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Poulsen M, Holland AE, Button B, Jones AW. Preferences and perspectives regarding telehealth exercise interventions for adults with cystic fibrosis: A qualitative study. Pediatr Pulmonol 2024; 59:1217-1226. [PMID: 38289142 DOI: 10.1002/ppul.26889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/14/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE Physical activity and exercise are key components in the management of cystic fibrosis (CF). Completing exercise programs online may minimize the risk of cross-infection and increase access for people with CF. This study aimed to understand the perspectives of people with CF regarding intervention content for a telehealth exercise program. METHODS Individual semistructured qualitative interviews were conducted in adults with CF purposefully sampled for age, disease severity, and social demographics. Interviews were recorded, transcribed verbatim, and analyzed thematically by two researchers independently. RESULTS Participants were 23 adults with CF (14 females) aged from 21 to 60 years. Three major themes (subthemes) were generated: "Personalizing components to an exercise program" (customizing an exercise program to the individual person and their unique health and exercise needs, enjoyment and variety of exercise activities, accessibility and exercise fitting around competing demands or commitments), "The importance of maintaining connections" (challenges regarding face-to-face interactions for people with CF, accountability of scheduled exercise sessions with others, shared experiences between people with CF and specialist support from the CF care team), and "Monitoring health and exercise" (perception of health status and monitoring and recording exercise participation and health). CONCLUSION This study provides important information regarding the preferences of adults with CF for telehealth exercise interventions. Interventions should be tailored to the individual person with CF, include an opportunity to maintain connections with peers and the CF multidisciplinary team, and provide a method to monitor progress over time.
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Affiliation(s)
- Megan Poulsen
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Anne E Holland
- Respiratory Research@Alfred, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Melbourne, Victoria, Australia
| | - Brenda Button
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
- Department of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Arwel W Jones
- Respiratory Research@Alfred, Monash University, Melbourne, Victoria, Australia
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McCoy M, Shorting T, Mysore VK, Fitzgibbon E, Rice J, Savigny M, Weiss M, Vincent D, Hagarty M, MacLeod KK, Ernecoff NC, Pattison R, Kornberg M, Bruni A, Bush SH, Kuluski K, Fiset V, Li C, Parsons HA, Lalumière G, Connolly T, Webber C, Isenberg SR. Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home (ACEPATH): Codesigning an intervention to improve patient and family caregiver experiences. Health Expect 2024; 27:e14002. [PMID: 38549352 PMCID: PMC10979115 DOI: 10.1111/hex.14002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Returning home from the hospital for palliative-focused care is a common transition, but the process can be emotionally distressing and logistically challenging for patients and caregivers. While interventions exist to aid in the transition, none have been developed in partnership with patients and caregivers. OBJECTIVE To undergo the initial stages of codesign to create an intervention (Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home [ACEPATH]) to improve the experience of hospital-to-home transitions for adult patients receiving palliative care and their caregiver(s). METHODS The codesign process consisted of (1) the development of codesign workshop (CDW) materials to communicate key findings from prior research to CDW participants; (2) CDWs with patients, caregivers and healthcare providers (HCPs); and (3) low-fidelity prototype testing to review CDW outputs and develop low-fidelity prototypes of interventions. HCPs provided feedback on the viability of low-fidelity prototypes. RESULTS Three patients, seven caregivers and five HCPs participated in eight CDWs from July 2022 to March 2023. CDWs resulted in four intervention prototypes: a checklist, quick reference sheets, a patient/caregiver workbook and a transition navigator role. Outputs from CDWs included descriptions of interventions and measures of success. In April 2023, the four prototypes were presented in four low-fidelity prototype sessions to 20 HCPs. Participants in the low-fidelity prototype sessions provided feedback on what the interventions could look like, what problems the interventions were trying to solve and concerns about the interventions. CONCLUSION Insights gained from this codesign work will inform high-fidelity prototype testing and the eventual implementation and evaluation of an ACEPATH intervention that aims to improve hospital-to-home transitions for patients receiving a palliative approach to care. PATIENT OR PUBLIC CONTRIBUTION Patients and caregivers with lived experience attended CDWs aimed at designing an intervention to improve the transition from hospital to home. Their direct involvement aligns the intervention with patients' and caregivers' needs when transitioning from hospital to home. Furthermore, four patient/caregiver advisors were engaged throughout the project (from grant writing through to manuscript writing) to ensure all stages were patient- and caregiver-centred.
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Affiliation(s)
| | | | - Vinay Kumar Mysore
- Parsons School of Design, The New SchoolNew YorkNew YorkUSA
- OpenBoxBrooklynNew YorkUSA
| | | | - Jill Rice
- Bruyère Research InstituteOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | | | | | | | - Meaghen Hagarty
- The Ottawa HospitalOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
| | - Krystal Kehoe MacLeod
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- Department of Family MedicineUniversity of OttawaOttawaOntarioCanada
| | | | | | | | | | - Shirley H. Bush
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Kerry Kuluski
- Institute for Better Health, Trillium Health PartnersMississaugaOntarioCanada
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Valerie Fiset
- Champlain Hospice Palliative Care ProgramOttawaOntarioCanada
- School of Nursing, University of OttawaOttawaOntarioCanada
| | - Cecilia Li
- The Ottawa HospitalOttawaOntarioCanada
- Bruyère Continuing CareOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
| | - Henrique A. Parsons
- The Ottawa HospitalOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Geneviève Lalumière
- Bruyère Continuing CareOttawaOntarioCanada
- Regional Palliative Consultation Team (RPCT)OttawaOntarioCanada
| | - Tara Connolly
- Accessibility InstituteCarleton UniversityOttawaOntarioCanada
| | - Colleen Webber
- Bruyère Research InstituteOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
| | - Sarina R. Isenberg
- Bruyère Research InstituteOttawaOntarioCanada
- Department of Medicine, Division of Palliative CareUniversity of OttawaOttawaOntarioCanada
- Ottawa Hospital Research InstituteOttawaOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
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Phoenix M, Moll S, Vrzovski A, Bhaskar L, Micsinszki S, Bruce E, Mulalu L, Hossain P, Freeman B, Mulvale G, Consortium C. Advancing a collective vision for equity-based cocreation through prototyping at an international forum. Health Expect 2024; 27:e14041. [PMID: 38567877 PMCID: PMC10989061 DOI: 10.1111/hex.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/26/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Cocreation has the potential to engage people with lived and living experiences in the design and evaluation of health and social services. However, guidance is needed to better include people from equity-deserving groups (EDGs), who are more likely to face barriers to participation, experience ongoing or historical harm, and benefit from accessible methods of engagement. OBJECTIVE The aim of this international forum (CoPro2022) was to advance a collective vision for equity-based cocreation. DESIGN A participatory process of engagement in experiential colearning and arts-based creative and reflective dialogue. Visual prototypes were created and synthesised to generate a collective vision for inclusive equity-based cocreation. SETTING AND PARTICIPANTS The Forum was held at the Gathering Place by the Grand River in Ohsweken, Ontario, Canada. A total of 48 participants attended the forum. They were purposely invited and have intersecting positionalities (21 academic experts, six experience experts, 10 trainees, and 11 members of EDGs) from nine countries (Bangladesh, Botswana, Canada, England, Italy, Norway, Scotland, Singapore, Sweden). COPRO2022 ACTIVITIES: CoPro2022 was an immersive experience hosted on Indigenous land that encouraged continuous participant reflection on their own worldviews and those of others as participants openly discussed the challenges and opportunities with engaging EDGs in cocreation activities. Visual prototypes and descriptions created in small groups were informed by participants' reflections on the panel presentations at the Forum and their own experiences with equity-based cocreation. Following the event, the authorship team inductively coded themes from the prototype descriptions and met to discuss the cross-cutting themes. These informed the design of an illustrated collective vision for Equity Based Co-Creation (EqCC). RESULTS Six prototypes were cocreated by each small group to illustrate their vision for EqCC. Within these, four cross-cutting themes were identified: (i) go to where people are, (ii) nurture relationships and creativity, (iii) reflect, replenish and grow, (iv) and promote thriving and transformation. These four themes are captured in the Collective EqCC Vision to guide a new era of inclusive excellence in cocreation activities. PATIENT OR PUBLIC CONTRIBUTION Service users, caregivers, and people with lived experience were involved in leading the design of the CoPro2022 and co-led the event. This included activities at the event such as presenting, facilitating small and large group discussion, leading art-based activities, and reflecting with the team on the lessons learned. People with lived experience were involved in the analysis and knowledge sharing from this event. Several members of the research team (students and researchers) also identified as members of EDGs and were invited to draw from their personal and academic knowledge.
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Affiliation(s)
- Michelle Phoenix
- School of Rehabilitation Sciences, CanChildMcMaster UniversityHamiltonOntarioCanada
| | - Sandra Moll
- School of Rehabilitation SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Alexa Vrzovski
- Ahousaht First NationAhousatBritish ColombiaCanada
- Indigenous Project Coordinator, School of MedicineToronto Metropolitan UniversityTorontoOntarioCanada
| | - Le‐Tien Bhaskar
- Health Research Methods, Evidence, and Impact (Health Policy)McMaster UniversityHamiltonOntarioCanada
| | - Samantha Micsinszki
- School of Rehabilitation Sciences, CanChildMcMaster UniversityHamiltonOntarioCanada
| | - Emma Bruce
- School of Rehabilitation SciencesMcMaster UniversityHamiltonOntarioCanada
| | | | - Puspita Hossain
- Health Research Methods, Evidence, and Impact (Health Policy)McMaster UniversityHamiltonOntarioCanada
| | - Bonnie Freeman
- School of Social Work and Indigenous Studies DepartmentMcMaster University; Algonquin/Mohawk, Member of the Six Nations of the Grand RiverCanada
| | - Gillian Mulvale
- Health Policy and Management, DeGroote School of BusinessMcMaster UniversityHamiltonOntarioCanada
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Taylor S, Barker K, Stephensen D, Williamson E. Using evidence-based co-design to develop a hybrid delivered exercise intervention that aims to increase confidence to exercise in people with haemophilia. Haemophilia 2024. [PMID: 38462814 DOI: 10.1111/hae.14972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Due to advances in treatments, people with haemophilia (PWH) are living longer. They are not as active as the general population due to joint damage and lack confidence to be active due to concerns about further bleeds and pain. There is a need to facilitate healthy aging through promotion of physical activity (PA) and exercise. Changing patient beliefs and increasing physical literacy and confidence to move are thought to be key to helping PWH become more active. AIM This paper describes the development of an exercise and behaviour change intervention to improve confidence to exercise in PWH. METHODS The 4-stage Medical Research Council framework for complex intervention development was used. RESULTS Stakeholders included 17 PWH and 7 physiotherapists working in haemophilia. Seven online focus group meetings were held. The final intervention is a hybrid 12-week physiotherapist led progressive exercise programme. Classes are 45 min including Pilates, High intensity interval training and balance elements, together with discussion sessions focusing on PA recommendations, the types and benefits of different exercise styles and the effects of PA, together with the effects of aging for PWH. The COM-B model of behaviour change was used to develop the intervention. CONCLUSION Co-design helps to produce an intervention that understands the stakeholders needs. Through this process the intervention developed to incorporate not only increasing PA but also confidence to exercise. The use of behaviour change theory identified the behaviour techniques included in the intervention and aims to increase physical literacy in this population.
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Affiliation(s)
- Stephanie Taylor
- Oxford Haemophilia and Thrombosis Centre, Churchill Hospital, Oxford, UK
| | - Karen Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford, UK
- NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences), University of Oxford, Oxford, UK
| | - David Stephensen
- Faculty of Medicine Health and Social Care, Canterbury Christ Church University, Canterbury, UK
| | - Esther Williamson
- NDORMS (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences), University of Oxford, Oxford, UK
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Kohut K, Morton K, Turner L, Foster R, Eccles D, Foster C. Codesign of Lynch Choices TM : Using implementation science to create a clinically deliverable patient decision support website to transform cancer genetics care pathways. Psychooncology 2024; 33:e6330. [PMID: 38502032 DOI: 10.1002/pon.6330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/29/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Resources including Patient Decision Aids (PtDA) are useful and valued by patients and clinicians to provide information and complement shared decision-making. Despite their promise, few PtDA exist for patients with genetic cancer susceptibility facing difficult decisions about risk management. We aimed to fill this gap, partnering with patients to codesign Lynch ChoicesTM , a PtDA website for families with Lynch Syndrome. In addition to a Patient Reference Panel, we purposively invited an international stakeholder panel including charities, public bodies, clinical and academic experts. Implementation strategies and frameworks were employed to optimise translation of research findings to improve care. METHODS Patient/stakeholder suggestions were incorporated in a transparent Table of Changes and prioritised using the Person-Based Approach throughout planning and codesign of Lynch ChoicesTM . An interactive stakeholder meeting was convened to identify barriers and facilitators to clinical implementation of the PtDA. RESULTS Patient and stakeholder partnerships drove the direction of the research throughout codesign, resulting in several iterative refinements to the PtDA prior to roll out including the addition of illustrations/videos, clearer presentation of cancer risks and increased accessibility for lower literacy. Barriers and facilitators identified from stakeholders were used to create an implementation process map. CONCLUSIONS Creating an effective, engaging PtDA is not enough. Systematic uptake in real world clinical practice, with its resource limitations, is needed to optimise benefit to patients and clinicians. Assessment of speed and breadth of dissemination and usage will be collected to further evidence the benefit of embedding implementation science methods from the outset to translate research findings into clinical practice.
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Affiliation(s)
- Kelly Kohut
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kate Morton
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
| | - Lesley Turner
- Patient and Public Contributor, University of Southampton, Southampton, UK
| | - Rebecca Foster
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Foster
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
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van der Laag PJ, Dorhout BG, Heeren AA, Veenhof C, Barten DJJA, Schoonhoven L. Identification and development of implementation strategies: the important role of codesign. Front Health Serv 2024; 4:1305955. [PMID: 38385048 PMCID: PMC10879593 DOI: 10.3389/frhs.2024.1305955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/12/2024] [Indexed: 02/23/2024]
Abstract
Background To date, implementation strategies reported in the literature are commonly poorly described and take the implementation context insufficiently into account. To unravel the black box of implementation strategy development, insight is needed into effective theory-based and practical-informed strategies. The current study aims to describe the stepwise development of a practical-informed and theory-based implementation strategy bundle to implement ProMuscle, a nutrition and exercise intervention for community-dwelling older adults, in multiple settings in primary care. Methods The first four steps of Implementation Mapping were adopted to develop appropriate implementation strategies. First, previously identified barriers to implementation were categorized into the constructs of the Consolidated Framework for Implementation Research (CFIR). Second, the CFIR-ERIC matching tool linked barriers to existing implementation strategies. Behavioral change strategies were added from the literature where necessary. Third, evidence for implementation strategies was sought. Fourth, in codesign with involved healthcare professionals and implementation experts, implementation strategies were operationalized to practical implementation activities following the guidance provided by Proctor et al. These practical implementation activities were processed into an implementation toolbox, which can be tailored to a specific context and presents prioritized implementation activities in a chronological order. Results A previous study identified and categorized a total of 654 barriers for the implementation of a combined lifestyle intervention within the CFIR framework. Subsequently, the barriers were linked to 40 strategies. Due to the fact that many strategies impacted multiple barriers, seven overarching themes emerged based on the strategies: assessing the context, network internally, network externally, costs, knowledge, champions, and patient needs and resources. Codesign sessions with professionals and implementation experts resulted in the development of supported and tangible implementation activities for the final 20 strategies. The implementation activities were processed into a web-based implementation toolbox, which allows healthcare professionals to tailor the implementation activities to their specific context and guides healthcare professionals to prioritize implementation activities chronologically during their implementation. Conclusion A theory-based approach in combination with codesign sessions with stakeholders is a usable Implementation Strategy Mapping Method for developing a practical implementation strategy bundle to implement ProMuscle across multiple settings in primary care. The next step involves evaluating the developed implementation strategies, including the implementation toolbox, to assess their impact on the implementation and adoption of ProMuscle.
