A realist review of community engagement with health research

Introduction: Community engagement is increasingly recognized as a critical aspect of global health. Recent years have seen an expansion of community engagement activities linked to health research, but debates and inconsistencies remain about the aims of different types of engagement, mechanisms underpinning their implementation and impact, and influential contextual factors. Greater commitment to and consistency around community engagement by health research programs, implementers and funders requires a more coherent evidence base. This realist review is designed to improve our understanding of how and why community engagement contributes to intended and unintended outcomes (including research and ethical outcomes) in different contexts. Given the breadth and diversity of the literature on community engagement in health research, the review will initially focus on malaria research in low- and middle-income countries (LMICs) and draw on wider global health literature where needed. Methods and analysis: Community engagement in practice is often a complex set of interventions. We will conduct a realist review – a theory driven approach to evidence synthesis – to provide explanations for how and why community engagement with health research produces the pattern of outcomes observed across different contexts of application. We will consolidate evidence from a range of documents, including qualitative, quantitative and mixed method studies. The review will follow several stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesizing and refining the programme theory, and reiteration of these steps as needed. Ethics and dissemination: A formal ethics review is not required for this literature review. Findings will be disseminated in a peer reviewed journal, through national and international conferences, and through a set of short briefings tailored for audiences with an interest in community engagement. Outputs and presentations will be informed by and feed into our network of community engagement experts. PROSPERO registration number: CRD42019125687

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Challenges and solutions: surveying researchers on what type of community engagement and involvement activities are feasible in low and middle income countries during the COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2021-052135 ◽

2021 ◽

Vol 11 (10) ◽

pp. e052135

Author(s):

Karolin Kroese ◽

Katie Porter ◽

Heidi Surridge ◽

Doreen Tembo

Keyword(s):

Global Health ◽

Community Engagement ◽

Health Research ◽

Round Table ◽

Global Health Research ◽

Middle Income ◽

Middle Income Countries ◽

Advantages And Disadvantages ◽

Health And Social Care ◽

Low And Middle Income

ObjectivesMeasures to limit the spread of infection during the COVID-19 global pandemic have made engaging and involving members of the community in global health research more challenging. This research aimed to explore how global health researchers adapted to the imposed pandemic measures in low and middle income countries (LMICs) and how they overcame challenges to effective community engagement and involvement (CEI).DesignA qualitative two-stage mixed-methods study involving an online survey and a virtual round table.SettingThe survey and round table were completed online.ParticipantsOf 53 participants, 43 were LMIC-based or UK-based global health researchers and/or CEI professionals, and 10 worked for the National Institute for Health Research or UK Government’s Department of Health and Social Care.Outcome measuresThis study aimed to capture data on: the number of CEI activities halted and adapted because of the COVID-19 pandemic; where CEI is possible; how it has been adapted; what the challenges and successes were; and the potential impact of adapted or halted CEI on global health research.ResultsPandemic control measures forced the majority of researchers to stop or amend their planned CEI activities. Most face-to-face CEI activities were replaced with remote methods, such as online communication. Virtual engagement enabled researchers to maintain already established relationships with community members, but was less effective when developing new relationships or addressing challenges around the inclusion of marginalised community groups.ConclusionsCOVID-19 has highlighted the need for contingency planning and flexibility in CEI. The redesigning and adopting of remote methods has come with both advantages and disadvantages, and required new skills, access to technology, funding, reliable services and enthusiasm from stakeholders. The methods suggested have the potential to augment or substitute previously preferred CEI activities. The effectiveness and impact of these remote CEI activities need to be assessed.

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‘Working relationships’ across difference - a realist review of community engagement with malaria research

Wellcome Open Research ◽

10.12688/wellcomeopenres.17192.1 ◽

2022 ◽

Vol 7 ◽

pp. 13

Author(s):

Robin Vincent ◽

Bipin Adhikari ◽

Claire Duddy ◽

Emma Richardson ◽

Geoff Wong ◽

...

