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1.
Health Expect ; 27(5): e70003, 2024 10.
Artículo en Inglés | MEDLINE | ID: mdl-39210782

RESUMEN

BACKGROUND: Research indicates that successful co-creation depends on a shared understanding of co-creation and its related concepts. However, it also shows that, in practice, views on co-creation and how to do it differ. This study aims to explore how patient innovators and researchers in a partnership research programme understand co-creation and how this understanding changes over time. METHODS: An explorative longitudinal qualitative study was conducted with the 'Patients in the Driver's Seat' partnership research programme. Fifty-eight interviews were performed and analysed using a reflexive thematic approach. FINDINGS: Four different ways of understanding co-creation were identified. These can be instrumentally conceptualized as themes using the inputs-process-outputs model: (1) combining different perspectives, experiences and backgrounds (inputs); (2) deliberately dynamic and exploratory (process); (3) striving for equity, not equality (process); and (4) diverse value creation, tangible and intangible (outputs). Together, these themes represent the varied understandings of co-creation among partnership programme members. CONCLUSIONS: Our study of patient innovators and researchers identified four distinct yet complementary understandings of co-creation. The study suggests that co-creation is the sum of its essential components, which can be divided into inputs, process, and outputs. PATIENT OR PUBLIC CONTRIBUTION: This study, and the partnership programme it explored, aims to improve the relevance of research for patients and informal caregivers through an improved understanding of the concept of co-creation within research on patient innovation. All patient innovators involved in the programme were invited, as interviewees and researchers, to contribute to the study design and data analysis.


Asunto(s)
Participación del Paciente , Investigación Cualitativa , Humanos , Estudios Longitudinales , Femenino , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Adulto
2.
Disabil Rehabil ; 46(5): 957-968, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36945786

RESUMEN

PURPOSE: To identify partnership research challenges and facilitators, as experienced by members of the Inclusive Society (IS) initiative. MATERIALS AND METHODS: A case study was conducted on all partnership research projects conducted between 2017 and 2019 under the IS initiative through surveys, interviews with the IS community, logbooks, and focus group. Thematic analysis and descriptive analysis were undertaken. RESULTS: To work effectively with a diversity of stakeholders, winning conditions must be created for the project from the outset. These include determining the team functioning, project objectives, the expectations of each party, and agreeing on a realistic action plan. Project implementation with concern for sustained stakeholder commitment, good working relationships, and achieving project objectives requires organizational planning that favours partner involvement, shared leadership, agreed methods for communicating, conflict resolution methods, recognition of each participant's expertise, and creating a climate of trust. Upon concluding a partnership research project, it is essential to devote time to implement project results in local environments and to ascertain their usefulness to partners.IS partnership research challenges and facilitators are similar to those identified in past research. Despite this knowledge, challenges persist. Future research could explore tools and practices from other domain to overcome partnership research challenges.


Partnership research has the potential to contribute to a more inclusive society for people with disabilities.Challenges and facilitators are identified for the stages of creating, implementing, and completing a partnership research project.Suggested solutions are offered to facilitate the conduct of a partnership research project and to increase the project's chances of success.Partnership research could benefit from using tools from other fields such as community development and social innovation to successfully implement some of the facilitators and overcome specific barriers to partnership research.


Asunto(s)
Personas con Discapacidad , Inclusión Social , Humanos , Grupos Focales
3.
Health Res Policy Syst ; 21(1): 74, 2023 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-37452332

