School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Health Expect. 2019 Oct;22(5):907-920. doi: 10.1111/hex.12935. Epub 2019 Jul 8.
Patient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes.
This realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self-management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type.
Data were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis.
Projects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co-design and co-deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes.
Achieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.
患者和公众参与糖尿病研究是国际要求，但对于参与过程与健康结果之间的关系知之甚少。
本真实主义综述旨在确定在不同背景和情况下，不同类型的参与对象谁将从中受益。检索策略包括在 Medline、CINAHL 和 EMBASE 上搜索，以确定使用有针对性、嵌入式或协作参与来降低糖尿病风险和促进自我管理的干预措施。研究对象包括处于风险之中/患有糖尿病的人、有兴趣解决糖尿病问题的提供者和社区组织。本研究没有对日期、语言或研究类型进行限制。
使用参与框架的要素从 29 个项目中提取数据。采用参与类型的概念分析来完成综合。
项目使用了有针对性的（4 个）、嵌入式的（8 个）和协作的（17 个）参与。经过足够时间的富有成效的互动，使人们能够为研究设定优先事项。承诺合作的伙伴关系提高了对糖尿病风险的认识，并动员人们共同设计和共同提供糖尿病干预措施。文化适应提高了干预措施的相关性和可接受性，因为人们信任当地的提供方式。当地的实施产生了高水平的招募和保留率，项目团队将其与实现糖尿病健康结果联系起来。
了解社区背景、在不同部门之间建立信任关系以及建立富有成效的伙伴关系是设计可行且具有本地相关性的研究的先决条件。纳入这些元素的糖尿病研究的比例令人惊讶地低。需要系统地解决资源伙伴关系的障碍。
