scholarly journals Developing a Canadian evaluation framework for patient and public engagement in research: study protocol

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Audrey L’Espérance ◽  
Nadia O’Brien ◽  
Alexandre Grégoire ◽  
Julia Abelson ◽  
Carolyn Canfield ◽  
...  

Abstract Background Patient and public engagement (PPE) in research is growing internationally, and with it, the interest for its evaluation. In Canada, the Strategy for Patient-Oriented Research has generated national momentum and opportunities for greater PPE in research and health-system transformation. As is the case with most countries, the Canadian research community lacks a common evaluation framework for PPE, thus limiting our capacity to ensure integrity between principles and practices, learn across projects, identify common areas for improvement, and assess the impacts of engagement. Objective This project aims to build a national adaptable framework for the evaluation of PPE in research, by: Building consensus on common evaluation criteria and indicators for PPE in research; Defining recommendations to implement and adapt the framework to specific populations. Methods Using a collaborative action-research approach, a national coalition of patient-oriented research leaders, (patient and community partners, engagement practitioners, researchers and health system leaders) will co-design the evaluation framework. We will develop core evaluation domains of the logic model by conducting a series of virtual consensus meetings using a nominal group technique with 50 patient partners and engagement practitioners, identified through 18 national research organizations. We will then conduct two Delphi rounds to prioritize process and impact indicators with 200 participants purposely recruited to include respondents from seldom-heard groups. Six expert working groups will define recommendations to implement and adapt the framework to research with specific populations, including Indigenous communities, immigrants, people with intellectual and physical disabilities, caregivers, and people with low literacy. Each step of framework development will be guided by an equity, diversity and inclusion approach in an effort to ensure that the participants engaged, the content produced, and the adaptation strategies proposed are relevant to diverse PPE. Discussion The potential contributions of this project are threefold: 1) support a national learning environment for engagement by offering a common blueprint for collaborative evaluation to the Canadian research community; 2) inform the international research community on potential (virtual) methodologies to build national consensus on common engagement evaluation frameworks; and 3) illustrate a shared attempt to engage patients and researchers in a strategic national initiative to strengthen evaluation capacity for PPE.

2018 ◽  
Vol 21 (6) ◽  
pp. 1075-1084 ◽  
Author(s):  
Antoine Boivin ◽  
Audrey L'Espérance ◽  
François-Pierre Gauvin ◽  
Vincent Dumez ◽  
Ann C. Macaulay ◽  
...  

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 162.2-162
Author(s):  
M. Bakker ◽  
P. Putrik ◽  
J. Rademakers ◽  
M. Van de Laar ◽  
H. Vonkeman ◽  
...  

Background:The prevalence of limited health literacy (i.e. cognitive and social resources of individuals to access, understand and apply health information to promote and maintain good health) in the Netherlands is estimated to be over 36% [1]. Access to and outcomes of rheumatological care may be compromised by limited patient health literacy, yet little is known about how to address this, thus action is required. As influencing individual patients’ health literacy in the rheumatology context is often unrealistic, it is paramount for the health system to be tailored to the health literacy needs of its patients. The OPtimising HEalth LIteracy and Access (Ophelia) process offers a method to inform system change [2].Objectives:Following the Ophelia approach:a. Identify health literacy profiles reflecting strengths and weaknesses of outpatients with RA, SpA and gout.b. Use the health literacy profiles to facilitate discussions on challenges for patients and professionals in rheumatological care and identify possible solutions the health system could offer to address these challenges.Methods:Patients with RA, SpA and gout attending outpatient clinics in three centres in the Netherlands completed the Health Literacy Questionnaire (HLQ) and questions on socio-demographic and health-related characteristics. Hierarchical cluster analysis using Ward’s method identified clusters based on the nine HLQ domains. Three researchers jointly examined 24 cluster solutions for meaningfulness by interpreting HLQ domain scores and patient characteristics. Meaningful clusters were translated into health literacy profiles using HLQ patterns and demographic data. A patient research partner confirmed the identified profiles. Patient vignettes were designed by combining cluster analyses results with qualitative patient interviews. The vignettes were used in two two-hour co-design workshops with rheumatologists and nurses to discuss their perspective on health literacy-related challenges for patients and professionals, and generate ideas on how to address these challenges.Results:In total, 895 patients participated: 49% female, mean age 61 years (±13.0), 25% lived alone, 18% had a migrant background, 6.6% did not speak Dutch at home and 51% had low levels of education. Figure 1 shows a heat map of identified health literacy profiles, displaying the score distribution per profile across nine health literacy domains. Figure 2 shows an excerpt of a patient vignette, describing challenges for a patient with profile number 9. The workshops were attended by 7 and 14 nurses and rheumatologists. Proposed solutions included health literacy communication training for professionals, developing and improving (visual) patient information materials, peer support for patients through patient associations or group consultations, a clear referral system for patients who need additional guidance by a nurse, social worker, lifestyle coach, pharmacist or family doctor, and more time with rheumatology nurses for target populations. Moreover, several system adaptations to the clinic, such as a central desk for all patient appointments, were proposed.Conclusion:This study identified several distinct health literacy profiles of patients with rheumatic conditions. Engaging with health professionals in co-design workshops led to numerous bottom-up ideas to improve care. Next steps include co-design workshops with patients, followed by prioritising and testing proposed interventions.References:[1]Heijmans M. et al. Health Literacy in the Netherlands. Utrecht: Nivel 2018[2]Batterham R. et al. BMC Public Health 2014, 14:694Disclosure of Interests:Mark Bakker: None declared, Polina Putrik: None declared, Jany Rademakers Speakers bureau: In March 2017, Prof. Dr. Rademakers was invited to speak about health literacy at the “Heuvellanddagen” Conference, hosted by Janssen-Cilag., Mart van de Laar Consultant of: Sanofi Genzyme, Speakers bureau: Sanofi Genzyme, Harald Vonkeman: None declared, Marc R Kok Grant/research support from: BMS and Novartis, Consultant of: Novartis and Galapagos, Hanneke Voorneveld: None declared, Sofia Ramiro Grant/research support from: MSD, Consultant of: Abbvie, Lilly, Novartis, Sanofi Genzyme, Speakers bureau: Lilly, MSD, Novartis, Maarten de Wit Grant/research support from: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Consultant of: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Speakers bureau: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Richard Osborne Consultant of: Prof. Osborne is a paid consultant for pharma in the field of influenza and related infectious diseases., Roy Batterham: None declared, Rachelle Buchbinder: None declared, Annelies Boonen Grant/research support from: AbbVie, Consultant of: Galapagos, Lilly (all paid to the department)