RESUMEN

BACKGROUND: Collaborative health research, such as integrated knowledge translation (IKT), requires researchers to have specific knowledge and skills in working in partnership with knowledge users. Graduate students are often not provided with the opportunity to learn skills in how to establish collaborative relationships with knowledge users in the health system or communities, despite its importance in research. The objective of this environmental scan is to identify available guidelines for graduate trainees to use an IKT approach in their research. METHODS: We conducted an environmental scan with three separate systematic searches to identify guidelines available to support graduate students in engaging in an IKT approach to research: (i) a customized Google search; (ii) a targeted Canadian university website search; and (iii) emails to administrators of graduate studies programmes asking for available guidelines and documents designed for graduate students. Data were extracted using a standardized data extraction tool and analysed using a directed content analysis approach. Due to the minimal results included based on the a priori eligibility criteria, we returned to the excluded records to further review the current state of the environment on trainee support for IKT research. RESULTS: Our search strategy yielded 22 900 items, and after a two-step screening process with strict inclusion criteria three documents met the eligibility criteria. All three documents highlighted the need for an IKT plan for knowledge user involvement throughout the research process. Furthermore, documents emphasized the need for tangible steps to guide graduate students to engage in effective communication with knowledge users. Due to the lack of documents retrieved, we conducted a post hoc content analysis of relevant IKT documents excluded and identified five themes demonstrating increased education and engagement in an IKT approach at an interpersonal and organizational level. CONCLUSION: We identified three documents providing guidance to trainees using a collaborative approach in their health research. This scan highlighted two key findings including the importance of supporting trainees to engage knowledge users in research and preparing an IKT plan alongside a research plan. Further research is needed to co-design guidelines to support graduate students and trainees in engaging in an IKT approach.


Asunto(s)
Investigación Biomédica Traslacional , Ciencia Traslacional Biomédica , Humanos , Canadá , Conducta Cooperativa , Investigadores , Guías como Asunto
4.
Health Expect ; 26(4): 1757-1767, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37291910

RESUMEN

BACKGROUND: Partnership research practices involving various stakeholder groups are gaining ground. Yet, the research community is still exploring how to effectively coproduce research together. This study describes (a) key programme developments in the creation of a 6-year partnership research programme in Sweden, and (b) explores the hopes, expectations, and experiences of patient innovators (i.e., individuals with lived experience as patients or caregivers who drive health innovations) and researchers involved in the programme during the first years. METHODS: We conducted a prospective longitudinal qualitative study spanning the first 2 years of the programme. Data consisted of meeting protocols and interviews with 14 researchers and 6 patient innovators; 39 interviews were carried out in three evenly-spaced rounds. We identified significant events and discussion themes in the meeting protocols and analyzed the interviews using thematic analysis, applying a cross-sectional recurrent approach to track changes over time. FINDINGS: Meeting protocols revealed how several partnership practices (e.g., programme management team, task forces, role description document) were cocreated, supporting the sharing of power and responsibilities among programme members. Based on the analysis of interviews, we created three themes: (1) paving the path to a better tomorrow, reflecting programme members' high expectations; (2) going on a road trip together, reflecting experiences of finding new roles and learning how to cocreate; (3) finding the tempo: from talking to doing, reflecting experiences of managing challenges and becoming productive as a team. CONCLUSIONS: Our findings suggest that sharing, respecting, and acknowledging each other's experiences and concerns helps build mutual trust and shape partnership practices. High expectations beyond research productivity suggest that we need to consider outcomes at different levels, from the individual to society, when evaluating the impact of partnership research. PATIENT OR PUBLIC CONTRIBUTION: The research team included members with formal experiences as researchers and members with lived experiences of being a patient or informal caregiver. One patient innovator coauthored this paper and contributed to all aspects of the research, including the design of the study; production of data (as interviewee); interpretation of findings; and drafting the manuscript.


Asunto(s)
Aprendizaje , Confianza , Humanos , Estudios Transversales , Estudios Prospectivos , Investigación Cualitativa
5.
Disabil Rehabil ; : 1-10, 2023 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-37277901

RESUMEN

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model.Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society's intersectoral collaboration agents, their logbooks, and Inclusive Society's annual reports.Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program.Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects' appropriation phases.


Networking activities stimulate the creation of intersectoral research teams centered on answering the needs of people with disabilities that are identified in the fieldHired facilitators can play an important role in the emergence of research teams, merging the academic and non-academic worlds, and supporting the teams during their research projectIn participatory research projects, some funding should be reserved to support the partner organization's participation and the appropriation phase of the research projects.

