin); Chicago Asthma Consortium, Chicago, Illinois (Ms Ignoffo); Respiratory Health Association, Chicago, Illinois (Mss McMahon, and O'Rourke); Department of Health Promotion Sciences, College of Public Health, University of Arizona, Tucson (Dr Gerald); Propeller Health, San Francisco, California (Dr Barrett); and Department of Medicine, University of Chicago, Illinois (Dr Press)
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Bombard Y, Baker GR, Orlando E, Fancott C, Bhatia P, Casalino S, Onate K, Denis JL, Pomey MP. Engaging patients to improve quality of care: a systematic review. Implement Sci 2018; 13:98. [PMID: 30045735 PMCID: PMC6060529 DOI: 10.1186/s13012-018-0784-z] [Citation(s) in RCA: 484] [Impact Index Per Article: 80.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/20/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To identify the strategies and contextual factors that enable optimal engagement of patients in the design, delivery, and evaluation of health services. METHODS We searched MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, PsychINFO, Social Science Abstracts, EBSCO, and ISI Web of Science from 1990 to 2016 for empirical studies addressing the active participation of patients, caregivers, or families in the design, delivery and evaluation of health services to improve quality of care. Thematic analysis was used to identify (1) strategies and contextual factors that enable optimal engagement of patients, (2) outcomes of patient engagement, and (3) patients' experiences of being engaged. RESULTS Forty-eight studies were included. Strategies and contextual factors that enable patient engagement were thematically grouped and related to techniques to enhance design, recruitment, involvement and leadership action, and those aimed to creating a receptive context. Reported outcomes ranged from educational or tool development and informed policy or planning documents (discrete products) to enhanced care processes or service delivery and governance (care process or structural outcomes). The level of engagement appears to influence the outcomes of service redesign-discrete products largely derived from low-level engagement (consultative unidirectional feedback)-whereas care process or structural outcomes mainly derived from high-level engagement (co-design or partnership strategies). A minority of studies formally evaluated patients' experiences of the engagement process (n = 12; 25%). While most experiences were positive-increased self-esteem, feeling empowered, or independent-some patients sought greater involvement and felt that their involvement was important but tokenistic, especially when their requests were denied or decisions had already been made. CONCLUSIONS Patient engagement can inform patient and provider education and policies, as well as enhance service delivery and governance. Additional evidence is needed to understand patients' experiences of the engagement process and whether these outcomes translate into improved quality of care. REGISTRATION N/A (data extraction completed prior to registration on PROSPERO).
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Affiliation(s)
- Yvonne Bombard
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada.
| | - G Ross Baker
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada
| | - Elaina Orlando
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada
- Niagara Health System, 1200 Fourth Avenue, St. Catharines, Ontario, L2S 0A9, Canada
| | - Carol Fancott
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada
| | - Pooja Bhatia
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada
| | - Selina Casalino
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada
| | - Kanecy Onate
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street 4th Floor, Toronto, Ontario, M5T 3M6, Canada
| | - Jean-Louis Denis
- Professor of Health Policy and Management, School of Public Health, Université de Montréal-CRCHUM & Canada Research Chair in Health System Design and Adaptation, 900, Saint Denis Street, Pavillion R, Montreal, Quebec, H2X 0A9, Canada
| | - Marie-Pascale Pomey
- Départment de Gestion, d'Évaluation et de Politique de Santé, École de santé Publique, Université de Montréal, Centre de recherche du CHUM, Carrefour de l'innovation et de l'évaluation en santé, 850 rue Saint-Denis, Montréal, Quebec, H2X 0A9, Canada
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10