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Affiliation(s)
- Patricia J. van der Laag
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Berber G. Dorhout
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Aaron A. Heeren
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands
| | - Di-Janne J. A. Barten
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
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Kehoe M, Whitehead R, de Boer K, Meyer D, Hopkins L, Nedeljkovic M. Are codesigned programmes more difficult to implement? A qualitative study of staff perceptions on the implementation of a new youth mental health programme. Health Expect 2024; 27:e13989. [PMID: 38367246 PMCID: PMC10874247 DOI: 10.1111/hex.13989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Codesigned interventions are becoming more common in health services and, in particular, in the design and development of mental health programmes and interventions. However, previous research has established that the transition from codesign to implementation can experience several challenges and that this transition process has received little research attention. OBJECTIVE The aim of this study was to explore the experience of staff members charged with the implementation of a codesigned intervention for young people and adolescents at risk of suicide. SETTING AND PARTICIPANTS Five staff members involved in the implementation of the new codesigned programme took part in semi-structured interviews. METHOD The study involved qualitative evaluation of staff experiences during the implementation of a new child and youth suicide intervention. Interviews were analysed using reflexive thematic analysis. RESULTS The analysis identified four themes of 'disconnect', 'operational challenges, 'service user' and 'being authentic'. 'Disconnect' captures the difficulties of implementing a codesigned programme which leads to 'operational challenges' in meeting broader expectations while ensuring the feasibility of the programme. The third theme, 'service user', captures the realisation that the young people accessing the new service were different to those involved in the codesign process. The final theme, 'being authentic', highlights how staff needed to be responsive and flexible while remaining true to the principles proposed in the codesign. DISCUSSION This study yielded some valuable insights into the challenges around the implementation of a codesigned intervention, an under-researched area. The findings suggest that adaption of the design may be necessary, if it is not informed by implementation constraints, making it necessary for the implementation team to be well-briefed on the initial design and given plenty of time to make the necessary adjustments in a coproduction process. Limitations for the generalisation of the results include a small sample of staff and particular challenges that may be unique to this study. CONCLUSION The present study highlights that for health services undertaking codesign approaches, appropriate time and resources need to be considered for the implementation phase of an initiative, to ensure that there is effective translation from design to implementation and that new codesigned services can be effective within operational constraints. PATIENT AND PUBLIC CONTRIBUTION The authors would like to thank and acknowledge the young people with a lived-experience and their carers who participated in the codesign process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in the evaluation.
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Affiliation(s)
- Michelle Kehoe
- Monash University and Alfred HealthMelbourneVictoriaAustralia
| | | | - Kathleen de Boer
- Centre for Mental Health and Brain ScienceSwinburne UniversityMelbourneVictoriaAustralia
| | - Denny Meyer
- Centre for Mental Health and Brain ScienceSwinburne UniversityMelbourneVictoriaAustralia
| | | | - Maja Nedeljkovic
- Centre for Mental Health and Brain ScienceSwinburne UniversityMelbourneVictoriaAustralia
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Burns K, Huckvale K, Borda A, Gilbert C, Ferdous H, Kalla M, Chapman W, Capurro D. Adapting an Environmental Scan for 'Insights Reporting': Learnings from an Online Brain Cancer Peer Support Platform. Stud Health Technol Inform 2024; 310:294-298. [PMID: 38269812 DOI: 10.3233/shti230974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
When developing a digital health solution, product owners, healthcare professionals, researchers, IT teams, and consumers require timely, accurate contextual information to inform solution development. Insights Reporting can rapidly draw together information from literature, end users and existing technology to inform the development process. This was the case when creating an online brain cancer peer support platform where solution development was conducted in parallel with contextual information synthesis. This paper discusses the novel adaptation of an environmental scan methodology using codesign and multiple layers of qualitative rigor, to create Insights Reporting. This seven-step process can be completed in two months and results in salient points of knowledge that can rapidly inform the design of a solution, creating a shared understanding of a digital health phenomenon. Project members noted that Insights Reporting surfaces previously inaccessible knowledge, catalyzes decision-making and allows all stakeholders to influence the report agenda, affirming principles of digital health equity.
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Affiliation(s)
- Kara Burns
- Centre for Digital Transformation of Health, University of Melbourne
| | - Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne
| | - Ann Borda
- Centre for Digital Transformation of Health, University of Melbourne
| | - Cecily Gilbert
- Centre for Digital Transformation of Health, University of Melbourne
| | - Hasan Ferdous
- Centre for Digital Transformation of Health, University of Melbourne
| | - Mahima Kalla
- Centre for Digital Transformation of Health, University of Melbourne
| | - Wendy Chapman
- Centre for Digital Transformation of Health, University of Melbourne
| | - Daniel Capurro
- Centre for Digital Transformation of Health, University of Melbourne
- School of Computing and Information Systems, University of Melbourne
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Frandsen CE, Dieperink H, Trettin B, Agerskov H. Advance care planning to patients with chronic kidney disease and their families: An intervention development study. J Clin Nurs 2023; 32:8104-8115. [PMID: 37743635 DOI: 10.1111/jocn.16875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023]
Abstract
AIM To develop an advance care planning intervention based on the needs of patients with chronic kidney disease, families and healthcare professionals. BACKGROUND Patients with chronic kidney disease and their families request early advance care planning that continues throughout their illness trajectory. Healthcare professionals experience barriers to initiating advance care planning. Involvement of stakeholders in development of health interventions is important, to identify priorities, understand the problem and find solutions. METHOD The development was inspired by the Medical Research Council's framework, and codesign was applied. One future workshop and one design workshop were conducted with the consumers. The process was iterative, and data were analysed using the action research spiral. The Guidance for reporting intervention development studies in healthcare (GUIDED) was used. RESULTS Five areas were considered significant to an advance care planning intervention; a biopsychosocial approach, early palliative care, a family-focused approach, early and continuous advance care planning and a consumer-centred approach. Based on these, a conversation process with healthcare professionals was designed to give patients and families the opportunity to share values, preferences and wishes for treatment and their family and everyday life. CONCLUSION Codesign facilitated a collaborative process that allowed the consumers to have a significant impact on the design of an advance care planning intervention. A conversation process concerning everyday life, illness and treatment was designed for patients and families. The intervention included an advance care planning tool to guide the healthcare professionals. PRACTICE IMPLICATIONS The intervention has the intention to improve the communication between healthcare professionals, patients and families. The study provides important knowledge about the significance of giving the patients and their families support in sharing their values, preferences and wishes for treatment and everyday life, thus, to improve care and treatment in their illness trajectory. IMPACT What problem did the study address Patients with chronic kidney disease and their families strongly request early initiation of advance care planning that continues throughout the illness trajectory. Healthcare professionals experience barriers to the initiation of the advance care planning and request a more systematic approach. What were the main findings Development of a conversation process about everyday life, illness and treatment for patients diagnosed with chronic kidney disease and families, including an advance care planning tool to guide the healthcare professionals. Where and on whom will the research have an impact The study contributes an advance care planning intervention to patients in the early stages of chronic kidney disease and their families. We believe that the intervention could be included during consultations with healthcare professionals in other stages of chronic kidney disease as well as other chronic disease. REPORTING METHOD To strengthen the reporting of the development of the advance care planning intervention, we used the Guidance for reporting intervention development studies in healthcare (GUIDED). PATIENT OR PUBLIC CONTRIBUTION The development of the intervention in this study was a collaborative process between patients, families, healthcare professionals and representatives from the Danish Kidney Association, the department's user council and the research team.
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Affiliation(s)
- Christina Egmose Frandsen
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Family Focused Healthcare Research Center (FaCe), Department of Clinical Research, University of Southern, Odense, Denmark
| | - Hans Dieperink
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bettina Trettin
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Family Focused Healthcare Research Center (FaCe), Department of Clinical Research, University of Southern, Odense, Denmark
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10
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Srivastava U, Dasari S, Shah N. Learnings in Digital Health Design: Insights From a Pilot Web App for Structured Note-Taking for Patients With Rheumatoid Arthritis. JMIR Form Res 2023; 7:e49358. [PMID: 38015609 DOI: 10.2196/49358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/09/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Patients fail to accurately remember 40% to 80% of medical information relayed during doctor appointments, and most standard after-visit summaries fail to effectively help patients comply with behaviors to manage their health conditions. The value of technology to empower and engage patients in their health management has been shown, and here we apply technology to help patients remember and act upon information communicated during their medical appointments. OBJECTIVE We describe the development of WellNote, a digital notebook designed for patients to create a customized plan to manage their condition, plan for their appointments, track important actions (eg, medications and labs), and receive reminders for appointments and labs. METHODS For this pilot, we chose to focus on rheumatoid arthritis, a chronic condition that relies on many of these features. The development of WellNote followed a structured method based on design thinking and co-design principles, with the app built in close collaboration with patients and a physician partner to ensure clinical relevance. Our design process consisted of 3 rounds: patient and physician interviews, visual prototypes, and a functional pilot app. RESULTS Over the course of the design process, WellNote's features were refined, with the final version being a digital notebook designed for patients with rheumatoid arthritis to manage their health by helping them track medications and labs and plan for appointments. It features several pages, like a dashboard, patient profile, appointment notes, preplanning, medication management, lab tracking, appointment archives, reminders, and a pillbox for medication visualization. CONCLUSIONS WellNote's active and structured note-taking features allow patients to clearly document the information from their physician without detracting from the conversation, helping the patient to become more empowered and engaged in their health management. The co-design process empowered these stakeholders to share their needs and participate in the development of a solution that truly solves pain points for these groups. This viewpoint highlights the role of digital health tools and the co-design of new health care innovations to empower patients and support clinicians.
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Affiliation(s)
- Ujwal Srivastava
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Shobha Dasari
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Neha Shah
- Division of Immunology and Rheumatology, Stanford School of Medicine, Stanford, CA, United States
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11
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Yates S, Gladstone B, Foster K, Silvén Hagström A, Reupert A, O'Dea L, Cuff R, McGaw V, Hine R. Epistemic injustice in experiences of young people with parents with mental health challenges. Sociol Health Illn 2023. [PMID: 37994180 DOI: 10.1111/1467-9566.13730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023]
Abstract
Amongst the impacts of growing up with a parent with mental health challenges is the experience of stigma-by-association, in which children and young people experience impacts of stigmatisation due to their parent's devalued identity. This article seeks to expand our understanding of this issue through an abductive analysis of qualitative data collected through a codesign process with young people. Results indicate that young people's experiences of stigmatisation can be effectively understood as experiences of epistemic injustice. Participants expressed that their experiences comprised 'more than' stigma, and their responses suggest the centrality to their experiences of being diminished and dismissed in respect of their capacity to provide accurate accounts of their experiences of marginalisation and distress. Importantly, this diminishment stems not only from their status as children, and as children of parents with mental health challenges but operates through a range of stigmatised identities and devalued statuses, including their own mental health status, sexual minoritisation, disability and social class. Forms of epistemic injustice thus play out across the social and institutional settings they engage with. The psychological and social impacts of this injustice are explored, and the implications for our understanding of stigma around family mental health discussed.
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Affiliation(s)
- Scott Yates
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Brenda Gladstone
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kim Foster
- National School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | | | - Andrea Reupert
- School of Educational Psychology and Counselling, Monash University, Clayton, Victoria, Australia
| | - Lotti O'Dea
- Satellite Foundation, Melbourne, Victoria, Australia
| | - Rose Cuff
- Satellite Foundation, Melbourne, Victoria, Australia
| | - Violette McGaw
- Trauma Recovery Program, Toowong Private Hospital, Brisbane, Queensland, Australia
| | - Rochelle Hine
- Monash Rural Health, Monash University, Clayton, Victoria, Australia
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12
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Lynch EA, Bulto LN, West M, Cadilhac DA, Cooper F, Harvey G. Codesigning implementation strategies to improve evidence-based stroke rehabilitation: A feasibility study. Health Expect 2023; 27:e13904. [PMID: 37990469 PMCID: PMC10757151 DOI: 10.1111/hex.13904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/09/2023] [Accepted: 10/21/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION People with lived experience are rarely involved in implementation science research. This study was designed to assess the feasibility of codesigning and delivering implementation strategies with people with lived experience of stroke and health professionals to improve evidence-based stroke rehabilitation. METHODS We used Experience-Based CoDesign to design and deliver strategies to implement Stroke Clinical Guideline recommendations at one Australian inpatient stroke rehabilitation unit. Workgroups were formed with health professionals and people with 6-12 months experience of living with stroke (survivors and carers). Feasibility of the codesign approach (focusing on acceptability, implementation fidelity, signal of promise) was evaluated using mixed methods, using data from interviews, observations and inpatient self-reported outcomes. RESULTS Of 18 people with stroke invited, eight (44%) agreed to join the lived experience workgroup. All disciplines with ≥1 full-time staff members on the stroke unit were represented on the health professional workgroup. Median workgroup attendance over 6 months was n = 8 health professionals, n = 4 survivors of stroke and n = 1 carers. Workgroup members agreed to focus on two Guideline recommendations: information provision and amount of therapy. Workgroup members indicated that the codesign approach was enjoyable and facilitated effective partnerships between health professionals and lived experience workgroup members. Both cohorts reported contributing valuable input to all stages of the project, with responsibility shifting between groups at different project stages. The codesigned strategies signalled promise for improving aspects of information provision and creating additional opportunities for therapy. We could not compare patient-reported outcomes before and after the implementation period due to high variability between the preimplementation and postimplementation patient cohorts. CONCLUSION It is feasible to codesign implementation strategies in inpatient rehabilitation with people with lived experience of stroke and health professionals. More research is required to determine the effect of the codesigned strategies on patient and service outcomes. PATIENT OR PUBLIC CONTRIBUTION People with lived experience of stroke codesigned and evaluated implementation strategies. Author F. C. has lived experience of stroke and being an inpatient at the inpatient rehabilitation service, and has provided input into analysis of the findings and preparation of this manuscript.