6.
Children (Basel) ; 10(5)2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37238347

RESUMEN

The 1616 Program is a newly developed and evidence-informed story-based positive youth development (PYD) program for young ice hockey players (10-12 years of age) in North America. The program uses elite ice hockey players as role models-through story-telling-to serve as inspirational figures to engage youth athletes and important social agents (i.e., parents, coaches) with evidence-informed PYD concepts. The objective of this study was to use a Proof-of-Concept evaluation to assess whether the 1616 Program 'worked' in enhancing PYD outcomes and to determine if the concepts were engaging and enjoyable for youth, their parents, and coaches. The 5 week Proof-of-Concept evaluation was conducted with 11 ice hockey teams (n = 160 youths, 93 parents, and 11 coaches), encompassing both qualitative (e.g., focus groups) and quantitative (e.g., retrospective pretest-posttest questionnaires) processes and outcome assessments. Results showed that the program was well received by participants and positively impacted the intended outcomes. Overall, the data presented in this Proof-of-Concept evaluation was deemed to support the development and implementation of the full-scale 1616 Program for a more comprehensive evaluation.

7.
Glob Implement Res Appl ; 1(4): 291-303, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34697606

RESUMEN

The purpose of the article is to illustrate how implementation science concepts and methods can be applied by researchers and implementers to understand and assist emergency management in a large primary and community healthcare organization. The article refers to a single-case implementation action evaluation of an emergency management system in a healthcare organization. It describes the methods used in this study and findings to explain how a joint healthcare and university research team were able to use the science and methods both to help implementation and contribute to science. We report two sets of findings. First, findings about implementation of emergency management to illustrate how the investigation adapted implementation science and concepts to achieve the objectives evaluation. We discovered that implementation science provides useful concepts to understand contextual factors and adds to knowledge about organizational change and emergency management in the uncertain and evolving situation we encountered. The second set of findings are the strengths and limitations of both implementation science and the action evaluation methods we used to achieve the dual objectives of practical help with implementation and to contribute to science. The article uses the first implementation action evaluation study of the response of large public primary and community healthcare organization to a pandemic to illustrate how implementation science can be applied. This type of study was able to improve implementation of the response as well as contribute to scientific knowledge about emergency healthcare management and organization.

8.
BJGP Open ; 5(2)2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33563700

RESUMEN

BACKGROUND: Coordination is critical to successful team-based health care. Most clinicians, however, are not trained in effective coordination or teamwork. Audit and feedback (A&F) could improve team coordination, if designed with teams in mind. AIM: The effectiveness of a multifaceted, A&F-plus-debrief intervention was tested to establish whether it improved coordination in primary care teams compared with controls. DESIGN & SETTING: Case-control trial within US Veterans Health Administration medical centres. METHOD: Thirty-four primary care teams selected from four geographically distinct hospitals were compared with 34 administratively matched control teams. Intervention-arm teams received monthly A&F reports about key coordination behaviours and structured debriefings over 7 months. Control teams were followed exclusively via their clinical records. Outcome measures included a coordination composite and its component indicators (appointments starting on time, timely recall scheduling, emergency department utilisation, and electronic patient portal enrolment). Predictors included intervention arm, extent of exposure to intervention, and degree of multiple team membership (MTM). RESULTS: Intervention teams did not significantly improve over control teams, even after adjusting for MTM. Follow-up analyses indicated cross-team variability in intervention fidelity; although all intervention teams received feedback reports, not all teams attended all debriefings. Compared with their respective baselines, teams with high debriefing exposure improved significantly. Teams with high debriefing exposure improved significantly more than teams with low exposure. Low exposure teams significantly increased patient portal enrolment. CONCLUSION: Team-based A&F, including adequate reflection time, can improve coordination; however, the effect is dose dependent. Consistency of debriefing appears more critical than proportion of team members attending a debriefing for ensuring implementation fidelity and effectiveness.

9.
Int J Health Policy Manag ; 9(6): 233-239, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32613791

RESUMEN

Effectiveness in health services research requires development of specific knowledge and skills for working in partnership with health system decision-makers. In an initial effort to frame capacity-building activities for researchers, we designed a workshop on working collaboratively within the health system. The workshop, based on recent research exploring health system experience and perspectives on research collaborations, was trialed at the annual Canadian Health Services and Policy Research (CAHSPR) conference in May 2019. Participants reported positive evaluations of the workshop. However, further efforts should target health services researchers that may not be as motivated to develop skills in collaborative research. Additional attention to equipping researchers with the skills needed to work in partnerships is recommended, including approaches and materials that avoid oversimplification of complex challenges.