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Martin MA, Press VG, Erwin K, Margellos-Anast H, Ignoffo S, McMahon KS, Mosnaim G, Ramsay J, Paik SM. Engaging end-users in intervention research study design. J Asthma 2018; 55:483-491. [PMID: 28699825 PMCID: PMC8350842 DOI: 10.1080/02770903.2017.1342256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Coordinated Healthcare Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) Plan is a 3-arm multicenter pragmatic trial to evaluate asthma interventions in high-risk Chicago children presenting to emergency departments (ED) with asthma. A formative evaluation with end-users to provide input into the trial design and outcome instruments was conducted prior to trial initiation. METHODS A multi-level data gathering framework from the field of design and standard qualitative methods was employed. This included one focus group with asthma Community Health Workers (N = 8), two focus groups with caregivers of children with asthma (N = 9), in-home interviews with caregivers (N = 9), key informant interviews at six EDs and outpatient clinical sites (N = 19), and ED tours and observations (N = 6). Data were presented, discussed, and organized into themes. RESULTS Data indicated that changes to the study design and discharge tool were warranted. A key insight was that ED discharge protocols typically place patient education at a single inopportune time, as families are preparing to leave the ED. At this point in time, families are less receptive to education due to fatigue and a desire to expedite the discharge process. The trial design was modified to reposition the discharge asthma plan to occur at earlier "teachable moments." Delivery of the asthma discharge plan was assigned to study-employed ED coordinators instead of ED providers and staff. Other potential challenges to study recruitment and implementation were raised and addressed. CONCLUSIONS Engagement of end-users in the design phase of implementation research is critical to improve research feasibility and relevance.
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Affiliation(s)
- Molly A Martin
- University of Illinois at Chicago, Department of Pediatrics, 840 South Wood Street, M/C 856, Chicago, IL, 60612
| | - Valerie G Press
- University of Chicago, Department of Medicine, 5841 S Maryland Ave, Chicago, IL, 60637
| | - Kim Erwin
- Illinois Institute of Technology, Institute of Design, 565 W Adams St, Chicago, IL, 60661
| | - Helen Margellos-Anast
- Sinai Urban Health Institute, Sinai Health System, 1500 S Fairfield Ave, Chicago, IL, 60608
| | - Stacy Ignoffo
- Chicago Asthma Consortium, PO Box 31757, Chicago, IL, 60631
| | | | - Giselle Mosnaim
- NorthShore University Health System, NorthShore Research Institute, 1001 University Pl, Evanston, IL, 60201
| | - Jessica Ramsay
- Sinai Urban Health Institute, Sinai Health System, 1500 S Fairfield Ave, Chicago, IL, 60608
| | - S. Margaret Paik
- University of Chicago, Department of Pediatrics, 5841 S Maryland Ave, Chicago, IL, 60637
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11
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Community-based Participatory Research Is Needed to Address Pulmonary Health Disparities. Ann Am Thorac Soc 2018; 13:1231-8. [PMID: 27249657 DOI: 10.1513/annalsats.201601-054ps] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Socioeconomic and racial disparities in the outcomes of medical management remain common across pulmonary diseases in the United States and worldwide. Acknowledging this, the American Thoracic Society recently put forth recommendations to advance respiratory health equity. Through engagement of vulnerable communities in search of collaborative solutions to improve health disparities, community-based participatory research embodies concepts essential to the American Thoracic Society mission for respiratory health equity. The purpose of this commentary is to provide an overview of the principles of community-based participatory research and the application of this approach to addressing inequity in the outcomes of treatment for lung disease. Community-based participatory research aims to decrease health disparities by recognizing the social and ecological paradigms of health care and by partnering community members with academic researchers in all aspects of the research process. Community partners are uniquely poised to offer insight into local culture, circumstances that guide health behaviors, and other challenges to improve their own community's health. Sustainable interventions, either through strengthening existing community assets or through community empowerment and local capacity building throughout the research process, are essential to the success of community-based participatory research. The National Institutes of Health and other funding agencies offer funding opportunities to support specific interventions aimed at engaging community members in the research process. In pulmonary medicine, community-based initiatives have focused primarily on improving pediatric asthma outcomes. Using a community-based approach in adult asthma and other pulmonary diseases could be an ideal manner in which to decrease pulmonary health disparities.