Keyword(s):

Community Engagement ◽

Health Research ◽

Access To Health Care ◽

Evidence Synthesis ◽

Realist Review ◽

Evidence Base ◽

Working Relationships ◽

Research Paradigm ◽

Malaria Research ◽

Conceptual Clarity

Background: Community engagement (CE) is increasingly accepted as a critical aspect of health research, because of its potential to make research more ethical, relevant and well implemented. While CE activities linked to health research have proliferated in Low and Middle Income Countries (LMICs), and are increasingly described in published literature, there is a lack of conceptual clarity around how engagement is understood to ‘work’, and the aims and purposes of engagement are varied and often not made explicit. Ultimately, the evidence base for engagement remains underdeveloped. Methods: To develop explanations for how and why CE with health research contributes to the pattern of outcomes observed in published literature, we conducted a realist review of CE with malaria research – a theory driven approach to evidence synthesis. Results: We found that community engagement relies on the development of provisional ‘working relationships’ across differences, primarily of wealth, power and culture. These relationships are rooted in interactions that are experienced as relatively responsive and respectful, and that bring tangible research related benefits. Contextual factors affecting development of working relationships include the facilitating influence of research organisation commitment to and resources for engagement, and constraining factors linked to the prevailing ‘dominant health research paradigm context’, such as: differences of wealth and power between research centres and local populations and health systems; histories of colonialism and vertical health interventions; and external funding and control of health research. Conclusions: The development of working relationships contributes to greater acceptance and participation in research by local stakeholders, who are particularly interested in research related access to health care and other benefits. At the same time, such relationships may involve an accommodation of some ethically problematic characteristics of the dominant health research paradigm, and thereby reproduce this paradigm rather than challenge it with a different logic of collaborative partnership.

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The burgeoning role of global health diplomacy to alleviate suffering of cancer patients in low- and middle-income countries

International Health ◽

10.1093/inthealth/ihaa004 ◽

2020 ◽

Vol 12 (3) ◽

pp. 231-233

Author(s):

Melissa Adomako ◽

Alaei Kamiar ◽

Abdulla Alshaikh ◽

Lyndsay S Baines ◽

Desiree Benson ◽

...

Keyword(s):

Global Health ◽

Evidence Base ◽

International Affairs ◽

Global Health Diplomacy ◽

Middle Income ◽

Middle Income Countries ◽

Health Diplomacy ◽

Health Practitioners ◽

And Control ◽

Low And Middle Income

Abstract The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies.

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Strengthening Mentoring in Low- and Middle-Income Countries to Advance Global Health Research: An Overview

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.18-0556 ◽

2019 ◽

Vol 100 (1_Suppl) ◽

pp. 3-8 ◽

Cited By ~ 11

Author(s):

Andres G. Lescano ◽

Craig R. Cohen ◽

Tony Raj ◽

Laetitia Rispel ◽

Patricia J. Garcia ◽

...

Keyword(s):

Global Health ◽

Health Research ◽

Global Health Research ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Understanding the impact of delegated home visiting services accessed via general practice by community-dwelling patients: a realist review protocol

BMJ Open ◽

10.1136/bmjopen-2018-024876 ◽

2018 ◽

Vol 8 (11) ◽

pp. e024876 ◽

Cited By ~ 7

Author(s):

Ruth Abrams ◽

Geoffrey Wong ◽

Kamal Ram Mahtani ◽

Stephanie Tierney ◽

Anne-Marie Boylan ◽

...

Keyword(s):