2021 ◽  
pp. 097206342199498
Author(s):  
Rajesh Kumar

Background: Since independence, life expectancy has increased substantially in India, but the goal of health-for-all has not been achieved yet. Hence, National Rural Health Mission was launched in 2005, and several strategies were implemented to strengthen the health system. Impact evaluation of the mission was done to learn lessons for future health planning. Materials and Methods: Logical evaluation framework was used to examine input, output and impact indicators systematically using time series data from Health Management Information System, National Family Health Surveys, National Sample Surveys and Sample Registration Scheme. Findings: After launch of the mission, fund allocation has increased nearly five times. The number of auxiliary nurse midwives has doubled, and the number of nurses has trebled. The number of accredited social health activists has increased to about one million. Institutional deliveries have increased from 38.7% in 2005–2006 to 78.9% in 2015–2016. Full immunisation coverage has increased from 43.5% to 62%. Oral rehydration solution (ORS) use in childhood diarrhoea has increased from 26% to 51%. Infant mortality rate has declined from 58 in 2005 to 33 per 1,000 live births in 2017 and maternal mortality ratio has also registered a decline from 254 in 2004–2006 to 122/100000 live births in 2015–2017. However, out-of-pocket health expenditure continues to be fairly high (69.3% of the total expenditure on health). Conclusions: Though National Health Mission has made a significant impact, the goal of universal care coverage is not yet fully achieved. Hence, capacity of health system needs to be trebled by a substantial increase in fund allocation.


2021 ◽  
Author(s):  
Tonya Haigh ◽  
Joel Lisonbee ◽  
Marina Skumanich ◽  
Molly Woloszyn

<p>Defining flash drought is important not only for the development of the science but also for ensuring clear and useful early warning information to end users. In preparation for a December 2020 U.S-based workshop on flash drought, the National Integrated Drought Information System (NIDIS) and National Drought Mitigation Center (NDMC) undertook a survey of NIDIS contacts to explore how flash drought is understood within and outside of the research community. End users represented in the survey include researchers (outside of flash drought specialty), policy-makers, decision-makers, communicators, and educators and public engagement specialists, largely working within universities or federal agencies across the U.S. Flash drought researchers were asked to describe how they intend for the term “flash drought” to be interpreted when they use it. End users (whether they had heard/used the term before or not) were asked to describe what they think of when they hear the term “flash drought”. Their answers emerged into themes, including: onset/intensification, duration, drivers, impacts, seasonality, predictability, intensity, spatial scale, and uncertainty about its meaning. In this presentation, we will elaborate upon these themes, and discuss similarities and differences in how flash drought researchers and end users conceptualize flash drought.</p>


2018 ◽  
Vol 34 (S1) ◽  
pp. 30-30
Author(s):  
Meredith Vanstone ◽  
Julia Bidonde ◽  
Ken Bond ◽  
Julia Abelson ◽  
Lisa Schwartz ◽  
...  

Introduction:It is widely recognized that the incorporation of patient and public perspectives can enrich health policy decision-making. Methodological and practical advice on engaging patients and the public has proliferated in recent years, with many health technology assessment (HTA) agencies working to formalize their processes in this area. However, despite growing enthusiasm for patient and public engagement, many ethical issues remain unaddressed including: balancing risks and benefits to participants; recruitment methods; reimbursement for time spent participating; representation; and, information disclosure.Methods:In this critical analysis, we draw on our collective experiences engaging with patients and public in the context of HTA. We use principles from two theories, i) research ethics, and ii) participatory governance, to analyze these challenges. The purpose of this analysis is to explore the ways in which risks and benefits to patient and public participants might be balanced in HTA activities.Results:We begin by describing some ethically challenging experiences we have faced when soliciting views and values from patients and members of the public, some anticipated and some unexpected. These challenges include unexpected disclosures of information, navigating power differentials when working with vulnerable populations, eliciting information about potentially traumatizing experiences, and fairly representing controversial and conflicting opinions. We offer examples about what types of patient engagement activities may subject participants to unreasonable risk, and suggest some guiding principles to help plan ethical patient and public engagement activities.Conclusions:Patient and public engagement requires more than just procedural methodological expertise- it also requires the ability to identify and analyze relevant ethical issues. We posit that health technology assessors have a moral obligation to ensure that the risks of patient and public engagement activities do not outweigh the benefits. We call upon the HTA community to engage in thoughtful deliberation about what can be learned from experiences within HTA and in other contexts.


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