Asunto(s)
Investigación sobre Servicios de Salud , Conducta Cooperativa , Humanos
10.
Health Res Policy Syst ; 18(1): 13, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005254

RESUMEN

BACKGROUND: Cross-sector collaborative partnerships are a vital strategy in efforts to strengthen research-informed policy and practice and may be particularly effective at addressing the complex problems associated with chronic disease prevention. However, there is still a limited understanding of how such partnerships are implemented in practice and how their implementation contributes to outcomes. This paper explores the operationalisation and outcomes of knowledge mobilisation strategies within the Australian Prevention Partnership Centre - a research collaboration between policy-makers, practitioners and researchers. METHODS: The Centre's programme model identifies six knowledge mobilisation strategies that are hypothesised to be essential for achieving its objectives. Using a mixed methods approach combining stakeholder interviews, surveys, participant feedback forms and routine process data over a 5-year period, we describe the structures, resources and activities used to operationalise these strategies and explore if and how they have contributed to proximal outcomes. RESULTS: Results showed that Centre-produced research, resources, tools and methods were impacting policy formation and funding. Policy-makers reported using new practical methodologies that were helping them to design, implement, evaluate and obtain funding for scaled-up policies and programmes, and co-creating compelling prevention narratives. Some strategies were better implemented and more impactful than others in supporting these outcomes, with variation in who they worked for. The activities used to effect engagement, capacity-building and partnership formation were mostly generating positive results, but co-production could be enhanced by greater shared decision-making. Considerably more work is needed to successfully operationalise knowledge integration and adaptive learning. CONCLUSIONS: Describing how collaborative cross-sector research partnerships are operationalised in practice, and with what effects, can provide important insights into practical strategies for establishing and growing such partnerships and for maximising their contributions to policy. Findings suggest that the Centre has many strengths but could benefit from more inclusive and transparent governance and internal processes that facilitate dialogue about roles, expectations and co-production practices.


Asunto(s)
Enfermedad Crónica/psicología , Investigación sobre Servicios de Salud/organización & administración , Enfermedades no Transmisibles/prevención & control , Formulación de Políticas , Servicios Preventivos de Salud/organización & administración , Investigación Biomédica Traslacional/organización & administración , Comités Consultivos/organización & administración , Australia , Creación de Capacidad/organización & administración , Comunicación , Procesos de Grupo , Personal de Salud/organización & administración , Humanos , Difusión de la Información/métodos , Relaciones Interinstitucionales , Liderazgo , Investigadores/organización & administración
11.
Health Res Policy Syst ; 17(1): 98, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31842896

RESUMEN

BACKGROUND: Researchers and policy-makers are increasingly working together with the goal of creating research that is focused on solving real-world problems; however, knowledge translation (KT) activities, and the partnerships they often require, can be challenging. The aim of this review is to determine the extent of the literature on training programs designed to improve researcher competency in KT and to describe existing training methods that may be used by those hoping to build capacity for partnership research. METHODS: MEDLINE, EMBASE, PsycINFO and CINAHL were searched for peer review articles published between January 2000 and July 2019. Studies were eligible for inclusion in the review if they described the development of, curriculum for, or evaluation of KT and/or partnership research training programs. Data extraction included information on evaluation methods, outcomes and implications as well as the format, aims and themes of each capacity-building program. RESULTS: The review identified nine published articles that met inclusion criteria - four papers described training events, two papers described participant experiences of specific learning sessions within a larger training course, two papers described part time secondments for KT capacity-building and one paper described a plan for KT training embedded within an existing research training course. All programs were delivered face-to-face, all included practical skills-building opportunities, and all employed multiple learning modalities such as seminars and small group discussions. Evaluation of the training programs was primarily conducted through qualitative interviews or feedback surveys. CONCLUSION: To date, few KT training initiatives have been described in the literature and none of these have been rigorously evaluated. The present review offers insights into the planning, development and participant experiences associated with the small number of training initiatives that have been described. There is insufficient evidence available at present to identify the most effective models for training researchers in KT and partnership skills.


