Developing theoretically grounded strategies to enable and promote patient and public involvement in implementation research studies.

Implementation research has emerged as a branch of healthcare research. It studies methods to promote the application of research findings into practice, and, thus, to improve the quality and effectiveness of services and care. Patient and public involvement (PPI) in implementation research is a means of bridging research and practice. However, the progress to achieve greater involvement is slow. The reasons might include potential tensions when including perspectives of stakeholders with diverse skills, backgrounds and experiences, and the risk of reproducing paternalistic clinician-patient relationship tradition of healthcare research, which is incompatible with PPI.In this commentary we shared the PPI navigation approach that we used in a recent implementation research project, where eight patient and public partners attended three 1-hour sessions to discuss a specific implementation research methodology. On reflection, we categorised the approach into three strategies that aimed to empower patient and public partners and promote their senses of autonomy, relatedness and competence. According to the Basic Psychological Needs Theory, these are principal human needs, fulfilment of which may lead to higher motivation, performance, and well-being. We outlined the process of applying each strategy and used this and other theories to show why this can lead to positive partner and research outcomes. Two patient and public partners provided their perspectives about what worked and what could be further improved. The strategies can be used in future implementation studies, and we provide recommendations for the development of more strategies using the theory-based approach.