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Affiliation(s)
- Elizabeth A. Lynch
- College of Nursing and Health Sciences, Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Lemma N. Bulto
- College of Nursing and Health Sciences, Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Maria West
- College of Nursing and Health Sciences, Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
- Occupational Therapy DepartmentCentral Adelaide Health ServiceAdelaideSouth AustraliaAustralia
| | - Dominique A. Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
- Stroke Theme, The Florey Institute of Neuroscience and Mental HealthUniversity of MelbourneHeidelbergVictoriaAustralia
| | | | - Gillian Harvey
- College of Nursing and Health Sciences, Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
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13
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Bosak J, Drainoni M, Bryer C, Goodman D, Messersmith L, Declercq E. 'It opened my eyes, my ears, and my heart': Codesigning a substance use disorder treatment programme. Health Expect 2023; 27:e13908. [PMID: 37920874 PMCID: PMC10726284 DOI: 10.1111/hex.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Pregnant and parenting women have low engagement and poor retention in substance use disorder (SUD) treatment. The aim of this study was to analyse the implementation of an adapted experience-based codesign (EBCD) process involving SUD treatment staff and pregnant or parenting women with lived experience (WWLE) of SUD to launch a residential treatment service where women could coreside with their children and receive long term comprehensive treatment for dual diagnosis of SUD and mental illness. METHODS A process evaluation was conducted utilising five data sources: two sets of semistructured interviews with WWLE and SUD treatment staff, ethnographic observation and transcripts from group events, and meeting minutes. Based on the Integrated Promoting Action on Research in Health Services framework constructs (context, recipients, facilitation, innovation) researchers applied thematic analysis to determine main themes within each construct. RESULTS The full sample across the implementation totalled 34 individuals (WWLE = 13 and SUD staff = 21). The EBCD process engaged both cohorts and supported group cohesion and collaborative brainstorming. WWLE felt respected, emotionally safe to share, and empowered by participation. A cohesive, multidisciplinary codesign planning group, inclusive of WWLE, supported a more equitable codesign process. The need for a virtual platform due to the COVID-19 pandemic impeded human connection and relationship building. The complex environment of residential regulations and uncertainties during start-up phase of an organisation presented implementation challenges. CONCLUSION These results highlight the feasibility of, and challenges to, effectively engaging WWLE in a codesign process. The findings also demonstrated a positive influence on WWLE's feelings of empowerment. Identified themes reinforce the purposeful components within EBCD that enhance participation, along with new insights to inform successful codesign with a vulnerable population. The author's team included a WWLE who collaborated throughout the full scope of the research process, enriching the overall research and ensuring the authenticity of the presentation of women in recovery's perspective. Utilising the codesign approach to design and implement new services should improve health equity by enhancing patient engagement and retention in care. PATIENT CONTRIBUTION Parenting WWLE of residential SUD treatment were involved in the full scope of the research process and the implementation being evaluated. For the actual codesign work WWLE were key members of the codesign planning team that met weekly throughout the implementation to plan, implement, problem solve and adapt the process over an 18 month timeframe. As is appropriate for codesign the actual ongoing workgroup participants had average 50% WWLE participation. For the research team, this research is a culmination of the lead author's doctoral dissertation. One member of the five-person dissertation committee was a recovery coach and a WWLE. She was an active participant across the entire research process overseeing and influencing the research design, conduct of the study, analysis, interpretation of findings and approval of the final manuscript. The findings were member checked with the larger codesign planning group that had additional WWLE members.
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Affiliation(s)
- Julie Bosak
- Community Health ServicesBoston University School of Public HealthBostonMassachusettsUSA
- Dartmouth Hitchcock Medical CenterLebanonNew HampshireUSA
- Dartmouth Geisel School of MedicineLebanonNew HampshireUSA
| | - Mari‐Lynn Drainoni
- Department of Medicine, Section of Infectious DiseasesBoston University Aram V. Chobanian & Edward Avedisian School of MedicineBostonMassachusettsUSA
- Department of Health Law Policy and ManagementBoston University School of Public HealthBostonMassachusettsUSA
| | - Cheri Bryer
- Dartmouth Hitchcock Medical CenterLebanonNew HampshireUSA
- Dartmouth Geisel School of MedicineLebanonNew HampshireUSA
| | - Daisy Goodman
- Dartmouth Hitchcock Medical CenterLebanonNew HampshireUSA
- Department of Health Law Policy and ManagementBoston University School of Public HealthBostonMassachusettsUSA
| | - Lisa Messersmith
- Department of Global HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Eugene Declercq
- Community Health ServicesBoston University School of Public HealthBostonMassachusettsUSA
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Deiana AM, Tran N, Agar J, Blott M, Di Guglielmo G, Duarte J, Harris P, Hauck S, Liu M, Neubauer MS, Ngadiuba J, Ogrenci-Memik S, Pierini M, Aarrestad T, Bähr S, Becker J, Berthold AS, Bonventre RJ, Müller Bravo TE, Diefenthaler M, Dong Z, Fritzsche N, Gholami A, Govorkova E, Guo D, Hazelwood KJ, Herwig C, Khan B, Kim S, Klijnsma T, Liu Y, Lo KH, Nguyen T, Pezzullo G, Rasoulinezhad S, Rivera RA, Scholberg K, Selig J, Sen S, Strukov D, Tang W, Thais S, Unger KL, Vilalta R, von Krosigk B, Wang S, Warburton TK. Corrigendum: Applications and techniques for fast machine learning in science. Front Big Data 2023; 6:1301942. [PMID: 37908454 PMCID: PMC10614289 DOI: 10.3389/fdata.2023.1301942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fdata.2022.787421.].
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Affiliation(s)
| | - Nhan Tran
- Fermi National Accelerator Laboratory, Batavia, IL, United States
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | - Joshua Agar
- Department of Materials Science and Engineering, Lehigh University, Bethlehem, PA, United States
| | | | | | - Javier Duarte
- Department of Physics, University of California, San Diego, San Diego, CA, United States
| | - Philip Harris
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Scott Hauck
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA, United States
| | - Mia Liu
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, United States
| | - Mark S. Neubauer
- Department of Physics, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | | | - Seda Ogrenci-Memik
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | - Maurizio Pierini
- European Organization for Nuclear Research (CERN), Meyrin, Switzerland
| | - Thea Aarrestad
- European Organization for Nuclear Research (CERN), Meyrin, Switzerland
| | - Steffen Bähr
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jürgen Becker
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anne-Sophie Berthold
- Institute of Nuclear and Particle Physics, Technische Universität Dresden, Dresden, Germany
| | | | - Tomás E. Müller Bravo
- Department of Physics and Astronomy, University of Southampton, Southampton, United Kingdom
| | - Markus Diefenthaler
- Thomas Jefferson National Accelerator Facility, Newport News, VA, United States
| | - Zhen Dong
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Nick Fritzsche
- Institute of Nuclear and Particle Physics, Technische Universität Dresden, Dresden, Germany
| | - Amir Gholami
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | | | - Dongning Guo
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | | | - Christian Herwig
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Babar Khan
- Department of Computer Science, Technical University Darmstadt, Darmstadt, Germany
| | - Sehoon Kim
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Thomas Klijnsma
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Yaling Liu
- Department of Bioengineering, Lehigh University, Bethlehem, PA, United States
| | - Kin Ho Lo
- Department of Physics, University of Florida, Gainesville, FL, United States
| | - Tri Nguyen
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | | | | | - Ryan A. Rivera
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Kate Scholberg
- Department of Physics, Duke University, Durham, NC, United States
| | | | - Sougata Sen
- Birla Institute of Technology and Science, Pilani, India
| | - Dmitri Strukov
- Department of Electrical and Computer Engineering, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - William Tang
- Department of Physics, Princeton University, Princeton, NJ, United States
| | - Savannah Thais
- Department of Physics, Princeton University, Princeton, NJ, United States
| | | | - Ricardo Vilalta
- Department of Computer Science, University of Houston, Houston, TX, United States
| | - Belina von Krosigk
- Karlsruhe Institute of Technology, Karlsruhe, Germany
- Department of Physics, Universität Hamburg, Hamburg, Germany
| | - Shen Wang
- Department of Bioengineering, Lehigh University, Bethlehem, PA, United States
| | - Thomas K. Warburton
- Department of Physics and Astronomy, Iowa State University, Ames, IA, United States
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15
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Adams C, Walpola R, Schembri A, Harrison R. The HUSH Project: Using codesign to reduce sleep disruptions for patients in hospital. Health Expect 2023; 27:e13881. [PMID: 37740911 PMCID: PMC10768860 DOI: 10.1111/hex.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Poor quality sleep in hospitals may be problematic for patients, negatively impacting their recovery and wellbeing. This project aimed to investigate the effectiveness of codesign in addressing key issues affecting sleep disruption in the healthcare setting. METHODS Codesign with patients, staff and consumer representatives was conducted in an acute metropolitan tertiary public hospital in Sydney, Australia. Through a four-stage process, a multimodal intervention to address and reduce the impact of sleep disruptions among hospital inpatients was created. Pre- and post-intervention evaluation was used to determine changes in patient-reported sleep disruption. RESULTS 'The HUSH Project' (Help Us Support Healing) intervention resulted from the codesign process, which included the provision of HUSH Sleep Packs (with earplugs, eye masks and herbal tea), patient information resources, and ward-based Sleep Champions. Survey data from 210 patients revealed a statistically significant decrease in patient-reported noise disturbances for patients in shared rooms following the 4-week intervention period of the HUSH program. CONCLUSION The HUSH Project demonstrated that a novel multimodal intervention may be valuable in reducing sleep disruption in hospitals. These findings also indicate the benefits of using codesign methodology to support improvement projects that seek to enhance patient experiences of care. PATIENT OR PUBLIC CONTRIBUTION This project utilised codesign methodology, which involved significant contributions from patients and consumer representatives, from research conceptualisation into intervention design, implementation and project evaluation.
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Affiliation(s)
- Corey Adams
- Australian Institute of Health Innovation (AIHI)Macquarie UniversitySydneyAustralia
| | - Ramesh Walpola
- School of Population HealthUniversity of New South Wales (UNSW)SydneyAustralia
- School of Health SciencesUniversity of New South Wales (UNSW)SydneyAustralia
| | | | - Reema Harrison
- Australian Institute of Health Innovation (AIHI)Macquarie UniversitySydneyAustralia
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Kohut K, Morton K, Hurley K, Turner L, Dale C, Eastbrook S, Gold R, Henwood K, Patton S, Punjabi R, White H, Young C, Young J, Bancroft E, Barnett L, Cable S, Connolly G, Coad B, Forman A, Hanson H, Kavanaugh G, Sahan K, Snape K, Torr B, Way R, Winchester E, Youngs A, Eccles D, Foster C. 'A good decision is the one that feels right for me': Codesign with patients to inform theoretical underpinning of a decision aid website. Health Expect 2023; 27:e13844. [PMID: 37705192 PMCID: PMC10768874 DOI: 10.1111/hex.13844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/17/2023] [Accepted: 08/01/2023] [Indexed: 09/15/2023] Open
Abstract
INTRODUCTION Patient decision aids (PtDA) complement shared decision-making with healthcare professionals and improve decision quality. However, PtDA often lack theoretical underpinning. We are codesigning a PtDA to help people with increased genetic cancer risks manage choices. The aim of an innovative workshop described here was to engage with the people who will use the PtDA regarding the theoretical underpinning and logic model outlining our hypothesis of how the PtDA would lead to more informed decision-making. METHODS Short presentations about psychological and behavioural theories by an expert were interspersed with facilitated, small-group discussions led by patients. Patients were asked what is important to them when they make health decisions, what theoretical constructs are most meaningful and how this should be applied to codesign of a PtDA. An artist created a visual summary. Notes from patient discussions and the artwork were analysed using reflexive thematic analysis. RESULTS The overarching theme was: It's personal. Contextual factors important for decision-making were varied and changed over time. There was no one 'best fit' theory to target support needs in a PtDA, suggesting an inductive, flexible framework approach to programme theory would be most effective. The PtDA logic model was revised based on patient feedback. CONCLUSION Meaningful codesign of PtDA including discussions about the theoretical mechanisms through which they support decision-making has the potential to lead to improved patient care through understanding the intricately personal nature of health decisions, and tailoring content and format for holistic care. PATIENT CONTRIBUTION Patients with lived experience were involved in codesign and coproduction of this workshop and analysis as partners and coauthors. Patient discussions were the primary data source. Facilitators provided a semi-structured guide, but they did not influence the patient discussions or provide clinical advice. The premise of this workshop was to prioritise the importance of patient lived experience: to listen, learn, then reflect together to understand and propose ideas to improve patient care through codesign of a PtDA.
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Affiliation(s)
- Kelly Kohut
- School of Health Sciences, Centre for Psychosocial Research in Cancer (CentRIC)University of SouthamptonSouthamptonUK
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Kate Morton
- School of Health Sciences, Centre for Psychosocial Research in Cancer (CentRIC)University of SouthamptonSouthamptonUK
| | - Karen Hurley
- Stanford R. Weiss, MD Center for Hereditary Colorectal NeoplasiaCleveland ClinicClevelandOhioUSA
| | | | | | | | | | | | | | | | | | | | | | | | - Elizabeth Bancroft
- Cancer Genetics Unit and Academic Urology UnitThe Royal Marsden NHS Foundation TrustLondonUK
- Oncogenetics TeamThe Institute of Cancer ResearchLondonUK
| | - Lily Barnett
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Sarah Cable
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Gaya Connolly
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Beth Coad
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Andrea Forman
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Helen Hanson
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Grace Kavanaugh
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Katherine Sahan
- Nuffield Department of Population Health, The Ethox CentreUniversity of OxfordOxfordUK
| | - Katie Snape
- St George's University Hospitals NHS Foundation TrustLondonUK
| | - Bethany Torr
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Rosalind Way
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | | | - Alice Youngs
- St George's University Hospitals NHS Foundation TrustLondonUK
| | | | - Diana Eccles
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Claire Foster
- School of Health Sciences, Centre for Psychosocial Research in Cancer (CentRIC)University of SouthamptonSouthamptonUK
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17
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Torrens GE, Asghar S. 20 years of the Loughborough user centered assistive technology design process: has it made a difference? Assist Technol 2023; 35:425-434. [PMID: 36040847 DOI: 10.1080/10400435.2022.2113477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 02/04/2023] Open
Abstract
An estimated 518 students were taught the Loughborough User Centered Assistive Technology design process, LUCAT, since 2000. Graduates were contacted via a professional networking website to take part in a survey with four being interviewed. The purpose of the survey was to find out if: 1) Did they still use any parts of the process; and 2) Where they had applied them. The respondents ranged from returning placement undergraduates to senior managers in research and development within major companies. From the 105 respondents 23% stated they used parts of the LUCAT process every working day, a further 25% once a week and 27% once a month. The elements of the process used were predominantly semi-structured interviews, concept generation, codesign, design presentation and feedback. Respondents highlighted the benefits of using this process including gaining insights from users, being time efficient, saving money, developing a relationship with end users and making a difference to the lives of people with disability. It was suggested some industries had still not incorporated a User Centered Design approach within New Product Development. The use of the process was shown to be useful beyond AT product design into most areas of design activity.
