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      Approaches to co-production of research in care homes: a scoping review

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          Abstract

          Background

          Using the technique of co-production to develop research is considered good practice. Co-production involves the public, practitioners and academics working together as equals throughout a research project. Co-production may help develop alternative ways of delivering care for older adults that are acceptable to those who live and work in care homes. However, guidance about applying co-production approaches in this context is lacking. This scoping review aims to map co-production approaches used in care homes for older adults in previous research to support the inclusion of residents and care staff as equal collaborators in future studies.

          Methods

          A scoping review was conducted using the Joanna Briggs Institute scoping review methodology. Seven electronic databases were searched for peer-reviewed primary studies using co-production approaches in care home settings for older adults. Studies were independently screened against eligibility criteria by two reviewers. Citation searching was completed. Data relating to study characteristics, co-production approaches used, including any barriers and facilitators, was charted by one reviewer and checked by another. Data was summarised using tables and diagrams with an accompanying narrative description. A collaborator group of care home and health service representatives were involved in the interpretation of the findings from their perspectives.

          Results

          19 studies were selected for inclusion. A diverse range of approaches to co-production and engaging key stakeholders in care home settings were identified. 11 studies reported barriers and 13 reported facilitators affecting the co-production process. Barriers and facilitators to building relationships and achieving inclusive, equitable and reciprocal co-production were identified in alignment with the five NIHR principles. Practical considerations were also identified as potential barriers and facilitators.

          Conclusion

          The components of co-production approaches, barriers and facilitators identified should inform the design of future research using co-production approaches in care homes. Future studies should be explicit in reporting what is meant by co-production, the methods used to support co-production, and steps taken to enact the principles of co-production. Sharing of key learning is required to support this field to develop. Evaluation of co-production approaches, including participants’ experiences of taking part in co-production processes, are areas for future research in care home settings.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40900-022-00408-z.

          Plain English Summary

          Co-production involves people from different backgrounds working together as equals throughout a research project. Co-production may be a useful approach to help ensure that research in care homes focuses on approaches that are important and agreeable to older people and staff. A wide range of research and guidance about co-production has been published but there is limited guidance about how to do co-production in care homes. We carried out a review that involved pulling together previous research that used co-production in care homes for older adults. We looked at published research studies to learn about:

          • Key components of the strategies used to achieve co-production,

          • How care home residents and care home staff were involved,

          • What helped or made co-production difficult to achieve.

          A collaborator group including representatives from care homes and healthcare services were involved in this research. They helped decide what was most important about the results.

          We found 19 published research articles that used co-production in care homes. The strategies used in the articles differed. There were also differences in how care home residents and staff were involved in co-production. Factors that helped people involved to work together in an inclusive and equal way were identified. At the same time, there were also many challenges.

          These results should be used to design future research using co-production in care homes. Future studies should clearly report what is meant by co-production, the strategies used and key learning points. Evaluation of co-production and the experiences of people involved is needed.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40900-022-00408-z.

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          Most cited references51

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

            Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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              Rayyan—a web and mobile app for systematic reviews

              Background Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed Rayyan (http://rayyan.qcri.org), a free web and mobile app, that helps expedite the initial screening of abstracts and titles using a process of semi-automation while incorporating a high level of usability. For the beta testing phase, we used two published Cochrane reviews in which included studies had been selected manually. Their searches, with 1030 records and 273 records, were uploaded to Rayyan. Different features of Rayyan were tested using these two reviews. We also conducted a survey of Rayyan’s users and collected feedback through a built-in feature. Results Pilot testing of Rayyan focused on usability, accuracy against manual methods, and the added value of the prediction feature. The “taster” review (273 records) allowed a quick overview of Rayyan for early comments on usability. The second review (1030 records) required several iterations to identify the previously identified 11 trials. The “suggestions” and “hints,” based on the “prediction model,” appeared as testing progressed beyond five included studies. Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements. The survey respondents reported 40% average time savings when using Rayyan compared to others tools, with 34% of the respondents reporting more than 50% time savings. In addition, around 75% of the respondents mentioned that screening and labeling studies as well as collaborating on reviews to be the two most important features of Rayyan. As of November 2016, Rayyan users exceed 2000 from over 60 countries conducting hundreds of reviews totaling more than 1.6M citations. Feedback from users, obtained mostly through the app web site and a recent survey, has highlighted the ease in exploration of searches, the time saved, and simplicity in sharing and comparing include-exclude decisions. The strongest features of the app, identified and reported in user feedback, were its ability to help in screening and collaboration as well as the time savings it affords to users. Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of reviewers.
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                Author and article information

                Contributors
                frances.hallam@nottingham.ac.uk
                Journal
                Res Involv Engagem
                Res Involv Engagem
                Research Involvement and Engagement
                BioMed Central (London )
                2056-7529
                23 December 2022
                23 December 2022
                2022
                : 8
                : 74
                Affiliations
                [1 ]GRID grid.240404.6, ISNI 0000 0001 0440 1889, Research and Innovation, , Nottingham University Hospitals NHS Trust, ; Nottingham, UK
                [2 ]GRID grid.4563.4, ISNI 0000 0004 1936 8868, Centre for Rehabilitation and Ageing Research, Injury, Inflammation and Recovery Sciences, Medical School, , University of Nottingham, ; Nottingham, UK
                [3 ]Nottingham CityCare Partnership, Nottingham, UK
                [4 ]GRID grid.4563.4, ISNI 0000 0004 1936 8868, Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, , University of Nottingham, ; Nottingham, UK
                Article
                408
                10.1186/s40900-022-00408-z
                9780102
                36550509
                c9f03900-947e-4677-bce0-50c3001acba5
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 25 October 2022
                : 9 December 2022
                Funding
                Funded by: NIHR
                Award ID: NIHR300115
                Award ID: NIHR300115
                Award ID: NIHR300115
                Award ID: NIHR300115
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2022

                barriers,co-production,co-creation,co-design,care homes,facilitators,participatory research,social care,stakeholder participation

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