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12
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Care transition interventions for children with asthma in the emergency department. J Allergy Clin Immunol 2017; 138:1518-1525. [PMID: 27931533 DOI: 10.1016/j.jaci.2016.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 11/22/2022]
Abstract
The emergency department (ED) is a critical point of identification and treatment for some of the most high-risk children with asthma. This review summarizes the evidence regarding care transition interventions originating in the ED for children with uncontrolled asthma, with a focus on care coordination and self-management education. Although many interventions on care transition for pediatric asthma have been tested, only a few were actually conducted in the ED setting. Most of these targeted both care coordination and self-management education but ultimately did not improve attendance at follow-up appointments with primary care providers, improve asthma control, or reduce health care utilization. Conducting any ED-based intervention in the current environment is challenging because of the many demands on ED providers and staff, poor communication within and outside of the medical sector, and caregiver/patient burden. The evidence to date suggests that ED care transition interventions should consider expanding beyond the ED to bridge the multiple sectors children with asthma navigate, including health care settings, homes, schools, and community spaces. Patient-centered approaches may also be important to ensure adequate intervention design, enrollment, retention, and evaluation of outcomes important to children and their families.
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13
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Anise A, Hasnain-Wynia R. Patient-centered outcomes research to improve asthma outcomes. J Allergy Clin Immunol 2017; 138:1503-1510. [PMID: 27931532 DOI: 10.1016/j.jaci.2016.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/10/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
The Patient-Centered Outcomes Research Institute is funding 8 comparative effectiveness research projects to improve patient-centered outcomes for African American and Hispanic/Latino patients with uncontrolled asthma. These projects aim to compare multilevel interventions with known efficacy at the community, home, and health system levels to enhance patient and clinician uptake of the National Heart, Lung, and Blood Institute's National Asthma Education Prevention Program guidelines and improve outcomes. The National Asthma Education Prevention Program guidelines provide clinicians with a range of acceptable approaches for the diagnosis and management of asthma and define general practices that meet the needs of most patients. Yet disparities in asthma care and outcomes remain pervasive for African Americans and Hispanics/Latinos. The National Heart, Lung, and Blood Institute AsthmaNet consortium has identified several top research priorities for pediatric and adult populations, including a recommendation to examine tailored approaches based on race/ethnicity. In addition, the guidelines emphasize the need for studies that focus on multicomponent interventions recognizing that single interventions are generally ineffective. This article will describe the Patient-Centered Outcomes Research Institute-funded asthma projects and how they are individually and collectively addressing evidence gaps in asthma care by focusing on multicomponent and tailored approaches for improving outcomes and reducing disparities for African American and Hispanic/Latino patients.
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Affiliation(s)
- Ayodola Anise
- Addressing Disparities Program, Patient-Centered Outcomes Research Institute, Washington, DC.