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Affiliation(s)
- George Edward Torrens
- Loughborough School of Design and Creative Arts, Loughborough University, Loughborough, Leicester, UK
| | - Salman Asghar
- Department of Product & Industrial Design, University of Engineering & Technology, Lahore, Pakistan
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18
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Lusambili A, Khaemba P, Agoi F, Oguna M, Nakstad B, Scorgie F, Filippi V, Hess J, Roos N, Chersich M, Kovats S, Luchters S. Process and outputs from a community codesign workshop on reducing impact of heat exposure on pregnant and postpartum women and newborns in Kilifi, Kenya. Front Public Health 2023; 11:1146048. [PMID: 37719738 PMCID: PMC10501312 DOI: 10.3389/fpubh.2023.1146048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Background Ambient heat exposure is increasing due to climate change and is known to affect the health of pregnant and postpartum women, and their newborns. Evidence for the effectiveness of interventions to prevent heat health outcomes in east Africa is limited. Codesigning and integrating local-indigenous and conventional knowledge is essential to develop effective adaptation to climate change. Methods Following qualitative research on heat impacts in a community in Kilifi, Kenya, we conducted a two-day codesign workshop to inform a set of interventions to reduce the impact of heat exposure on maternal and neonatal health. Participants were drawn from a diverse group of purposively selected influencers, implementers, policy makers, service providers and community members. The key domains of focus for the discussion were: behavioral practices, health facilities and health system factors, home environment, water scarcity, and education and awareness. Following the discussions and group reflections, data was transcribed, coded and emerging intervention priorities ranked based on the likelihood of success, cost effectiveness, implementation feasibility, and sustainability. Results Twenty one participants participated in the codesign discussions. Accessibility to water supplies, social behavior-change campaigns, and education were ranked as the top three most sustainable and effective interventions with the highest likelihood of success. Prior planning and contextualizing local set-up, cross-cultural and religious practices and budget considerations are important in increasing the chances of a successful outcome in codesign. Conclusion Codesign of interventions on heat exposure with diverse groups of participants is feasible to identify and prioritize adaptation interventions. The codesign workshop was used as an opportunity to build capacity among facilitators and participants as well as to explore interventions to address the impact of heat exposure on pregnant and postpartum women, and newborns. We successfully used the codesign model in co-creating contextualized socio-culturally acceptable interventions to reduce the risk of heat on maternal and neonatal health in the context of climate change. Our interventions can be replicated in other similar areas of Africa and serve as a model for co-designing heat-health adaptation.
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Affiliation(s)
- Adelaide Lusambili
- Environmental Health and Governance Center, Leadership and Governance HUB - School of Business, Africa International University, Nairobi, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Peter Khaemba
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Felix Agoi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Martha Oguna
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Emergency Medicine, Environmental and Occupational Health Sciences, Global Health, University of Washington, Seattle, WA, United States
| | - Britt Nakstad
- Division of Pediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Fiona Scorgie
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Veronique Filippi
- MARCH, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jeremy Hess
- Emergency Medicine, Environmental and Occupational Health Sciences, Global Health, University of Washington, Seattle, WA, United States
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
| | - Mathew Chersich
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Sari Kovats
- MARCH, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stanley Luchters
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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19
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Bray EA, George A, Everett B, Salamonson Y, Ramjan LM. Feasibility and Acceptability of a Codesigned Health Care Transition Intervention for Young People With Spinal Cord Injuries. Top Spinal Cord Inj Rehabil 2023; 29:89-97. [PMID: 38076288 PMCID: PMC10644856 DOI: 10.46292/sci22-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Due in part to medical complications, adults with a pediatric onset spinal cord injury (SCI) are at higher risk of experiencing dissatisfaction with life and lower perceived physical health when compared to their peers with no disability. To support the prevention of medical complications, young people with SCI must successfully transition to adult health care. Health care transition (HCT) interventions can support young people with chronic conditions in their move to adult health care. Objectives To evaluate the feasibility and acceptability of a web-based HCT intervention codesigned with young people with SCI and parents/caregivers. Methods Semi-structured individual interviews were conducted online with young people with SCI and parents/caregivers who transitioned or were preparing for the transition from pediatric to adult health care. Interviews were also conducted with health care professionals. The interviews were analyzed using a hybrid deductive and inductive qualitative content analysis process. Feasibility and acceptability were measured using Bowen and colleagues' framework, which includes eight focus areas: acceptability, demand, implementation, practicality, adaption, integration, expansion, and limited efficacy. Results Overall, participants responded positively to the intervention and believed that it would be useful to young people with SCI and parents/caregivers. Two areas of Bowen et al.'s framework, implementation and integration, require further consideration in terms of how to embed the intervention into the current transition process. Conclusion This study found the HCT intervention to be an innovative approach to support young people with SCI and their parent/caregivers that demonstrates promise in the areas of feasibility and acceptability.
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Affiliation(s)
- Emily Alice Bray
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Lucie M. Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
- Ingham Institute Applied Medical Research, Liverpool, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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20
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Kim KK, McGrath SP, Solorza JL, Lindeman D. The ACTIVATE Digital Health Pilot Program for Diabetes and Hypertension in an Underserved and Rural Community. Appl Clin Inform 2023; 14:644-653. [PMID: 37201542 PMCID: PMC10431973 DOI: 10.1055/a-2096-0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/16/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Community health centers and patients in rural and agricultural communities struggle to address diabetes and hypertension in the face of health disparities and technology barriers. The stark reality of these digital health disparities were highlighted during the coronavirus disease 2019 pandemic. OBJECTIVES The objective of the ACTIVATE (Accountability, Coordination, and Telehealth in the Valley to Achieve Transformation and Equity) project was to codesign a platform for remote patient monitoring and program for chronic illness management that would address these disparities and offer a solution that fit the needs and context of the community. METHODS ACTIVATE was a digital health intervention implemented in three phases: community codesign, feasibility assessment, and a pilot phase. Pre- and postintervention outcomes included regularly collected hemoglobin A1c (A1c) for participants with diabetes and blood pressure for those with hypertension. RESULTS Participants were adult patients with uncontrolled diabetes and/or hypertension (n = 50). Most were White and Hispanic or Latino (84%) with Spanish as a primary language (69%), and the mean age was 55. There was substantial adoption and use of the technology: over 10,000 glucose and blood pressure measures were transmitted using connected remote monitoring devices over a 6-month period. Participants with diabetes achieved a mean reduction in A1c of 3.28 percentage points (standard deviation [SD]: 2.81) at 3 months and 4.19 percentage points (SD: 2.69) at 6 months. The vast majority of patients achieved an A1c in the target range for control (7.0-8.0%). Participants with hypertension achieved reductions in systolic blood pressure of 14.81 mm Hg (SD: 21.40) at 3 months and 13.55 mm Hg (SD: 23.31) at 6 months, with smaller reductions in diastolic blood pressure. The majority of participants also reached target blood pressure (less than 130/80). CONCLUSION The ACTIVATE pilot demonstrated that a codesigned solution for remote patient monitoring and chronic illness management delivered by community health centers can overcome digital divide barriers and show positive health outcomes for rural and agricultural residents.
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Affiliation(s)
- Katherine K. Kim
- MITRE Corporation, Health Innovation Center, McLean, Virginia, United States
- Department of Public Health Sciences, Division of Health Informatics, University of California Davis, School of Medicine, Sacramento, California, United States
| | - Scott P. McGrath
- CITRIS and the Banatao Institute, University of California Berkeley, Berkeley, California, United States
| | - Juan L. Solorza
- Livingston Community Health, Livingston, California, United States
| | - David Lindeman
- CITRIS and the Banatao Institute, University of California Berkeley, Berkeley, California, United States
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21
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Lai-Kwon J, Dushyanthen S, Seignior D, Barrett M, Buisman-Pijlman F, Buntine A, Woodward-Kron R, McArthur G, Kok DL. Designing a wholly online, multidisciplinary Master of Cancer Sciences degree. BMC Med Educ 2023; 23:544. [PMID: 37525150 PMCID: PMC10391849 DOI: 10.1186/s12909-023-04537-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Improving oncology-specific knowledge and skills of healthcare professionals is critical for improving the outcomes of people with cancer. Many current postgraduate education offerings may be inaccessible to busy professionals, contain minimal consumer input or do not focus on the multidisciplinary nature of cancer care. In response to these needs, a Master of Cancer Sciences degree was developed. Our aim is to describe the development of the Master of Cancer Sciences. METHODS We describe the development of the Master of Cancer Sciences, including its theoretical and its pedagogical underpinnings. RESULTS Our approach to curriculum design was guided by Kern's Six-Step Approach to Medical Curriculum and underpinned by the Seven Principles of Online Learning. These approaches were further underpinned by the Cognitive Theory of Multimedia Learning which informed our approach to audio and visual information design. The pedagogy is interactive, experiential, interprofessional and importantly, includes consumers as educators. In practice, learning activities include peer feedback, multidisciplinary team meeting simulations, group work and clinical role plays. The online environment was visually shaped through infographics, high-quality educational videos and gamification. CONCLUSION We have designed a Master of Cancer Sciences that is one of the first wholly online, cancer-specific Masters' programs. Its industry-led curriculum using evidence-based pedagogical choices utilises a range of novel digital formats and integrates the consumer perspective to provide a holistic overview of the field. Quantitative and qualitative evaluation of learning outcomes is ongoing.
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Affiliation(s)
- Julia Lai-Kwon
- Victorian Comprehensive Cancer Centre (VCCC) Alliance, Melbourne, Australia
- Department of Medical Education, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia
| | - Sathana Dushyanthen
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - David Seignior
- Melbourne School of Professional and Continuing Education, University of Melbourne, Melbourne, Australia
| | - Michelle Barrett
- Victorian Comprehensive Cancer Centre (VCCC) Alliance, Melbourne, Australia
| | - Femke Buisman-Pijlman
- Melbourne School of Professional and Continuing Education, University of Melbourne, Melbourne, Australia
| | - Andrew Buntine
- Melbourne School of Professional and Continuing Education, University of Melbourne, Melbourne, Australia
| | - Robyn Woodward-Kron
- Department of Medical Education, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Grant McArthur
- Victorian Comprehensive Cancer Centre (VCCC) Alliance, Melbourne, Australia
- Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia
- Department of Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - David L Kok
- Victorian Comprehensive Cancer Centre (VCCC) Alliance, Melbourne, Australia.
- Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, 3000, Australia.
- Department of Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
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22
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Drobne D, Ciornii D, Hodoroaba V, Bohmer N, Novak S, Kranjc E, Kononenko V, Reuther R. Knowledge, Information, and Data Readiness Levels (KaRLs) for Risk Assessment, Communication, and Governance of Nano-, New, and Other Advanced Materials. Glob Chall 2023; 7:2200211. [PMID: 37483420 PMCID: PMC10362106 DOI: 10.1002/gch2.202200211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/03/2023] [Indexed: 07/25/2023]
Abstract
The obvious benefits derived from the increasing use of engineered nano-, new, and advanced materials and associated products have to be weighed out by a governance process against their possible risks. Differences in risk perception (beliefs about potential harm) among stakeholders, in particular nonscientists, and low transparency of the underlying decision processes can lead to a lack of support and acceptance of nano-, new, and other advanced material enabled products. To integrate scientific outcomes with stakeholders needs, this work develops a new approach comprising a nine-level, stepwise categorization and guidance system entitled "Knowledge, Information, and Data Readiness Levels" (KaRLs), analogous to the NASA Technology Readiness Levels. The KaRL system assesses the type, extent, and usability of the available data, information, and knowledge and integrates the participation of relevant and interested stakeholders in a cocreation/codesign process to improve current risk assessment, communication, and governance. The novelty of the new system is to communicate and share all available and relevant elements on material related risks in a user/stakeholder-friendly, transparent, flexible, and holistic way and so stimulate reflection, awareness, communication, and a deeper understanding that ultimately enables the discursive process that is needed for the sustainable risk governance of new materials.
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Affiliation(s)
- Damjana Drobne
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Dmitri Ciornii
- Bundesanstalt für Materialforschung und‐Prüfung (BAM)Division 6.1 Surface Analysis and Interfacial ChemistryUnter den Eichen 8712205BerlinGermany
| | - Vasile‐Dan Hodoroaba
- Bundesanstalt für Materialforschung und‐Prüfung (BAM)Division 6.1 Surface Analysis and Interfacial ChemistryUnter den Eichen 8712205BerlinGermany
| | - Nils Bohmer
- Evonik Operations GmbHRodenbacher Chaussee 463457Hanau‐WolfgangGermany
| | - Sara Novak
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Eva Kranjc
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Veno Kononenko
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Rudolf Reuther
- Environmental AssessmentsOberes Lautenbächle 377886LaufGermany
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23
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Monje MHG, Grosjean S, Srp M, Antunes L, Bouça-Machado R, Cacho R, Domínguez S, Inocentes J, Lynch T, Tsakanika A, Fotiadis D, Rigas G, Růžička E, Ferreira J, Antonini A, Malpica N, Mestre T, Sánchez-Ferro Á. Co-Designing Digital Technologies for Improving Clinical Care in People with Parkinson's Disease: What Did We Learn? Sensors (Basel) 2023; 23:4957. [PMID: 37430871 DOI: 10.3390/s23104957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 07/12/2023]
Abstract
The healthcare model is shifting towards integrated care approaches. This new model requires patients to be more closely involved. The iCARE-PD project aims to address this need by developing a technology-enabled, home-based, and community-centered integrated care paradigm. A central part of this project is the codesign process of the model of care, exemplified by the active participation of patients in the design and iterative evaluation of three sensor-based technological solutions. We proposed a codesign methodology used for testing the usability and acceptability of these digital technologies and present initial results for one of them, MooVeo. Our results show the usefulness of this approach in testing the usability and acceptability as well as the opportunity to incorporate patients' feedback into the development. This initiative will hopefully help other groups incorporate a similar codesign approach and develop tools that are well adapted to patients' and care teams' needs.