Asunto(s)
Creación de Capacidad/organización & administración , Investigadores/educación , Investigadores/organización & administración , Investigación Biomédica Traslacional/organización & administración , Conducta Cooperativa , Humanos , Capacitación en Servicio/organización & administración , Aprendizaje , Enseñanza/organización & administración
12.
Health Res Policy Syst ; 17(1): 73, 2019 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-31362791

RESUMEN

BACKGROUND: Partnerships between academic researchers and health system leadership are often promoted by health research funding agencies as an important strategy in helping ensure that funded research is relevant and the results used. While potential benefits of such partnerships have been identified, there is limited guidance in the scientific literature for either healthcare organisations or researchers on how to select, build and manage effective research partnerships. Our main research objective was to explore the health system perspective on partnerships with researchers with a focus on issues related to the design and organisation of the health system and services. Two structured web reviews were conducted as one component of this larger study. METHODS: Two separate structured web reviews were conducted using structured data extraction tools. The first review focused on sites of health research bodies and those providing information on health system management and knowledge translation (n = 38) to identify what guidance to support partnerships might be available on websites commonly accessed by health leaders and researchers. The second reviewed sites from all health 'regions' in Canada (n = 64) to determine what criteria and standards were currently used in guiding decisions to engage in research partnerships; phone follow-up ensured all relevant information was collected. RESULTS: Absence of guidance on partnerships between research institutions and health system leaders was found. In the first review, absence of guidance on research partnerships and knowledge coproduction was striking and in contrast with coverage of other forms of collaboration such as patient/community engagement. In the second review, little evidence of criteria and standards regarding research partnerships was found. Difficulties in finding appropriate contact information for those responsible for research and obtaining a response were commonly experienced. CONCLUSION: Guidance related to health system partnerships with academic researchers is lacking on websites that should promote and support such collaborations. Health region websites provide little evidence of partnership criteria and often do not make contact information to research leaders within health systems readily available; this may hinder partnership development between health systems and academia.


Asunto(s)
Personal Administrativo/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Relaciones Interinstitucionales , Investigadores/organización & administración , Universidades/organización & administración , Canadá , Conducta Cooperativa , Humanos , Internet , Liderazgo , Investigación Biomédica Traslacional
13.
Health Res Policy Syst ; 16(1): 109, 2018 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-30445963

RESUMEN

BACKGROUND: Cross-sectoral, multidisciplinary partnership research is considered one of the most effective means of facilitating research-informed policy and practice, particularly for addressing complex problems such as chronic disease. Successful research partnerships tend to be underpinned by a range of features that enable knowledge mobilisation (KMb), seeking to connect academic researchers with decision-makers and practitioners to improve the nature, quality and use of research. This paper contributes to the growing discourse on partnership approaches by illustrating how knowledge mobilisation strategies are operationalised within the Australian Prevention Partnership Centre (the Centre), a national collaboration of academics, policy-makers and practitioners established to develop systems approaches for the prevention of lifestyle-related chronic diseases. METHODS: We undertook interviews with key academics, policy, and practice partners and funding representatives at the mid-point of the Centre's initial 5-year funding cycle. We aimed to explore how the Centre is functioning in practice, to develop a conceptual model of KMb within the Centre for use in further evaluation, and to identify ways of strengthening our approach to partnership research. Inductive and deductive thematic analysis was used to identify the key mechanisms underpinning the Centre's KMb approach. RESULTS: Six key mechanisms appeared to facilitate KMb within our Centre, namely Engagement, Partnerships, Co-production, Capacity and Skills, Knowledge Integration, and Adaptive Learning and Improvement. We developed a conceptual model that articulated these mechanisms in relation to the structures and processes that support them, as well as the Centre's goals. Findings also informed adaptations designed to strengthen the Centre. CONCLUSIONS: Findings provide insights into the practical realities of operationalising KMb strategies within a research partnership. Overall, the centre is perceived to be progressing towards its KMb goals, but challenges include stakeholders from different settings understanding each other's contexts and working together effectively, and ensuring knowledge generated across different projects within the Centre is integrated into a more comprehensive understanding of chronic disease prevention policy and practice. Our conceptual model is now informing ongoing developmental evaluation activities within the Centre, where it is being tested and refined.