| | - Romana Hasnain-Wynia
- Addressing Disparities Program, Patient-Centered Outcomes Research Institute, Washington, DC
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14
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Krishnan JA, Martin MA, Lohff C, Mosnaim GS, Margellos-Anast H, DeLisa JA, McMahon K, Erwin K, Zun LS, Berbaum ML, McDermott M, Bracken NE, Kumar R, Margaret Paik S, Nyenhuis SM, Ignoffo S, Press VG, Pittsenbarger ZE, Thompson TM. Design of a pragmatic trial in minority children presenting to the emergency department with uncontrolled asthma: The CHICAGO Plan. Contemp Clin Trials 2017; 57:10-22. [PMID: 28366780 PMCID: PMC5496921 DOI: 10.1016/j.cct.2017.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 03/20/2017] [Accepted: 03/26/2017] [Indexed: 12/30/2022]
Abstract
Among children with asthma, black children are two to four times as likely to have an emergency department (ED) visit and die from asthma, respectively, compared to white children in the United States. Despite the availability of evidence-based asthma management guidelines, minority children are less likely than white children to receive or use effective options for asthma care. The CHICAGO Plan is a three-arm multi-center randomized pragmatic trial of children 5 to 11years old presenting to the ED with uncontrolled asthma that compares: [1] an ED-focused intervention to improve the quality of care on discharge to home, [2] the same ED-focused intervention together with a home-based community health worker (CHW)-led intervention, and [3] enhanced usual care. All children receive spacers for the metered dose inhaler and teaching about its use. The Patient-Reported Outcomes Measurement Information System (PROMIS) Asthma Impact Scale and Satisfaction with Participation in Social Roles at 6months are the primary outcomes in children and in caregivers, respectively. Other patient-reported outcomes and indicators of healthcare utilization are assessed as secondary outcomes. Innovative features of the CHICAGO Plan include early and continuous engagement of children, caregivers, the Chicago Department of Public Health, and other stakeholders to inform the design and implementation of the study and a shared research infrastructure to coordinate study activities. The objective of this report is to describe the development of the CHICAGO Plan, including the methods and rationale for engaging stakeholders, the shared research infrastructure, and other features of the pragmatic clinical trial design.
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Affiliation(s)
- Jerry A Krishnan
- Population Health Sciences Program, Office of the Vice Chancellor for Health Affairs, University of Illinois at Chicago, United States; Department of Medicine, University of Illinois at Chicago, United States.
| | - Molly A Martin
- Department of Pediatrics, University of Illinois at Chicago, United States
| | | | | | | | - Julie A DeLisa
- Population Health Sciences Program, Office of the Vice Chancellor for Health Affairs, University of Illinois at Chicago, United States; Department of Medicine, University of Illinois at Chicago, United States
| | | | - Kim Erwin
- Institute of Design, Illinois Institute of Technology, United States
| | - Leslie S Zun
- Department of Emergency Medicine, Sinai Health System, United States
| | - Michael L Berbaum
- Center for Clinical and Translational Science, University of Illinois at Chicago, United States
| | - Michael McDermott
- Illinois Emergency Department Asthma Surveillance Project, United States
| | - Nina E Bracken
- Population Health Sciences Program, Office of the Vice Chancellor for Health Affairs, University of Illinois at Chicago, United States; Department of Medicine, University of Illinois at Chicago, United States
| | - Rajesh Kumar
- Department of Pediatrics, Northwestern University, Anne and Robert H. Lurie Children's Hospital of Chicago, United States
| | - S Margaret Paik
- Department of Pediatrics, University of Chicago, Comer Children's Hospital, United States
| | | | | | - Valerie G Press
- Department of Medicine and Pediatrics, University of Chicago, United States
| | - Zachary E Pittsenbarger
- Department of Pediatrics, Northwestern University, Anne and Robert H. Lurie Children's Hospital of Chicago, United States
| | - Trevonne M Thompson
- Department of Emergency Medicine, Cook County Health & Hospitals System, United States; Department of Emergency Medicine, University of Illinois at Chicago, United States
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15
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Optimizing a Nurse-led Transitional Home Visit Program in Preparation for a Randomized Control Trial. Pediatr Qual Saf 2017; 2:e012. [PMID: 30229150 PMCID: PMC6132790 DOI: 10.1097/pq9.0000000000000012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/23/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction: The Hospital to Home Outcomes study began with the end goal of evaluating the effectiveness of a single, nurse-led transitional home visit (home visit) program, for acutely ill, pediatric patients, which had been piloted at our institution. As part of the overall study design, building on prior randomized control trials that utilized a run-in period prior to the trial, our study team designed an optimization period to test the home visit and study procedures under real-world conditions. Methods: For this optimization project, there were 3 process improvement goals: to improve the referral process to the home visit, to optimize the home visit content, and to define and operationalize measures of patient- and family-centered outcomes to be used in the subsequent randomized control trial. During the optimization period, a multidisciplinary study team met weekly to review family and stakeholder feedback about the iterative modifications made to the home visit process, content, and outcome measures. Results: Optimization home visits were completed with 301 families across a variety of discharge diagnoses. The outcomes planned for the clinical trial were tested and refined. Feedback from families and stakeholders indicated that the content changes made to the home visits resulted in increased family knowledge of warning signs to monitor postdischarge. Thirty-one percent of families reported that they altered the care of their child after the home visit. Conclusion: Through iterative testing, informed by multistakeholder feedback, we leveraged patient and family engagement to maximize the effectiveness and generalizability of the home visit intervention.