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Affiliation(s)
- Mariana H G Monje
- HM CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, 28968 Madrid, Spain
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Sylvie Grosjean
- Department of Communication, Com&Tech Innovations Lab (CTI-Lab), University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Martin Srp
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, 128 21 Prague, Czech Republic
| | - Laura Antunes
- CNS-Campus Neurológico, 28933 Torres Vedras, Portugal
| | | | - Ricardo Cacho
- CNS-Campus Neurológico, 28933 Torres Vedras, Portugal
| | - Sergio Domínguez
- LAIMBIO, Laboratorio de Análisis de Imagen Médica y Biometría, Universidad Rey Juan Carlos, 2560-280 Madrid, Spain
| | - John Inocentes
- Dublin Neurological Institute, Mater Misericordiae University Hospital, D07 W7XF Dublin, Ireland
| | - Timothy Lynch
- Dublin Neurological Institute, Mater Misericordiae University Hospital, D07 W7XF Dublin, Ireland
| | | | | | | | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, 128 21 Prague, Czech Republic
| | | | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neurosciences (DNS), Padova University, 35131 Padova, Italy
| | - Norberto Malpica
- LAIMBIO, Laboratorio de Análisis de Imagen Médica y Biometría, Universidad Rey Juan Carlos, 2560-280 Madrid, Spain
| | - Tiago Mestre
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Research Institute, Ottawa, ON 60611, Canada
| | - Álvaro Sánchez-Ferro
- HM CINAC, Hospital Universitario HM Puerta del Sur, Universidad CEU-San Pablo, 28968 Madrid, Spain
- Movement Disorders Unit, Neurology Department, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
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24
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Rojo J, George A, Salamonson Y, Hunt L, Ramjan LM. Using Codesign to Develop a Novel Oral Healthcare Educational Intervention for Undergraduate Nursing Students. Int J Environ Res Public Health 2023; 20:4919. [PMID: 36981828 PMCID: PMC10048837 DOI: 10.3390/ijerph20064919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
To build a nursing workforce that is equipped to undertake oral health promotion and screening, an educational program was needed. With codesign being used in multiple settings, it was selected as the approach to use, with Mezirow's Transformative Learning theory as the underpinning framework. This study aimed to develop an oral healthcare educational intervention for nursing students. Using a six-step codesign framework, nursing students and faculty staff were invited to participate in two Zoom™ Video Communication workshops to codesign the learning activities to be used in the classroom. The codesign process was evaluated through focus groups and analysed using a hybrid content analysis approach. A multifaceted oral healthcare educational intervention was developed. Learning material was delivered using a range of different learning and teaching resources such as dental models, podcasts, and an oral health assessment across two subjects. Multiple approaches to recruitment, the inclusion of participants, and good facilitation of workshop discussions were critical to the codesign of the educational intervention. Evaluation revealed that preparing participants prior to the workshops acted as a catalyst for conversations, which facilitated the codesign process. Codesign was a useful approach to employ in the development of an oral healthcare intervention to address an area of need.
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Affiliation(s)
- Jacqueline Rojo
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
- School of Nursing, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Leanne Hunt
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
| | - Lucie M. Ramjan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, NSW 2170, Australia
- School of Nursing, University of Wollongong, Wollongong, NSW 2522, Australia
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25
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Davis H, Elmer S, Graves K, Learmonth C. Codesign and community outreach to create COVID-19 safe communities: A Karen community case study. Front Public Health 2023; 11:1081767. [PMID: 37033045 PMCID: PMC10079966 DOI: 10.3389/fpubh.2023.1081767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
During the COVID-19 pandemic, government directives for health and community services focused on building capacity for COVID-19 safe behaviors. During 2020-2021, there was mounting pressure to increase vaccination numbers to boost population-wide immunity, thereby enabling the lessening of pandemic response restrictions. The Australian population, in general, faced communication hurdles in understanding COVID-19, government directives and policies, and health initiatives. This was particularly challenging given the rapid changes in disease behaviors and community response requirements. This community case study documents local experience in delivering information about COVID-19 safety and vaccination to a former refugee community (the Karen community) in regional Victoria. Community outreach and codesign approaches established closer engagement between the Karen community and Bendigo Community Health Services (BCHS). This case study is explored through semi-structured interviews conducted face-to-face and via videoconferencing with key Karen community leaders, Karen community members, vaccination clinic volunteers, and BCHS staff and bicultural workers. A hybrid approach that employed community outreach and codesign approaches in tandem built trust and closer ties between the Karen community and BCHS, leading to increased understanding and compliance with COVID-19 safe messages and vaccination uptake. Community-led innovations included codesign of COVID-19 fact sheets and videos in the Karen language, involvement of "local champions," assisting Karen businesses with COVID-19 safe plans, and creation of a COVID-19 information hotline. The latter was facilitated by BCHS bicultural staff. These innovations supported the delivery of vaccination clinics at the local Karen Temple. Embedding multi-level, tailored, and responsive public health approaches is particularly important in complex settings where there are disproportionately high levels of community disadvantage, as occurred during the COVID-19 pandemic.
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Affiliation(s)
- Hilary Davis
- The Centre for Social Impact, Faculty of Business and Law, Swinburne University of Technology, Melbourne, VIC, Australia
- *Correspondence: Hilary Davis,
| | - Shandell Elmer
- The Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Kaye Graves
- Bendigo Community Health Services, Bendigo, VIC, Australia
| | - Caitlin Learmonth
- The Centre for Social Impact, Faculty of Business and Law, Swinburne University of Technology, Melbourne, VIC, Australia
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26
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Varotsis E, Schlegel L, Slovis BH, Henwood PC, Brooks SE, Pugliese R, Ku B, Hutchinson M. COVID-19 Vaccine Equity: Codesigning Public Health Interventions with Community Partners. Popul Health Manag 2022; 25:828-830. [PMID: 36454177 DOI: 10.1089/pop.2022.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Eva Varotsis
- Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Lauren Schlegel
- Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Benjamin H Slovis
- Department of Emergency Medicine and Office of Clinical Informatics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Patricia C Henwood
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sandra E Brooks
- Jefferson Collaborative for Health Equity, Thomas Jefferson University Health System, Philadelphia, Pennsylvania, USA
| | - Robert Pugliese
- Innovation Pilar, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Bon Ku
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Morgan Hutchinson
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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27
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Zhang S, Ke X, Jiang Q, Chai Z, Wu Z, Ding H. Fabrication and Functionality Integration Technologies for Small-Scale Soft Robots. Adv Mater 2022; 34:e2200671. [PMID: 35732070 DOI: 10.1002/adma.202200671] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/12/2022] [Indexed: 06/15/2023]
Abstract
Small-scale soft robots are attracting increasing interest for visible and potential applications owing to their safety and tolerance resulting from their intrinsic soft bodies or compliant structures. However, it is not sufficient that the soft bodies merely provide support or system protection. More importantly, to meet the increasing demands of controllable operation and real-time feedback in unstructured/complicated scenarios, these robots are required to perform simplex and multimodal functionalities for sensing, communicating, and interacting with external environments during large or dynamic deformation with the risk of mismatch or delamination. Challenges are encountered during fabrication and integration, including the selection and fabrication of composite/materials and structures, integration of active/passive functional modules with robust interfaces, particularly with highly deformable soft/stretchable bodies. Here, methods and strategies of fabricating structural soft bodies and integrating them with functional modules for developing small-scale soft robots are investigated. Utilizing templating, 3D printing, transfer printing, and swelling, small-scale soft robots can be endowed with several perceptual capabilities corresponding to diverse stimulus, such as light, heat, magnetism, and force. The integration of sensing and functionalities effectively enhances the agility, adaptability, and universality of soft robots when applied in various fields, including smart manufacturing, medical surgery, biomimetics, and other interdisciplinary sciences.
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Affiliation(s)
- Shuo Zhang
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
| | - Xingxing Ke
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
| | - Qin Jiang
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
| | - Zhiping Chai
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
| | - Zhigang Wu
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
| | - Han Ding
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, P. R. China
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28
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Mistry SK, Harris E, Harris MF. Learning from a codesign exercise aimed at developing a navigation intervention in the general practice setting. Fam Pract 2022; 39:1070-1079. [PMID: 35365997 DOI: 10.1093/fampra/cmac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES In this study, we aimed to describe and evaluate the codesign of an intervention in general practice setting to help address navigation problems faced by the patients from the culturally and linguistically diverse (CALD) community in Australia. METHODS An experience-based codesign (EBCD) methodology was adopted using the Double Diamond design process. Two codesign workshops were conducted online with 13 participants including patients, their caregivers, health service providers, researchers, and other stakeholders. Workshops were audio-recorded, transcribed, and thematically analyzed. RESULTS The codesign participants identified several navigation problems among CALD patients such as inadequate health literacy, cultural and language barriers, and difficulties with navigating health and social services. They believed that bilingual community navigators (BCNs; lay health workers from the same language or cultural background) could help them address these problems. However, this depended on BCNs being trained and supervised, with a clear role definition and manageable workloads, and not used as an interpreter. In undertaking the codesign process, we found that pre-workshop consultations were useful to ensure engagement, especially for consumers who participated more actively in group activities with service providers after these and their own separate small group discussions during the workshop. CONCLUSION Overall, participants identified that BCNs could offer help in addressing the problems faced by the CALD patients in accessing care in general practice setting. The codesign process provided new insights into the navigation problems faced by CALD patients in accessing care and collaboratively developed a strategy for further testing and evaluation.
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Affiliation(s)
- Sabuj K Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Botany Street, Kensington, NSW 2052, Australia
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Botany Street, Kensington, NSW 2052, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Botany Street, Kensington, NSW 2052, Australia
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Liddle J, Worthy P, Frost D, Taylor E, Taylor D. Partnering with people living with dementia and care partners in technology research and design: Reflections and recommendations. Aust Occup Ther J 2022; 69:723-741. [PMID: 36203322 PMCID: PMC10092369 DOI: 10.1111/1440-1630.12843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/15/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Occupational therapists may recommend and support technology use for facilitating independence, safety, wellbeing, and participation. There are high expectations for technology for people living with dementia. However, there is recognition that technologies will need to improve to deliver these expected benefits. People living with dementia have historically been excluded from direct involvement in research and design. A program of participatory research was undertaken to codesign technologies and technology research with people living with dementia and care partners. This work aims to capture the requirements, actions, and barriers experienced in forming these partnerships in technology research and design. METHODS A shared metareflection of experiences was conducted by members (5) of the research teams involved in three participatory research and technology design studies. The team comprising living experience experts, an occupational therapist, and interaction designer reflected on their experiences and derived recommendations. Key considerations for effective partnerships were drawn inductively by the authors from study experiences, materials, and reflexive discussion. FINDINGS Six core areas were identified. These were four action areas-(1) Agree on the value; (2) The time to start partnering is now; (3) Ask not assume; and (4) Push back on 'we always have'-(5) barriers and tensions, and (6) unexpected benefits. The reflections indicated that genuine partnerships and engagements were possible with living experience experts in research and design teams. These required resourcing and focussed actions to promote partnership. Despite some structural changes that encourage partnering, there are considerable barriers to this engagement; however, benefits beyond the expected ones can be realised. CONCLUSION Genuine partnerships in technology research and design with living experience experts are possible and lead to benefits for the team, research outcomes, and technologies. Recommended actions could support expansion of effective partnerships with people living with dementia and care partners as well as other partnerships in research.
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Affiliation(s)
- Jacki Liddle
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Peter Worthy
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Dennis Frost
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Eileen Taylor
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
| | - Dubhglas Taylor
- The Florence Project, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland, Australia
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30
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Robinson A, O'Brien N, Sile L, Guraya HK, Govind T, Harris V, Pilkington G, Todd A, Husband A. Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person-centred codesign study. Health Expect 2022; 25:3040-3052. [PMID: 36161966 DOI: 10.1111/hex.13611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Medicines-centred consultations are vital to support medicine effectiveness and optimize health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking; this study will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities. METHODS A series of codesign workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call (adhering to COVID-19 restrictions). Existing evidence-based perceptions affecting access to medicines advice were critiqued and recommendations were generated, by use of reflexive thematic analysis, to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim. QSR NVivo (Version 12) facilitated data analysis. RESULTS Twelve participants were recruited using purposive sampling; including eight UK citizens, two asylum seekers and two participants in receipt of residency visas. In total, four different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and cocreate recommendations to improve access to medicines advice in community pharmacies. Three recommendations were developed and centred on: (i) delivering and providing culturally competent medicines advice; (ii) building awareness of accessing medicines advice from community pharmacies; and (iii) enabling better discussions with patients from ethnic minority communities. CONCLUSIONS These recommendations have the potential to support community pharmacy services to overcome ethnic inequalities affecting medicines advice; service commissioners should consider these findings to best meet the needs of ethnic minority patients. Cultural competence training for community pharmacy staff could support the creation of pharmacies as inclusive healthcare settings. Collaborative working with ethnic minority communities could enable specific tailoring of medicines-centred services to best meet their needs. PATIENT OR PUBLIC CONTRIBUTION The National Institute for Health Research (NIHR) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualization. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and findings were reported, with cultural competence. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Laura Sile
- Alumni, School of Pharmacy, Liverpool John Moores University, Liverpool, UK
| | | | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Cruddas Park Surgery, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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31
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Meldahl LG, Krijger L, Andvik MM, Cardenas NE, Cuddeford O, Duerto S, Game JR, Ibenfeldt M, Mustafa M, Tong M, Viksveen P. Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives. Health Expect 2022; 25:2924-2936. [PMID: 36074720 DOI: 10.1111/hex.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. METHODS A two-stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in-depth perspectives of 10 adolescent coresearchers were gathered through self-reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. RESULTS Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. DISCUSSION This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self-learning system to continuously adapt to user feedback. CONCLUSION This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost-effectiveness and safety. PATIENT OR PUBLIC CONTRIBUTION This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript.
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Affiliation(s)
- Laia G Meldahl
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Lou Krijger
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,ESCP Europe (Business Management), Ecole Supérieure de Commerce de Paris, Paris, France
| | - Maren M Andvik
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Medical, Veterinary and Life Sciences (Zoology), University of Glasgow, Glasgow, Scotland
| | - Nicole E Cardenas
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Psychology (Psychology), University of Aberdeen, Aberdeen, Scotland
| | - Oliver Cuddeford
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Art Design and Architecture (Architecture), University of Huddersfield, Huddersfield, UK
| | - Samuel Duerto
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Philosophy, Theology and Religious Studies (Philosophy, Politics and Societies), Radboud University, Nijmegen, The Netherlands
| | - Julia R Game
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Maya Ibenfeldt
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Biology, Medicine and Health (Pharmacology), University of Manchester, Manchester, UK
| | - Murad Mustafa
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Health Sciences (Nursing), University of Stavanger, Stavanger, Norway
| | - Mathias Tong
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Chemical Engineering and Analytical Science (Chemical Engineering), University of Manchester, Manchester, UK
| | - Petter Viksveen
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Cranston KA, Wong WY, Knowlton S, Bennett C, Rivadeneira S. Five psychological principles of codesigning conservation with (not for) communities. Zoo Biol 2022; 41:409-417. [PMID: 35978562 DOI: 10.1002/zoo.21725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 07/18/2022] [Accepted: 07/28/2022] [Indexed: 01/07/2023]
Abstract
A growing number of environmental professionals are realizing that equitable and meaningful engagement of local community members in the development of programming is essential for catalyzing the durable, long-term action needed to conserve wildlife. Many who attempt to codesign programs with (not for) communities find that choosing the most effective strategies to accomplish this task is crucial and can oftentimes feel daunting. In this paper, a validated psychometric instrument called the Five Factors of Sustained Engagement (Five Factors) was used to analyze community engagement projects from two AZA-accredited institutions, highlighting how the leaders of each project believe they have fostered each factor in their projects. Professionals can use the Five Factors as guideposts and evaluation criteria to increase the long-term motivation of community members to engage in conservation efforts over time. The discussion offers strategies that psychological research has shown to increase long-term motivation for wildlife conservation and suggest how to implement them in the codesign of conservation programming with the communities that are impacted by it the most. Together, this synthesis offers an innovative, psychology-based approach to fostering and evaluating the success of sustainable community engagement for conservation Wildlife conservation projects are rarely su long-term engagement from the humans who are most impacted by those projects.