Asunto(s)
Creación de Capacidad , Enfermedad Crónica/prevención & control , Conducta Cooperativa , Atención a la Salud , Política de Salud , Investigación sobre Servicios de Salud , Comunicación Interdisciplinaria , Personal Administrativo , Australia , Toma de Decisiones , Humanos , Conocimiento , Estilo de Vida , Enfermedades no Transmisibles , Formulación de Políticas , Salud Pública , Investigadores
14.
Health Res Policy Syst ; 16(1): 46, 2018 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-29843735

RESUMEN

BACKGROUND: Getting research into policy and practice in healthcare is a recognised, world-wide concern. As an attempt to bridge the gap between research and practice, research funders are requesting more interdisciplinary and collaborative research, while actual experiences of such processes have been less studied. Accordingly, the purpose of this study was to gain more knowledge on the interdisciplinary, collaborative and partnership research process by investigating researchers' experiences of and approaches to the process, based on their participation in an inventive national research programme. The programme aimed to boost collaborative and partnership research and build learning structures, while improving ways to lead, manage and develop practices in Swedish health and social services. METHODS: Interviews conducted with project leaders and/or lead researchers and documentation from 20 projects were analysed using directed and conventional content analysis. RESULTS: Collaborative approaches were achieved by design, e.g. action research, or by involving practitioners from several levels of the healthcare system in various parts of the research process. The use of dual roles as researcher/clinician or practitioner/PhD student or the use of education designed especially for practitioners or 'student researchers' were other approaches. The collaborative process constituted the area for the main lessons learned as well as the main problems. Difficulties concerned handling complexity and conflicts between different expectations and demands in the practitioner's and researcher's contexts, and dealing with human resource issues and group interactions when forming collaborative and interdisciplinary research teams. The handling of such challenges required time, resources, knowledge, interactive learning and skilled project management. CONCLUSIONS: Collaborative approaches are important in the study of complex phenomena. Results from this study show that allocated time, arenas for interactions and skills in project management and communication are needed during research collaboration to ensure support and build trust and understanding with involved practitioners at several levels in the healthcare system. For researchers, dealing with this complexity takes time and energy from the scientific process. For practitioners, this puts demands on understanding a research process and how it fits with on-going organisational agendas and activities and allocating time. Some of the identified factors may be overlooked by funders and involved stakeholders when designing, performing and evaluating interdisciplinary, collaborative and partnership research.


Asunto(s)
Conducta Cooperativa , Atención a la Salud , Política de Salud , Investigación sobre Servicios de Salud , Servicios de Salud , Servicio Social , Investigación Biomédica Traslacional , Personal de Salud , Humanos , Comunicación Interdisciplinaria , Liderazgo , Aprendizaje , Investigadores , Encuestas y Cuestionarios , Suecia
15.
Implement Sci ; 12(1): 146, 2017 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-29208000

RESUMEN

BACKGROUND: The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs. Also, given considerable difficulties with e-monitoring systems in the clinical sector, scholars have called for a more sophisticated re-examination of e-monitoring's role in enhancing implementation. METHODS: In the state of New South Wales (NSW), Australia, the Population Health Information Management System (PHIMS) was created to support the dissemination of obesity prevention programs to 6000 childcare centres and elementary schools across all 15 local health districts. We have established a three-way university-policymaker-practice research partnership to investigate the impact of PHIMS on practice, how PHIMS is used, and how achievement of key performance indicators of program adoption may be associated with local contextual factors. Our methods encompass ethnographic observation, key informant interviews and participatory workshops for data interpretation at a state and local level. We use an on-line social network analysis of the collaborative relationships across local health district health promotion teams to explore the relationship between PHIMS use and the organisational structure of practice. DISCUSSION: Insights will be sensitised by institutional theory, practice theory and complex adaptive system thinking, among other theories which make sense of socio-technical action. Our working hypothesis is that the science of getting evidence-based programs into practice rests on an in-depth understanding of the role they play in the on-going system of local relationships and multiple accountabilities. Data will be synthesised to produce a typology to characterise local context, PHIMS use and key performance indicator achievement (of program implementation) across the 15 local health districts. Results could be used to continuously align e-monitoring technologies within quality improvement processes to ensure that such technologies enhance practice and innovation. A partnership approach to knowledge production increases the likelihood that findings will be put into practice.


