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      Patient stakeholder engagement in research: A narrative review to describe foundational principles and best practice activities

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          Abstract

          Background

          Health research is evolving to include patient stakeholders (patients, families and caregivers) as active members of research teams. Frameworks describing the conceptual foundations underlying this engagement and strategies detailing best practice activities to facilitate engagement have been published to guide these efforts.

          Objective

          The aims of this narrative review are to identify, quantify and summarize (a) the conceptual foundational principles of patient stakeholder engagement in research and (b) best practice activities to support these efforts.

          Search Strategy, Inclusion Criteria, Data Extraction and Synthesis

          We accessed a publicly available repository of systematically identified literature related to patient engagement in research. Two reviewers independently screened articles to identify relevant articles and abstracted data.

          Main Results

          We identified 990 potentially relevant articles of which 935 (94.4%) were excluded and 55 (5.6%) relevant. The most commonly reported foundational principles were “respect” (n = 25, 45%) and “equitable power between all team members” (n = 21, 38%). Creating “trust between patient stakeholders and researchers” was described in 17 (31%) articles. Twenty‐seven (49%) articles emphasized the importance of providing training and education for both patient stakeholder and researchers. Providing financial compensation for patient stakeholders’ time and expertise was noted in 19 (35%) articles. Twenty articles (36%) emphasized regular, bidirectional dialogue between patient partners and researchers as important for successful engagement.

          Discussion and Conclusions

          Engaging patient stakeholders in research as partners presents an opportunity to design, implement and disseminate patient‐centred research. This review creates an overarching foundational framework for authentic and sustainable partnerships between patient stakeholders and researchers.

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          Most cited references55

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          The value and challenges of participatory research: strengthening its practice.

          The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.
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            Evaluating patient and stakeholder engagement in research: moving from theory to practice.

            Despite the growing demand for research that engages stakeholders, there is limited evidence in the literature to demonstrate its value - or return on investment. This gap indicates a general lack of evaluation of engagement activities. To adequately inform engagement activities, we need to further investigate the dividends of engaged research, and how to evaluate these effects. This paper synthesizes the literature on hypothesized impacts of engagement, shares what has been evaluated and identifies steps needed to reduce the gap between engagement's promises and the underlying evidence supporting its practice. This assessment provides explicit guidance for better alignment of engagement's promised benefits with evaluation efforts and identifies specific areas for development of evaluative measures and better reporting processes.
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              Community engagement in research: frameworks for education and peer review.

              Community engagement in research may enhance a community's ability to address its own health needs and health disparities issues while ensuring that researchers understand community priorities. However, there are researchers with limited understanding of and experience with effective methods of engaging communities. Furthermore, limited guidance is available for peer-review panels on evaluating proposals for research that engages communities. The National Institutes of Health Director's Council of Public Representatives developed a community engagement framework that includes values, strategies to operationalize each value, and potential outcomes of their use, as well as a peer-review framework for evaluating research that engages communities. Use of these frameworks for educating researchers to create and sustain authentic community-academic partnerships will increase accountability and equality between the partners.
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                Author and article information

                Contributors
                james.harrison@ucsf.edu
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                13 February 2019
                June 2019
                : 22
                : 3 ( doiID: 10.1111/hex.2019.22.issue-3 )
                : 307-316
                Affiliations
                [ 1 ] Division of Hospital Medicine University of California San Francisco San Francisco California
                [ 2 ] University of Miami Health System Miami Florida
                [ 3 ] Center for Patients and Families Brigham and Women’s Hospital Boston Massachusetts
                [ 4 ] Intensive Care Unit Patient and Family Advisory Council University of California San Francisco San Francisco California
                [ 5 ] Department of Medicine Christiana Care Health System Wilmington Delaware
                [ 6 ] Department of Medicine Brigham and Women’s Hospital Boston Massachusetts
                Author notes
                [*] [* ] Correspondence

                James Harrison, Division of Hospital Medicine, University of California San Francisco, San Francisco, CA.

                Email: james.harrison@ 123456ucsf.edu

                Author information
                https://orcid.org/0000-0002-7761-7039
                Article
                HEX12873
                10.1111/hex.12873
                6543160
                30761699
                37434bfa-7294-4e8f-bf7b-26d786cf49e9
                © 2019 The Authors Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 August 2018
                : 16 January 2019
                : 17 January 2019
                Page count
                Figures: 2, Tables: 2, Pages: 10, Words: 7004
                Funding
                Funded by: Patient‐Centered Outcomes Research Institute (PCORI) Eugene Washington Engagement Award
                Award ID: Harrison #3455
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                hex12873
                June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:31.05.2019

                Health & Social care
                patient engagement,patient involvement,patient participation,research,review,systematic review

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