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Affiliation(s)
- Kayla A Cranston
- Conservation Psychology Institute, Antioch University New England, Keene, New Hampshire, USA
| | - Wei Ying Wong
- Science and Education Department, Alaska SeaLife Center, Seward, Alaska, USA
| | | | | | - Shannen Rivadeneira
- Conservation Psychology Institute, Antioch University New England, Keene, New Hampshire, USA
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Buettgen A, Micsinszki SK, Phoenix M, Mulvale G, Wyndham-West M, Park S, Bruce E, Fleisig R, Rogerson K, Murray-Leung L, Moll S. Unpacking the potential of developmental evaluation in codesign work. Health Expect 2022; 25:1186-1189. [PMID: 35894808 PMCID: PMC9327853 DOI: 10.1111/hex.13456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/22/2022] [Accepted: 02/05/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Samantha K Micsinszki
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Michelle Phoenix
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | | | | | - Sean Park
- McMaster University, Hamilton, Ontario, Canada
| | - Emma Bruce
- McMaster University, Hamilton, Ontario, Canada
| | | | | | | | - Sandra Moll
- McMaster University, Hamilton, Ontario, Canada
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Sellen K, Goso N, Halleran L, Mulvale A, Sarmiento F, Ligabue F, Handford C, Klaiman M, Milos G, Wright A, Charles M, Sniderman R, Hunt R, Parsons JA, Leece P, Hopkins S, Shahin R, Yüni P, Morrison L, Campbell DM, Strike C, Orkin A. Design details for overdose education and take-home naloxone kits: Codesign with family medicine, emergency department, addictions medicine and community. Health Expect 2022; 25:2440-2452. [PMID: 35909312 DOI: 10.1111/hex.13559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Overdose education and naloxone distribution (OEND) programmes equip and train people who are likely to witness an opioid overdose to respond with effective first aid interventions. Despite OEND expansion across North America, overdose rates are increasing, raising questions about how to improve OEND programmes. We conducted an iterative series of codesign stakeholder workshops to develop a prototype for take-home naloxone (THN)-kit (i.e., two doses of intranasal naloxone and training on how to administer it). METHODS We recruited people who use opioids, frontline healthcare providers and public health representatives to participate in codesign workshops covering questions related to THN-kit prototypes, training on how to use it, and implementation, including refinement of design artefacts using personas and journey maps. Completed over 9 months, the workshops were audio-recorded and transcribed with visible results of the workshops (i.e., sticky notes, sketches) archived. We used thematic analyses of these materials to identify design requirements for THN-kits and training. RESULTS We facilitated 13 codesign workshops to identify and address gaps in existing opioid overdose education training and THN-kits and emphasize timely response and stigma in future THN-kit design. Using an iterative process, we created 15 prototypes, 3 candidate prototypes and a final prototype THN-kit from the synthesis of the codesign workshops. CONCLUSION The final prototype is available for a variety of implementation and evaluation processes. The THN-kit offers an integrated solution combining ultra-brief training animation and physical packaging of nasal naloxone to be distributed in family practice clinics, emergency departments, addiction medicine clinics and community settings. PATIENT OR PUBLIC CONTRIBUTION The codesign process was deliberately structured to involve community members (the public), with multiple opportunities for public contribution. In addition, patient/public participation was a principle for the management and structuring of the research team.
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Affiliation(s)
- Kate Sellen
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | - Nick Goso
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | - Laura Halleran
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | - Alison Mulvale
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | | | - Filipe Ligabue
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | - Curtis Handford
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Michelle Klaiman
- Department of Emergency Medicine, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Geoffrey Milos
- SOONER Project Community Advisory Committee, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Amy Wright
- SOONER Project Community Advisory Committee, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Mercy Charles
- Allan Waters Family Simulation Centre, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Ruby Sniderman
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Richard Hunt
- Health Design Studio, OCAD University, Toronto, Ontario, Canada
| | - Janet A Parsons
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Rita Shahin
- Toronto Public Health, Toronto, Ontario, Canada
| | - Peter Yüni
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Laurie Morrison
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Douglas M Campbell
- Allan Waters Family Simulation Centre, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Aaron Orkin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.,Inner City Health Associates, Toronto, Ontario, Canada.,Department of Emergency Medicine, St. Joseph's Health Centre, Unity Health, Toronto, Ontario, Canada.,Department of Emergency Medicine, Humber River Hospital, Toronto, Ontario, Canada
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35
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Rapin L, Garnier E. [A collaborative project to improve emergency room admissions through codesign]. Soins 2022; 67:22-25. [PMID: 36253059 DOI: 10.1016/j.soin.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Design is a project approach that is gradually opening up in the hospital sector with the ambition of contributing to the improvement of hospitality for the benefit of patients and caregivers. This is the challenge taken up by the University Hospital of Montpellier (34) by creating an experimental project that integrates design practices in the emergency room.
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Affiliation(s)
- Loélia Rapin
- LS2N, UMR 6004, Faculté des sciences et des techniques, 2 rue de la Houssinière, Bât. 34, 44322 Nantes cedex 03, France; Sensipode, 40 rue de la Tour-d'Auvergne, 44200 Nantes, France; École de design Care Design Lab, L'École de design Nantes Atlantique, 61 boulevard de la Prairie-aux-Ducs, 44200 Nantes, France
| | - Emmanuelle Garnier
- Centre hospitalier universitaire de Montpellier, 191 avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
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36
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Knowles S, Sharma V, Fortune S, Wadman R, Churchill R, Hetrick S. Adapting a codesign process with young people to prioritize outcomes for a systematic review of interventions to prevent self-harm and suicide. Health Expect 2022; 25:1393-1404. [PMID: 35521681 PMCID: PMC9327872 DOI: 10.1111/hex.13479] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background Research and clinical outcomes that matter to people with lived experience can significantly differ from those outcomes studied by researchers. To inform a future Cochrane review of suicide and self‐harm prevention interventions, we aimed to work with young people with relevant lived experience to agree on priority outcomes. Design Four participatory codesign workshops were completed across two sites (New Zealand, United Kingdom) with 28 young people in total. We iteratively adapted the methods over the course of the study. Results ‘Improved coping’ and ‘safer/more accepting environment to disclose’ were the final top‐rated outcomes. ‘Reduction of self‐harm’ was considered a low priority as it could be misleading, stigmatizing and was considered a secondary consequence of other improvements. In contrast to typical research outcomes, young people emphasized the diversity of experience, the dynamic nature of improvement and holistic and asset‐based framing. Methodologically, dialogue using design materials (personas) to thematically explore outcomes was effective in overcoming the initial challenge of disparate quantitative ratings. Discussion The results will directly inform the development of a Cochrane review, enabling identification of whether and how outcomes of most importance to young people are measured in trials. Rather than producing discrete measurable outcomes that could be easily added to the systematic review, the young people challenged the academic conceptualization of outcomes, with implications for future evidence synthesis and intervention research, and for future codesign. Patient or Public Contribution Young people with lived experience were codesigners of the outcomes, and their feedback informed iterative changes to the study methods.
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Affiliation(s)
- Sarah Knowles
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Vartika Sharma
- Department of Psychological Medicine, School of Medicine, The University of Auckland, Auckland, New Zealand.,Children and Young People Satellite, Cochrane Common Mental Disorders, The University of Auckland, Auckland, New Zealand
| | - Sarah Fortune
- Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ruth Wadman
- Department of Health Sciences, University of York, York, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sarah Hetrick
- Department of Psychological Medicine, School of Medicine, The University of Auckland, Auckland, New Zealand.,Children and Young People Satellite, Cochrane Common Mental Disorders, The University of Auckland, Auckland, New Zealand
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Puigdomènech E, Robles N, Balfegó M, Cuatrecasas G, Zamora A, Saigí-Rubió F, Paluzié G, Moharra M, Carrion C. Codesign and Feasibility Testing of a Tool to Evaluate Overweight and Obesity Apps. Int J Environ Res Public Health 2022; 19:ijerph19095387. [PMID: 35564781 PMCID: PMC9103883 DOI: 10.3390/ijerph19095387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022]
Abstract
Background: Digital health interventions and mobile technologies can help to reduce the rates of obesity and overweight conditions. Although weight management apps are widely used, they usually lack professional content and evaluation, so the quality of these apps cannot be guaranteed. The EVALAPPS project aims to design and validate a tool to assess the safety and effectiveness of health-related apps whose main goal is to manage and prevent obesity and overweight conditions. Objective: The aim of this paper is two-fold: (a) to co-create and codesign the EVALAPPS assessment tool and (b) to pilot its feasibility among overweight and obese individuals that use weight control apps. Methods: A mixed-methods approach was used. A multidisciplinary team (n = 12) participated in a co-creation workshop to provide proposals and inputs about the look and feel of the content, usability aspects, appearance, sections, and main features of the EVALAPPS tool. The tool was tested for its feasibility among 31 overweight and obese individuals, attending the CP Endocrinologia i Nutrició SL Clinic for the first time. Participants were asked to use a specific weight control app [Yazio (YAZIO GmbH, Erfurt, Germany), My FitnessPal (MyFitnessPal, Austin, TX, USA) or MyPlate (MyPlate, Santa Monica, CA, USA)] for two weeks and then evaluate them by using the EVALAPPS (EVALAPPS, David Ganyan, Barcelona, Spain) (June 2020, David Ganyan, Barcelona, Spain) tool. Seven participants were phone interviewed to gain more insight into the use of the EVALAPPS tool. Results: The co-creation workshop allowed conceptualizing the EVALAPPS tool. The feasibility study showed that all criteria from the Usability and Functionality dimensions had valid answers, while Reliability, Security, Privacy, and Health indicators were the dimensions with less valid answers. In all three apps, the dimension with the highest score was Usability/functionality, followed by app purpose. Clinical effectiveness and Development were the dimensions with the lowest scores in all three tested weight control apps. Conclusions: The participation of the multidisciplinary team and end-users in the conceptualization and testing of a tool to assess health apps was feasible and relevant for the usability of the tool.
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Affiliation(s)
- Elisa Puigdomènech
- Agència de Salut Pública de Barcelona (ASPB), 08023 Barcelona, Spain;
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain;
- eHealth Lab Research Group, Universitat Oberta de Catalunya, 08035 Barcelona, Spain
| | - Noemi Robles
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain;
- eHealth Lab Research Group, Universitat Oberta de Catalunya, 08035 Barcelona, Spain
- eHealth Center, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- Correspondence:
| | - Mariona Balfegó
- Clínica Sagrada Família, Cuatrecasas-Peitx Endocrinologia i Nutricio Societat Limitada (CPEN SL) Servei d’Endocrinologia i Nutrició, 08022 Barcelona, Spain; (M.B.); (G.C.)
| | - Guillem Cuatrecasas
- Clínica Sagrada Família, Cuatrecasas-Peitx Endocrinologia i Nutricio Societat Limitada (CPEN SL) Servei d’Endocrinologia i Nutrició, 08022 Barcelona, Spain; (M.B.); (G.C.)
| | - Alberto Zamora
- Corporació de Salut del Maresme i la Selva, Hospital de Blanes, 17300 Blanes, Spain; (A.Z.); (G.P.)
- Grup de Medicina Traslacional i Ciències de la Decisió, Universitat de Girona, 17003 Girona, Spain
| | - Francesc Saigí-Rubió
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain;
- Interdisciplinary Research Group on ICTs, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain
| | - Guillem Paluzié
- Corporació de Salut del Maresme i la Selva, Hospital de Blanes, 17300 Blanes, Spain; (A.Z.); (G.P.)
| | - Montserrat Moharra
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), 08005 Barcelona, Spain;
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
| | - Carme Carrion
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain;
- eHealth Lab Research Group, Universitat Oberta de Catalunya, 08035 Barcelona, Spain
- eHealth Center, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- TransLab Research Group, Faculty of Health Sciences, Universitat de Girona (UdG), 17003 Girona, Spain
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Deiana AM, Tran N, Agar J, Blott M, Di Guglielmo G, Duarte J, Harris P, Hauck S, Liu M, Neubauer MS, Ngadiuba J, Ogrenci-Memik S, Pierini M, Aarrestad T, Bähr S, Becker J, Berthold AS, Bonventre RJ, Müller Bravo TE, Diefenthaler M, Dong Z, Fritzsche N, Gholami A, Govorkova E, Guo D, Hazelwood KJ, Herwig C, Khan B, Kim S, Klijnsma T, Liu Y, Lo KH, Nguyen T, Pezzullo G, Rasoulinezhad S, Rivera RA, Scholberg K, Selig J, Sen S, Strukov D, Tang W, Thais S, Unger KL, Vilalta R, von Krosigk B, Wang S, Warburton TK. Applications and Techniques for Fast Machine Learning in Science. Front Big Data 2022; 5:787421. [PMID: 35496379 PMCID: PMC9041419 DOI: 10.3389/fdata.2022.787421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/31/2020] [Indexed: 01/10/2023] Open
Abstract
In this community review report, we discuss applications and techniques for fast machine learning (ML) in science-the concept of integrating powerful ML methods into the real-time experimental data processing loop to accelerate scientific discovery. The material for the report builds on two workshops held by the Fast ML for Science community and covers three main areas: applications for fast ML across a number of scientific domains; techniques for training and implementing performant and resource-efficient ML algorithms; and computing architectures, platforms, and technologies for deploying these algorithms. We also present overlapping challenges across the multiple scientific domains where common solutions can be found. This community report is intended to give plenty of examples and inspiration for scientific discovery through integrated and accelerated ML solutions. This is followed by a high-level overview and organization of technical advances, including an abundance of pointers to source material, which can enable these breakthroughs.
