TRUE PATIENT & PARTNER ENGAGEMENT HOW IS IT DONE?

OBJECTIVES 1.Describe patient and/or community engagement within research. 2.Describe how CBPR principles apply to their project. 3.Plan for how to engage patients and/or community members as equal partners in research. 4.Recognize the strengths and challenges of full patient engagement and partnerships in research. 5.Plan for the appropriate time and resources within projects to appropriately engage partners within the research.

BEFORE STARTING AN ENGAGEMENT EFFORT… Be clear about the purposes and goals of the effort and who you want to engage. Acknowledge community culture, networks, norms, history, and experiences with engagement efforts by outside groups. Collectively define what kind of engagement you are aiming for.

CONTINUUM OF RESEARCH ENGAGEMENT Consultation Patients and communities are asked to provide information Examples: Surveys Focus groups Involvement Patients and communities are asked to participate in advisory roles Examples: Advisory board members Consultants Shared Leadership Patients and communities co-lead the research Examples: Co- investigator s Active governing member This content was modified from Developing Interventions And Policies Patient And Family Engagement

A BRIEF HISTORY OF RESEARCH AND ENGAGEMENT In the beginning, research was conducted on patients, often without their consent or knowledge. Around 1940 Participatory Action Research emerged. PAR contrasts with many historical research methods, which emphasize disinterested researchers and reproducibility of findings. In 1947 The Nuremberg Code was established to provide a set of research ethics principles for human experimentation, following the Nuremberg trials at the end of WWII. In 1979 The Belmont Report was published, summarizing ethical principles and guidelines for research involving human subjects. Three core principles are identified: respect for persons, beneficence, and justice. In the late 1990s Community-Based Participatory Research began to be recognized by federal funders. Today, we are proving that CBPR and PAR are valuable and essential elements of research.

THE BENEFITS OF ENGAGING PATIENTS & COMMUNITIES IN RESEARCH Laboratory science can tell us if something will work, but it can’t tell us if something will be useful to the population it is intended for. Engaging patients and their communities in research ensures the right questions are answered and that those answers will be acceptable and more quickly adopted by patients and spread throughout their communities. Engaging patients and their communities in research can reduce the fear and mistrust that can inhibit quality research from doing the good it intends. Working with patients and their communities to publish the findings of research adds credibility to the research amongst those who need it most.

FOR ENGAGEMENT TO OCCUR, IT IS NECESSARY TO… Build relationships and get commitments from formal and informal leaders. Create space for collective self-determination as the responsibility and right of all community members. Establish trust and actively maintain that trust over the long term.

FOR ENGAGEMENT TO SUCCEED… Recognize and respect diversity, cultures, and other factors that affect planning, design, implementation, and dissemination. Identify and mobilize assets and strengths and by developing capacity and resources to make decisions and take action. Be prepared to release control of actions to others and be flexible enough to meet changing needs. Establish long-term commitment from organizations, their partners, researchers and stakeholders who are working toward the same collaborative goal.

BENEFITS OF ENGAGED RESEARCH Findings will be culturally and logistically acceptable to the population of interest. Recruitment into the research will be better. Partnership synergism will create greater benefits and more robust outcomes over time. Capacity to sustain momentum during unfunded times will be greater and more productive. Systemic changes and unanticipated new projects will be generated organically.

CHALLENGES TO ENGAGED RESEARCH Building partnerships and trust takes time and dedication. Natural conflicts must be dealt with openly and often, with the goal of turning the conflict into productive negotiation and common understanding within the partnership. Institutions based on traditional research may not understand the value of patient and community engaged research. Traditional research journals and other publishers may not understand the importance of the patient and community voice and authorship.

SUMMARY “Data moves at the speed of trust.”  Drs. David Ross & Ivor Horn Research impacts move at the speed of trust.

RESOURCES Jagosh, Bush, Salsberg, et. al. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health (2015) 15:725 Carman, Dardess, Maurer, et. al. Developing Interventions And Policies Patient And Family Engagement: A Framework For Understanding The Elements And Developing Interventions And Policies. Health Affairs, 32, no.2 (2013):

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