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16
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Dormer L. Introducing Volume 6 of the Journal of Comparative Effectiveness Research. J Comp Eff Res 2016; 6:1-3. [PMID: 28001117 DOI: 10.2217/cer-2016-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Laura Dormer
- Future Medicine Ltd, Unitec House, London, N3 1QB, UK
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17
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Using stakeholder engagement to develop a patient-centered pediatric asthma intervention. J Allergy Clin Immunol 2016; 138:1512-1517. [PMID: 27744029 DOI: 10.1016/j.jaci.2016.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/29/2016] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
Abstract
Stakeholder engagement has the potential to develop research interventions that are responsive to patient and provider preferences. This approach contrasts with traditional models of clinical research in which researchers determine the study's design. This article describes the effect of stakeholder engagement on the design of a randomized trial of an intervention designed to improve child asthma outcomes by reducing parental stress. The study team developed and implemented a stakeholder engagement process that provided iterative feedback regarding the study design, patient-centered outcomes, and intervention. Stakeholder engagement incorporated the perspectives of parents of children with asthma; local providers of community-based medical, legal, and social services; and national experts in asthma research methodology and implementation. Through a year-long process of multidimensional stakeholder engagement, the research team successfully refined and implemented a patient-centered study protocol. Key stakeholder contributions included selection of patient-centered outcome measures, refinement of intervention content and format, and language framing the study in a culturally appropriate manner. Stakeholder engagement was a useful framework for developing an intervention that was acceptable and relevant to our target population. This approach might have unique benefits in underserved populations, leading to sustainable improvement in health outcomes and reduced disparities.
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18
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Erwin K, Krishnan JA. Using design methods to provide the care that people want and need. J Comp Eff Res 2016; 5:13-5. [PMID: 26698828 DOI: 10.2217/cer.15.62] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Kim Erwin is an Assistant Professor at IIT Institute of Design and trained in user-centered design methods, which put people at the center of any problem space so as to develop solutions that better fit their everyday lives, activities and context. Her expertise is in making complex information easier to understand and use. Her research targets communication tools and methods for collaborative knowledge construction built through shared experiences. Her book, Communicating the New: Methods to shape and accelerate innovation focuses on helping teams explore, build and diffuse critical knowledge inside organizations. Jerry Krishnan is a Professor of Medicine and Public Health, and Associate Vice President for Population Health Sciences at the University of Illinois Hospital & Health Sciences System. He pioneered the use of Analytic Hierarchy Process to elicit the expressed needs of stakeholders for research. He previously served as Chair of the US FDA Pulmonary and Allergy Drugs Advisory Committee and is a Principal Investigator in NIH and Patient Centered Outcomes Research Institute (PCORI)-funded research consortia. He chairs the US National Heart, Lung, and Blood Institute (NHLBI) Clinical Trials review committee and the PCORI Improving Healthcare Systems merit review panel.
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Affiliation(s)
- Kim Erwin
- Assistant professor, IIT Institute of Design, Chicago, IL 60654, USA
| | - Jerry A Krishnan
- Professor of Medicine & Public Health, Associate Vice President for Population Health Sciences UIC, Chicago, IL 60612, USA
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