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Affiliation(s)
| | - Nhan Tran
- Fermi National Accelerator Laboratory, Batavia, IL, United States
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | - Joshua Agar
- Department of Materials Science and Engineering, Lehigh University, Bethlehem, PA, United States
| | | | | | - Javier Duarte
- Department of Physics, University of California, San Diego, San Diego, CA, United States
| | - Philip Harris
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Scott Hauck
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA, United States
| | - Mia Liu
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, United States
| | - Mark S. Neubauer
- Department of Physics, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | | | - Seda Ogrenci-Memik
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | - Maurizio Pierini
- European Organization for Nuclear Research (CERN), Meyrin, Switzerland
| | - Thea Aarrestad
- European Organization for Nuclear Research (CERN), Meyrin, Switzerland
| | - Steffen Bähr
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jürgen Becker
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anne-Sophie Berthold
- Institute of Nuclear and Particle Physics, Technische Universität Dresden, Dresden, Germany
| | | | - Tomás E. Müller Bravo
- Department of Physics and Astronomy, University of Southampton, Southampton, United Kingdom
| | - Markus Diefenthaler
- Thomas Jefferson National Accelerator Facility, Newport News, VA, United States
| | - Zhen Dong
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Nick Fritzsche
- Institute of Nuclear and Particle Physics, Technische Universität Dresden, Dresden, Germany
| | - Amir Gholami
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | | | - Dongning Guo
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | | | - Christian Herwig
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Babar Khan
- Department of Computer Science, Technical University Darmstadt, Darmstadt, Germany
| | - Sehoon Kim
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Thomas Klijnsma
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Yaling Liu
- Department of Bioengineering, Lehigh University, Bethlehem, PA, United States
| | - Kin Ho Lo
- Department of Physics, University of Florida, Gainesville, FL, United States
| | - Tri Nguyen
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | | | | | - Ryan A. Rivera
- Fermi National Accelerator Laboratory, Batavia, IL, United States
| | - Kate Scholberg
- Department of Physics, Duke University, Durham, NC, United States
| | | | - Sougata Sen
- Birla Institute of Technology and Science, Pilani, India
| | - Dmitri Strukov
- Department of Electrical and Computer Engineering, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - William Tang
- Department of Physics, Princeton University, Princeton, NJ, United States
| | - Savannah Thais
- Department of Physics, Princeton University, Princeton, NJ, United States
| | | | - Ricardo Vilalta
- Department of Computer Science, University of Houston, Houston, TX, United States
| | - Belina von Krosigk
- Karlsruhe Institute of Technology, Karlsruhe, Germany
- Department of Physics, Universität Hamburg, Hamburg, Germany
| | - Shen Wang
- Department of Physics, University of Florida, Gainesville, FL, United States
| | - Thomas K. Warburton
- Department of Physics and Astronomy, Iowa State University, Ames, IA, United States
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Shemesh B, Opie J, Tsiamis E, Ayton D, Satasivam P, Wilton P, Gough K, Lewis K, O'Brien C, Shub M, Pomery A, Mac Manus C, Millar J, Evans S. Codesigning a patient support portal with health professionals and men with prostate cancer: An action research study. Health Expect 2022; 25:1319-1331. [PMID: 35411697 PMCID: PMC9327875 DOI: 10.1111/hex.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The supportive care needs of men with prostate cancer (PCa) have been well documented, but little is known about how an online portal may address these. This study sought to determine priority issues facing men with PCa, barriers and enablers to accessing care and whether health professionals (HPs) and men would support the inclusion of a patient-reported outcome (PRO) comparator tool. METHODS We conducted four online focus groups with HPs recruited from healthcare services in Victoria, followed by seven online codesign workshops with men with PCa, recruited through the Victorian Prostate Cancer Outcomes Registry, Prostate Cancer Foundation Australia and the Cancer Council Victoria. Men were eligible to participate if they had lived experience of PCa and access to the internet. We analysed focus groups thematically. Workshops were analysed using descriptive-content analysis. RESULTS HPs (n = 39) highlighted that men had shifting priorities over time, but noted the importance of providing information to men in lay terms to assist in treatment decision-making and side-effect management. HPs identified key enablers to men accessing support services such as practice nurses, partners and having men share their stories with each other. HPs raised financial, cultural, geographic and emotional barriers to accessing supportive care. Inclusion of a PRO comparator tool received mixed support from HPs, with 41% (n = 16) supportive, 49% (n = 19) unsure and 10% (n = 4) not supportive. Men involved in workshops (n = 28) identified informational needs to assist in treatment decision-making and side-effect management as the top priority throughout care. Men described support groups and practice nurses as key enablers. Short consultation times and complex information were described as barriers. Unlike HPs, all men supported the inclusion of a PRO comparator tool in a portal. CONCLUSIONS Our findings suggest that a patient support portal should provide information in lay terms that address the shifting priorities of men with PCa. Men with PCa would welcome the development of a portal to centralize support information and a PRO comparator tool to prompt health-seeking behaviour. Future research will implement these findings in the development of a portal, and pilot and evaluate the portal within a population-based sample. PATIENT OR PUBLIC CONTRIBUTION This project adopted a codesign approach including both men with PCa and HPs involved in PCa care. Men with PCa also formed part of the study's steering committee and consumer advisory groups. HPs were consulted in a serious of online focus groups. Subsequently, men with PCa and their support persons participated in workshops. Men with PCa were also involved in the preparation of this manuscript.
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Affiliation(s)
- Benjamin Shemesh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacinta Opie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ellie Tsiamis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Prassannah Satasivam
- Department of Surgery, Northern Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Wilton
- The Victorian Agency for Health Information (VAHI), Melbourne, Victoria, Australia
| | - Karla Gough
- Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Katrina Lewis
- Patient Experience and Consumer Participation, Alfred Health, Melbourne, Victoria, Australia
| | - Colin O'Brien
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Max Shub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | - Jeremy Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - Susan Evans
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Cancer Council Victoria, Melbourne, Victoria, Australia
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Walker SC, White J, Rodriguez V, Turk E, Gubner N, Ngo S, Bekemeier B. Cocreating evidence-informed health equity policy with community. Health Serv Res 2022; 57 Suppl 1:137-148. [PMID: 35239188 PMCID: PMC9108222 DOI: 10.1111/1475-6773.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To explore the feasibility of a rapid, community‐engaged strategy to prioritize health equity policy options as informed by research evidence, community‐voiced needs, and public health priorities. Data Sources Data came from residents in a midsized, demographically, and geographically diverse county over a period of 8 months in 2020 and an evidence review of the health equity policy literature during the same time period. Study Design A descriptive case study is used to explore the feasibility and potential value of a community codesigned approach to establish community priorities for health equity policy. Data Collection/Extraction Methods Evidence synthesis of health equity policy was conducted parallel to 15 community listening sessions across the county to elicit information on health needs. We used scoping review methods to obtain literature from academic databases and scholarly public health and policy organizations. This information was cross walked with themes from the listening sessions to identify 10 priority policy areas, which were taken back to the community for 15 participatory discussion and ranking sessions. Principal Findings The process appeared to authentically engage the input of 200 community members representative of minoritized groups while identifying 99 evidence‐informed policy levers to promote health equity. Discussion and ranking activities were successful in facilitating community discussion and policy decision making. Remote platforms may have limited the engagement of some residents while promoting the participation of others. Conducting information integration within the research team prior to community policy ranking sessions limited the community ownership over how policies were interpreted and communicated. Conclusions A combination of information integration and community ranking activities can be used to achieve community‐engaged policy prioritization of options in a fairly rapid period of time. While this process provides an example of authentic community ownership of policy prioritization, the compressed timeline limited the community's engagement in the information integration phase.
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Affiliation(s)
- Sarah Cusworth Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Johnna White
- Tacoma-Pierce County Health Department, Tacoma, Washington, USA
| | | | - Emily Turk
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle Campus, Seattle, Washington, USA
| | - Noah Gubner
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle Campus, Seattle, Washington, USA
| | - Sally Ngo
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Betty Bekemeier
- School of Public Health, University of Washington, Seattle, Washington, USA
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Gorgon E, Maka K, Kam A, Nisbet G, Sullivan J, Regan G, Pourkazemi F, Lin J, Mohamed M, Leaver A. Needs assessment for health service design for people with back pain in a hospital setting: A qualitative study. Health Expect 2022; 25:721-731. [PMID: 35150036 PMCID: PMC8957737 DOI: 10.1111/hex.13419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is a need for effective health service solutions to provide greater structure and support for implementing evidence-based practice in back pain care. Patient involvement in developing these solutions is crucial to increase relevance, acceptability and uptake. OBJECTIVES To determine patients' perceived needs and barriers to best-practice back pain care, and potential solutions to better address care needs. The study is the third in a series of needs assessment studies feeding into the 'idea generation' for service design in a large teaching hospital in a culturally and linguistically diverse community in metropolitan Sydney, Australia. DESIGN We conducted a combination of focus groups and in-depth interviews using an interpretive description approach. We used inductive thematic analysis to identify the main themes. SETTING AND PARTICIPANTS We purposively sampled patients with diverse characteristics from the neurosurgery and physiotherapy outpatient clinics, in particular those whose primary language was English, Arabic, Persian or Mandarin. Non-English audio recordings were translated and transcribed by bilingual researchers. RESULTS There were 24 participants (focus groups = 9; individual interviews = 15) when data saturation was reached. The analysis identified three key themes with several subthemes around what service designers needed to understand in helping people with back pain in this setting: (1) This is who I am; (2) It's not working for me; and (3) What I think I need. DISCUSSION AND CONCLUSION This study highlights that perceived unmet needs of patients are underpinned by unhelpful beliefs about the causes of and solutions for back pain, misaligned care expectations, unclear expectations of the hospital role and fragmentations in the health system. To design and implement a service that can deliver better back pain care, several solutions need to be integrated around: developing new resources that challenge unhelpful beliefs and set realistic expectations; improving access to education and self-management resources; focusing on individualized care; using a collaborative multidisciplinary approach within the hospital; and better connecting with and directing primary health care services. PATIENT OR PUBLIC CONTRIBUTION A consumer representative of the Western Sydney Local Health District provided input during study conceptualisation and is duly recognized in the Acknowledgements section.
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Affiliation(s)
- Edward Gorgon
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Physical Therapy, University of the Philippines Manila, Manila, Philippines
| | - Katherine Maka
- Western Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Andrew Kam
- Western Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Gillian Nisbet
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Justin Sullivan
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Gerard Regan
- Western Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Fereshteh Pourkazemi
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jianhua Lin
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Rehabilitation Therapy, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China
| | - Mahmoud Mohamed
- Western Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Andrew Leaver
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Goodyear M, Zechmeister-Koss I, Bauer A, Christiansen H, Glatz-Grugger M, Paul JL. Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness- "It Takes a Village" Approach. Front Psychiatry 2022; 12:806884. [PMID: 35173638 PMCID: PMC8841827 DOI: 10.3389/fpsyt.2021.806884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Providing support to parents and their children to help address the cycle of intergenerational impacts of mental illness and reduce the negative consequences for children is a key focus of selective prevention approaches in public mental health. However, a key issue for children of parents with a mental illness is the lack of access to early intervention and prevention support when needed. They are not easily identifiable (until presenting with significant mental health issues of their own) and not easily accessing the necessary support that address the complex interplay of parental mental illness within families. There are significant barriers to the early identification of these children, particularly for mental health care. Furthermore, there is a lack of collaborative care that might enhance identification as well as offer services and support for these families. The "It takes a Village" project seeks to improve mental health outcomes for children through the co-development, implementation and evaluation of an approach to collaborative practice concerned with the identification of families where a parent has a mental illness, and establishing a service model to promote child-focused support networks in Austria. Here we describe the development of service delivery approach for the "It takes a Village" project that aims to improve identification and support of these children within enhancements of the existing service systems and informal supports. The paper describes the use of codesign and other implementation strategies, applied to a research setting, with the aim of impacting the sustainability of workforce reform to achieve lasting social impact. Results highlight the steps involved in translating evidence-based components, local practice wisdom and lived experience into the "It takes a Village" practice model for Tyrol, Austria. We highlight through this paper how regional context-specific solutions are essential in the redesign of care models that meet the complex needs of children of parents with a mental illness. Service system and policy formation with local and experienced stakeholders are also vital to ensure the solutions are implementation-ready, particularly when introducing new practice models that rely on organizational change and new ways of practice with vulnerable families. This also creates a solid foundation for the evaluation of the "It take a Village" approach for children of parents with a mental illness in Austria.
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Affiliation(s)
- Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, VIC, Australia
- Emerging Minds, National Workforce Centre for Child Mental Health, Hilton, SA, Australia
| | | | - Annette Bauer
- Department of Health Policy, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Hanna Christiansen
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Martina Glatz-Grugger
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
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Meulendijks P, van Haren NEM, Gielen MA, van Veelen-Vincent MLC. A self-portrait: Design opportunities for a tool that supports children's involvement in brain-related health care. Health Expect 2022; 25:2235-2245. [PMID: 35084076 PMCID: PMC9615056 DOI: 10.1111/hex.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/02/2021] [Accepted: 12/27/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Paediatric patients with disorders that involve brain functioning are particularly vulnerable with respect to including them in shared decision‐making. Current tools are mostly paper or digital patient information. We lay the groundwork for improving engagement with a concept that we coined ‘the Self‐Portrait’. The main goals were to identify (1) obstacles and (2) design parameters that enable patient participation. Methods A research‐through‐design approach was utilized in nine patients with brain‐related disorders (4–12 years), 15 parents and 15 medical professionals, involving contextual research (interviews and observations) within the paediatric hospital and patients' homes and codesign. Sensitizing materials and early instances of design solutions were deployed as catalysts for communication. Five rounds of enriched interviews and design reviews were thematically analysed to answer the research questions. Results Obstacles to child involvement were related to children's level of understanding, the time and energy necessary for information processing and lack of perceived relevance of the information. Patients' engagement is supported by design features that extend the time frame of interaction beyond the consultation, transfer information interactively and give control and influence during the consultation. Conclusion Obstacles were detected that complicate child engagement, which differ between stakeholders. Promising design features were identified that have the potential to play an important role in enabling active child involvement. These findings show that applying principles of human‐centred design research and codesign can bring together patients, parents and medical professionals around a tool that provides a shared language and focus, which are prerequisites to increase child engagement. Patient or Public Contribution Patients, parents and clinicians contributed as design informants during contextual research and design reviews. Clinicians provided feedback on the initial outcomes of thematic analysis. Two researchers assisted in consensus sessions during the thematic analysis.