Home Visiting ◽

Hospital Admissions ◽

Evidence Synthesis ◽

Realist Review ◽

Professional Associations ◽

Community Dwelling ◽

Mixed Method Research ◽

Programme Theory ◽

Registration Number ◽

The Impact

IntroductionIn western countries, early visiting services (EVS) have been proposed as a recent intervention to reduce both general practitioner workload and hospital admissions among housebound individuals experiencing a healthcare need within the community. EVS involves the delegation of the patient home visits to other staff groups such as paramedics or nursing staff. However, the principles of organising this care are unknown and it remains unclear how different contexts, such as patient conditions and the processes of organising EVS influence care outcomes. A review has been designed to understand how EVS are enacted and, specifically, who benefits, why, how and when in order to provide further insight into the design and delivery of EVS.Methods and analysisThe purpose of this review is to produce findings that provide explanations of how and why EVS contexts influence their associated outcomes. Evidence on EVS will be consolidated through realist review—a theory-driven approach to evidence synthesis. A realist approach is needed as EVS is a complex intervention. What EVS achieve is likely to vary for different individuals and contexts. We expect to synthesise a range of relevant data such as qualitative, quantitative and mixed-method research in the following stages: devising an initial programme theory, searching evidence, selecting appropriate documents, extracting data, synthesising and refining the programme theory.Ethics and disseminationA formal ethics review is not required as this study is secondary research. Findings will be disseminated in a peer-reviewed journal, at national and international conferences and to relevant professional associations.PROSPERO registration numberCRD42018096518.

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Authorship ethics in global health research partnerships between researchers from low or middle income countries and high income countries

BMC Medical Ethics ◽

10.1186/1472-6939-15-42 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 54

Author(s):

Elise Smith ◽

Matthew Hunt ◽

Zubin Master

Keyword(s):

Global Health ◽

Health Research ◽

High Income ◽

Global Health Research ◽

Research Partnerships ◽

Middle Income ◽

Middle Income Countries

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North–south collaboration and capacity development in global health research in low- and middle-income countries – the ARCADE projects

Global Health Action ◽

10.3402/gha.v9.30524 ◽

2016 ◽

Vol 9 (1) ◽

pp. 30524 ◽

Cited By ~ 9

Author(s):

Salla Atkins ◽

Sophie Marsden ◽

Vishal Diwan ◽

Merrick Zwarenstein ◽

Keyword(s):

Global Health ◽

Health Research ◽

Capacity Development ◽

Global Health Research ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Not enough traction: Barriers that aspiring researchers from low- and middle-income countries face in global health research

Journal of Global Health Economics and Policy ◽

10.52872/001c.25802 ◽

2021 ◽

Author(s):

Constance S. Shumba ◽

Adelaide M Lusambili

Keyword(s):

Global Health ◽

Health Research ◽

Global Health Research ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Understanding how and why audits work: protocol for a realist review of audit programmes to improve hospital care

BMJ Open ◽

10.1136/bmjopen-2016-015121 ◽

2017 ◽

Vol 7 (6) ◽

pp. e015121 ◽

Cited By ~ 3

Author(s):

Lisanne Hut-Mossel ◽

Gera Welker ◽

Kees Ahaus ◽

Rijk Gans

Keyword(s):

Hospital Care ◽

Evidence Synthesis ◽

Realist Review ◽

Local Context ◽

Quality Improvements ◽

Programme Theory ◽

Meta Review ◽

Ethical Approval ◽

Registration Number ◽

Improve Hospital

IntroductionMany types of audits are commonly used in hospital care to promote quality improvements. However, the evidence on the effectiveness of audits is mixed. The objectives of this proposed realist review are (1) to understand how and why audits might, or might not, work in terms of delivering the intended outcome of improved quality of hospital care and (2) to examine under what circumstances audits could potentially be effective. This protocol will provide the rationale for using a realist review approach and outline the method.Methods and analysisThis review will be conducted using an iterative four-stage approach. The first and second steps have already been executed. The first step was to develop an initial programme theory based on the literature that explains how audits are supposed to work. Second, a systematic literature search was conducted using relevant databases. Third, data will be extracted and coded for concepts relating to context, outcomes and their interrelatedness. Finally, the data will be synthesised in a five-step process: (1) organising the extracted data into evidence tables, (2) theming, (3) formulating chains of inference from the identified themes, (4) linking the chains of inference and formulating CMO configurations and (5) refining the initial programme theory. The reporting of the review will follow the ‘Realist and Meta-Review Evidence Synthesis: Evolving Standards’ (RAMESES) publication standards.Ethics and disseminationThis review does not require formal ethical approval. A better understanding of how and why these audits work, and how context impacts their effectiveness, will inform stakeholders in deciding how to tailor and implement audits within their local context. We will use a range of dissemination strategies to ensure that findings from this realist review are broadly disseminated to academic and non-academic audiences.PROSPERO registration numberCRD42016039882.

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