Asunto(s)
Medicina Basada en la Evidencia/métodos , Implementación de Plan de Salud , Promoción de la Salud/métodos , Obesidad/prevención & control , Evaluación de Programas y Proyectos de Salud/métodos , Niño , Preescolar , Electrónica Médica/métodos , Humanos , Internet , Nueva Gales del Sur , Proyectos de Investigación
16.
Int J Health Policy Manag ; 6(1): 27-42, 2017 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-28005540

RESUMEN

BACKGROUND: The current literature proposing criteria and guidelines for collaborative health system research often fails to differentiate between: (a) various types of partnerships, (b) collaborations formed for the specific purpose of developing a research proposal and those based on long-standing relationships, (c) researcher vs. decision-maker initiatives, and (d) the underlying drivers for the collaboration. METHODS: Qualitative interviews were conducted with 16 decision-makers and researchers who partnered on a Canadian major peer-reviewed grant proposal in 2013. Objectives of this exploration of participants' experiences with health system research collaboration were to: (a) explore perspectives and experience with research collaboration in general; (b) identify characteristics and strategies associated with effective partnerships; and (c) provide guidance for development of effective research partnerships. Interviews were audio-recorded and transcribed: transcripts were qualitatively analyzed using a general inductive approach. RESULTS: Findings suggest that the common "two cultures" approach to research/decision-maker collaboration provides an inadequate framework for understanding the complexity of research partnerships. Many commonly-identified challenges to researcher/knowledge user (KU) collaboration are experienced as manageable by experienced research teams. Additional challenges (past experience with research and researchers; issues arising from previous collaboration; and health system dynamics) may be experienced in partnerships based on existing collaborations, and interact with partnership demands of time and communication. Current research practice may discourage KUs from engaging in collaborative research, in spite of strong beliefs in its potential benefits. Practical suggestions for supporting collaborations designed to respond to real-time health system challenges were identified. CONCLUSION: Participants' experience with previous research activities, factors related to the established collaboration, and interpersonal, intra- and inter-organizational dynamics may present additional challenges to research partnerships built on existing collaboration. Differences between researchers and KUs may pose no greater challenges than differences among KUs (at various levels, and representing diverse perspectives and organizations) themselves. Effective "relationship brokering" is essential for meaningful collaboration.


Asunto(s)
Conducta Cooperativa , Atención a la Salud , Relaciones Interinstitucionales , Relaciones Interprofesionales , Investigación , Canadá , Toma de Decisiones , Humanos , Organizaciones , Investigadores
17.
Ann Fam Med ; 12(5): 447-55, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25354409

RESUMEN

Research often fails to find its way into practice or policy in a timely way, if at all. Given the current pressure and pace of health care change, many authors have recommended different approaches to make health care research more relevant and rapid. An emerging standard for research, the "5 R's" is a synthesis of recommendations for care delivery research that (1) is relevant to stakeholders; (2) is rapid and recursive in application; (3) redefines rigor; (4) reports on resources required; and (5) is replicable. Relevance flows from substantive ongoing participation by stakeholders. Rapidity and recursiveness occur through accelerated design and peer reviews followed by short learning/implementation cycles through which questions and answers evolve over time. Rigor is the disciplined conduct of shared learning within the specific changing situations in diverse settings. Resource reporting includes costs of interventions. Replicability involves designing for the factors that may affect subsequent implementation of an intervention or program in different contexts. These R's of the research process are mutually reinforcing and can be supported by training that fosters collaborative and reciprocal relationships among researchers, implementers, and other stakeholders. In sum, a standard is emerging for research that is both rigorous and relevant. Consistent and bold application will increase the value, timeliness, and applicability of the research enterprise.


Asunto(s)
Atención a la Salud/normas , Reforma de la Atención de Salud , Investigación sobre Servicios de Salud/normas , Proyectos de Investigación/normas , Medicina Familiar y Comunitaria/normas , Femenino , Humanos , Comunicación Interdisciplinaria , Masculino , Encuestas y Cuestionarios , Gestión de la Calidad Total
18.
Eur J Ageing ; 1(1): 73-78, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28794704

RESUMEN

Undertaking projects with European partners is an enterprising and rewarding activity, where societies can start to learn how to transfer knowledge and take advantage of best practices to further the benefits to health and social care service users. However, this can also be a challenging experience, more so when there is scanty guidance about the best way to conduct European partnership research. Using an on-going study of integrated care for older persons as an example (the PROCARE project), this paper provides an account of the methodological strengths and challenges of the qualitative approach used. It suggests that factors assisting a rigorous approach include sound and inclusive coordination, a strong research design, the construction of universally acceptable selection criteria, detailed interview schedules, and a transversal approach to data analysis.

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