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Affiliation(s)
- Paul Meulendijks
- Department of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Mathieu A Gielen
- Department of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
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Grosjean S, Ciocca JL, Gauthier-Beaupré A, Poitras E, Grimes D, Mestre T. Co-designing a digital companion with people living with Parkinson's to support self-care in a personalized way: The eCARE-PD Study. Digit Health 2022; 8:20552076221081695. [PMID: 35251682 PMCID: PMC8891888 DOI: 10.1177/20552076221081695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/30/2022] [Indexed: 12/24/2022] Open
Abstract
eHealth technologies play a role in the development of integrated care models for people living with Parkinson disease by improving communication with their health care teams and support self-care practices in a personalized way. This article presents a co-design approach to designing an eHealth technology, the eCARE-PD platform, that addresses the needs and expectations of people living with Parkinson disease, generates tailored care tips, and recommends actions for managing care priorities at home. We use a co-design approach involving four main iterative phases: (1) preparation, (2) mapping, (3) testing and using, and (4) co-producing solutions and requirements. This approach uses several methods to engage people directly to design this technology. The study allowed us to identify design principles to be integrated in the development of the eCARE-PD platform. These principles incorporate the expectations of future users, which were expressed during the iterative phases of the co-design process: (a) six key design features based on users’ needs and expectations, (b) six main issues users raised during a test at home and key features for improving the design of the eCARE-PD platform, and (c) collective solutions to design an interactive, meaningful, tailored, empathic, and socially acceptable technology. The results of the successive phases of the co-design process allow us to underline the progressive constitution of a technology defined over successive iterations as a digital companion supporting the self-care process at home and having the capacity to generate tailored digital health communication.
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Affiliation(s)
| | | | | | - Emely Poitras
- Department of Communication, University of Ottawa, Canada
| | - David Grimes
- Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
| | - Tiago Mestre
- Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
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Nevin SM, Wakefield CE, Dadich A, LeMarne F, Macintosh R, Beavis E, Sachdev R, Bye A, Nunn K, Palmer EE. Hearing parents' voices: A priority-setting workshop to inform a suite of psychological resources for parents of children with rare genetic epilepsies. PEC Innov 2021; 1:100014. [PMCID: PMC10194388 DOI: 10.1016/j.pecinn.2021.100014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Objective To understand parents' of children with developmental and epileptic encephalopathies needs and preferences for psychological resources. Methods Using a person-based approach, a multidisciplinary panel of clinician and researchers (n = 9) hosted a priority-setting workshop to 1) understand parents' needs and preferences for psychological resources and 2) to develop ‘guiding principles’ to inform a future suite of psychological resources. The multidisciplinary panel analysed the parent priority-setting workshop data, using a combination of thematic and lexical analysis. Results Thematic analysis identified six key domains wherein parents (n = 8) prioritised a need for psychological resources to support adaptation to their child's genetic DEE diagnosis. Lexical analysis revealed that connection to diagnosis-specific resources provided a pathway to promote enhanced psychological adaptation, by reducing social isolation and reorienting parents towards feelings of hope. Combination of both analyses generated six thematic informed ‘guiding principles’. Conclusion Codesigned psychological resources may help parents to cope with the unique and complex interplay of stressors associated with their child's DEE diagnosis and treatment. Our ‘guiding principles’ will be translated to inform a future suite of tailored psychological resources. Innovation This study demonstrates an innovative codesign approach to inform tailored psychological resources for families of children with rare genetic conditions. There is a deficit of research exploring the psychological impacts of parenting children with genetic DEEs. Tailored and codesigned psychological resources are essential due to the complexity and uniqueness of genetic DEEs. We collaborated with parents to codesign the content and scope of a future suite of person-based psychological resources. Thematic and lexical analyses combined identified that person-based resources reduced parent isolation and promoted hope. Insights generated from this study will be applied to inform psychological resources tailored for rare disease families.
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Affiliation(s)
- Suzanne M. Nevin
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Claire E. Wakefield
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Fleur LeMarne
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Department of Neurology, Sydney Children's Hospital, Randwick, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital, Randwick, Australia
| | - Rani Sachdev
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, Australia
| | - Ann Bye
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Department of Neurology, Sydney Children's Hospital, Randwick, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Elizabeth E. Palmer
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, Australia
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Manalili K, Siad FM, Antonio M, Lashewicz B, Santana MJ. Codesigning person-centred quality indicators with diverse communities: A qualitative patient engagement study. Health Expect 2021; 25:2188-2202. [PMID: 34854190 PMCID: PMC9615079 DOI: 10.1111/hex.13388] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Effective engagement of underrepresented communities in health research and policy remains a challenge due to barriers that hinder participation. Our study had two objectives: (1) identify themes of person‐centred care (PCC) from perspectives of diverse patients/caregivers that would inform the development of person‐centred quality indicators (PC‐QIs) for evaluating the quality of PCC and initiatives to improve PCC and (2) explore innovative participatory approaches to engage ethnocultural communities in qualitative research. Methods Drawing on participatory action research methods, we partnered with a community‐based organization to train six ‘Community Brokers’ from the Chinese, Filipino, South Asian, Latino‐Hispanic, East African and Syrian communities, who were engaged throughout the study. We also partnered with the provincial health organization to engage their Patient and Family Advisory, who represented further aspects of diversity. We conducted focus group discussions with patients/caregivers to obtain their perspectives on their values, preferences and needs regarding PCC. We identified themes through our study and engaged provincial stakeholders to prioritize these themes for informing the development of PC‐QIs and codesign initiatives for improving PCC. Results Eight focus groups were conducted with 66 diverse participants. Ethnocultural communities highlighted themes related to access and cost of care, language barriers and culture, while the Patient and Family Advisory emphasized patient and caregiver engagement. Together with provincial stakeholders, initiatives were identified to improve PCC, such as codesigning innovative models of training and evaluation of healthcare providers. Conclusion Incorporating patient and community voices requires addressing issues related to equity and understanding barriers to effective and meaningful engagement. Patient or Public Contribution Patient and public engagement was central to our research study. This included partnership with a community‐based organization, with a broad network of ethnocultural communities, as well as the provincial health service delivery organization, who both facilitated the ongoing engagement of diverse patients/caregiver communities throughout our study including designing the study, recruiting participants, collecting and organizing data, interpreting findings and mobilizing knowledge. Drawing from participatory action research methods, patients and the public were involved in the codesign of the PC‐QIs and initiatives to improve PCC in the province based on the findings from our study.
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Affiliation(s)
- Kimberly Manalili
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Fartoon M Siad
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
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47
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Walter JK, Hill DL, Schall TE, Szymczak JE, Parikh S, DiDomenico C, Carroll KW, Nye RT, Feudtner C. An Interprofessional Team-Based Intervention to Address Barriers to Initiating Palliative Care in Pediatric Oncology: A Multiple-Method Evaluation of Feasibility, Acceptability, and Impact. J Pain Symptom Manage 2021; 62:1135-1144. [PMID: 34153461 PMCID: PMC8648922 DOI: 10.1016/j.jpainsymman.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Many children with advanced cancer are not referred to palliative care despite both professional recommendations to do so and bereaved parental preference for earlier support from sub-specialty palliative care. OBJECTIVES To assess the feasibility, acceptability, and impact of an adaptive intervention to address individual and team-level barriers to specialty palliative care referrals. METHODS A multiple-method approach assessed feasibility and acceptability among clinicians from pediatric oncology teams at a single institution. Quantitative measures of comfort with palliative care consultations, team cohesion, and team collaboration were conducted before and after the intervention. Number of palliative care consults were examined before, during, and after sessions. Intervention satisfaction surveys and qualitative interviews were conducted after the intervention. RESULTS Twenty-six team members (90% of consented) attended at least one intervention session with 20 (69%) participants completing 75% or more sessions. The intervention was modified in response to participant feedback. After the intervention, participants reported greater team cohesion, comfort discussing palliative care consultation, team collaboration, process satisfaction, and decision satisfaction. Participants agreed that the training was useful, effective, helpful, and worthwhile, that they would use the skills, and that they would recommend the training to other providers. The numbers of palliative care consults increased before intervention sessions were conducted, but did not significantly change during or after the sessions. In the interviews, participants reported overall favorably regarding the intervention with some participants reporting changes in practice. CONCLUSION An adaptive intervention to reduce barriers to initiating palliative care for pediatric oncology teams is feasible and acceptable.
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Affiliation(s)
- Jennifer K Walter
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
| | - Douglas L Hill
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA.
| | - Theodore E Schall
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Julia E Szymczak
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania (J.E.S.), Philadelphia, Pennsylvania, USA
| | - Shefali Parikh
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
| | - Connie DiDomenico
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Division of Pediatric Oncology (C.D.), Philadelphia, Pennsylvania, USA
| | - Karen W Carroll
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Russell T Nye
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA
| | - Chris Feudtner
- Children's Hospital of Philadelphia (J.K.W., D.L.H., T.E.S., S.P., C.D., K.W.C., C.F.,), Philadelphia, Pennsylvania, USA; Justin Ingerman Center for Palliative Care (J.K.W., S.P., C.F.), Philadelphia, Pennsylvania, USA
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48
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Palmer VJ, Chondros P, Furler J, Herrman H, Pierce D, Godbee K, Densley K, Gunn JM. The CORE study-An adapted mental health experience codesign intervention to improve psychosocial recovery for people with severe mental illness: A stepped wedge cluster randomized-controlled trial. Health Expect 2021; 24:1948-1961. [PMID: 34350669 PMCID: PMC8628597 DOI: 10.1111/hex.13334] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Mental health policies outline the need for codesign of services and quality improvement in partnership with service users and staff (and sometimes carers), and yet, evidence of systematic implementation and the impacts on healthcare outcomes is limited. OBJECTIVE The aim of this study was to test whether an adapted mental health experience codesign intervention to improve recovery-orientation of services led to greater psychosocial recovery outcomes for service users. DESIGN A stepped wedge cluster randomized-controlled trial was conducted. SETTING AND PARTICIPANTS Four Mental Health Community Support Services providers, 287 people living with severe mental illnesses, 61 carers and 120 staff were recruited across Victoria, Australia. MAIN OUTCOME MEASURES The 24-item Revised Recovery Assessment Scale (RAS-R) measured individual psychosocial recovery. RESULTS A total of 841 observations were completed with 287 service users. The intention-to-treat analysis found RAS-R scores to be similar between the intervention (mean = 84.7, SD= 15.6) and control (mean = 86.5, SD= 15.3) phases; the adjusted estimated difference in the mean RAS-R score was -1.70 (95% confidence interval: -3.81 to 0.40; p = .11). DISCUSSION This first trial of an adapted mental health experience codesign intervention for psychosocial recovery outcomes found no difference between the intervention and control arms. CONCLUSIONS More attention to the conditions that are required for eight essential mechanisms of change to support codesign processes and implementation is needed. PATIENT AND PUBLIC INVOLVEMENT The State consumer (Victorian Mental Illness Awareness Council) and carer peak bodies (Tandem representing mental health carers) codeveloped the intervention. The adapted intervention was facilitated by coinvestigators with lived-experiences who were coauthors for the trial and process evaluation protocols, the engagement model and explanatory model of change for the trial.
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Affiliation(s)
- Victoria J. Palmer
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
- The ALIVE National Centre for Mental Health Research TranslationThe University of MelbourneParkvilleVictoriaAustralia
| | - Patty Chondros
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
- The ALIVE National Centre for Mental Health Research TranslationThe University of MelbourneParkvilleVictoriaAustralia
| | - John Furler
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| | - David Pierce
- Department of Rural HealthThe University of MelbourneBallaratVictoriaAustralia
| | - Kali Godbee
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
| | - Konstancja Densley
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
- The ALIVE National Centre for Mental Health Research TranslationThe University of MelbourneParkvilleVictoriaAustralia
| | - Jane M. Gunn
- The Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical SchoolThe University of MelbourneParkvilleVictoriaAustralia
- The ALIVE National Centre for Mental Health Research TranslationThe University of MelbourneParkvilleVictoriaAustralia
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Knowles SE, Allen D, Donnelly A, Flynn J, Gallacher K, Lewis A, McCorkle G, Mistry M, Walkington P, Brunton L. Participatory codesign of patient involvement in a Learning Health System: How can data-driven care be patient-driven care? Health Expect 2021; 25:103-115. [PMID: 34668634 DOI: 10.1111/hex.13345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/21/2021] [Accepted: 08/03/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A Learning Health System (LHS) is a model of how routinely collected health data can be used to improve care, creating 'virtuous cycles' between data and improvement. This requires the active involvement of health service stakeholders, including patients themselves. However, to date, research has explored the acceptability of being 'data donors' rather than considering patients as active contributors. The study aimed to understand how patients should be actively involved in an LHS. DESIGN Ten participatory codesign workshops were conducted with eight experienced public contributors using visual, collective and iterative methods. This led contributors to challenge and revise not only the idea of an LHS but also revise the study aims and outputs. RESULTS The contributors proposed three exemplar roles for patients in patient-driven LHS, which aligned with the idea of three forms of transparency: informational, participatory and accountability. 'Epistemic injustice' was considered a useful concept to express the risks of an LHS that did not provide active roles to patients (testimonial injustice) and that neglected their experience through collecting data that did not reflect the complexity of their lives (hermeneutic injustice). DISCUSSION Patient involvement in an LHS should be 'with and by' patients, not 'about or for'. This requires systems to actively work with and respond to patient feedback, as demonstrated within the study itself by the adaptive approach to responding to contributor questions, to work in partnership with patients to create a 'virtuous alliance' to achieve change. PATIENT OR PUBLIC CONTRIBUTION Public contributors were active partners throughout, and co-authored the paper.
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Affiliation(s)
- Sarah E Knowles
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Dawn Allen
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Ailsa Donnelly
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Jackie Flynn
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Kay Gallacher
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Annmarie Lewis
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Grace McCorkle
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Manoj Mistry
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Pat Walkington
- NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, University of Manchester, Manchester, UK
| | - Lisa Brunton
- Centre for Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
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50
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Bailey E, Teh Z, Bleeker C, Simmons M, Robinson J. Youth partnerships in suicide prevention research: A failed investigator survey. Early Interv Psychiatry 2021; 15:1429-1432. [PMID: 33181863 DOI: 10.1111/eip.13069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/30/2020] [Accepted: 11/03/2020] [Indexed: 12/28/2022]
Abstract
AIM Youth suicide research stands to benefit from involving young people with lived experience as research partners; however, there may be a number of barriers to doing this successfully. The aim of this study was to identify the extent to which international youth suicide prevention researchers actively partner with young people in intervention research design, and to explore the barriers, facilitators and benefits to such engagement. METHODS Ninety-seven eligible researchers were identified using a systematic literature search and invited via email to participate in an online questionnaire. RESULTS Only 17 participants (17.5%) at least partially completed the questionnaire, and minimal qualitative data were provided. CONCLUSIONS Analysis of the limited data together with the low response rate suggests that the rate of youth partnerships in suicide prevention intervention research is very low. Guidelines regarding how to safely and effectively partner with young people in this sensitive research area may help to address this gap.
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Affiliation(s)
- Eleanor Bailey
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Zoe Teh
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Caitlin Bleeker
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Magenta Simmons
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jo Robinson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
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