Chisholm Ashley, Gilfoyle Meghan, MacNeil Maggie, Melro Carolyn
Canadian Medical Association, Ottawa, ON, Canada.
Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada.
Health Res Policy Syst. 2025 Aug 4;23(1):98. doi: 10.1186/s12961-025-01366-0.
Access to healthcare in Canada remains a significant issue, with over one in five people lacking attachment to a regular primary care provider. To address this, patients, health professionals, researchers and policymakers are advocating for health system transformation aimed at improving access and achieving the quintuple aim. As a result, research funding increasingly prioritizes health system transformation. However, whilst collaborative approaches such as integrated knowledge translation (IKT) are critical for success, trainees face barriers to integrating patient and public engagement into their research. These challenges include limited time and resources, difficulties in developing meaningful partnerships, tensions between independent intellectual contributions and collaborative research and academic structures that reinforce power imbalances. This commentary presents four trainee experiences that demonstrate successful capacity-building initiatives for trainees to embed patient and public engagement in health system transformation research. The first case study focusses on the Patient Expertise in Research Collaboration (PERC), which supports Transdisciplinary Understanding and Training on Research-Primary Health Care (TUTOR-PHC) trainees in incorporating patient perspectives into primary healthcare research. The second highlights the role of the Integrated Knowledge Translation Research Network (IKTRN) in building trainee capacity through funding. The third explores a trainee experience with the ACCESS Open Minds Network (AOM). The fourth describes a trainee experience within a co-design study, the Enhancing Physical and Community MoBility in OLDEr Adults with Health Inequities Using CommuNity Co-Design (EMBOLDEN). These case studies provide insights into effective strategies for overcoming barriers to patient and public engagement in research. However, opportunities for such engagement remain uneven and depend on limited funding. To foster sustainable support, academic institutions must integrate these capacity-building initiatives, promoting a future of primary care in Canada that is inclusive, patient-centred and responsive to evolving population needs.
在加拿大，获得医疗保健服务仍然是一个重大问题，超过五分之一的人没有固定的初级保健提供者。为了解决这一问题，患者、卫生专业人员、研究人员和政策制定者都在倡导卫生系统转型，旨在改善医疗服务可及性并实现“五重目标”。因此，研究资金越来越优先考虑卫生系统转型。然而，尽管诸如整合知识转化（IKT）等协作方法对成功至关重要，但受训人员在将患者和公众参与纳入其研究方面面临障碍。这些挑战包括时间和资源有限、难以建立有意义的伙伴关系、独立学术贡献与合作研究之间的矛盾，以及加剧权力不平衡的学术结构。本评论介绍了四个受训人员的经历，展示了成功的能力建设举措，使受训人员能够将患者和公众参与融入卫生系统转型研究。第一个案例研究聚焦于研究合作中的患者专业知识（PERC），该项目支持跨学科理解与研究-初级卫生保健培训（TUTOR-PHC）的受训人员将患者观点纳入初级卫生保健研究。第二个案例强调了整合知识转化研究网络（IKTRN）在通过资金支持培养受训人员能力方面的作用。第三个案例探讨了一名受训人员在ACCESS开放思维网络（AOM）中的经历。第四个案例描述了一名受训人员在一项共同设计研究中的经历，即利用社区共同设计增强患有健康不平等问题的老年人的身体和社区流动性（EMBOLDEN）。这些案例研究为克服患者和公众参与研究的障碍提供了有效策略。然而，这种参与的机会仍然不均衡，且依赖于有限的资金。为了促进可持续的支持，学术机构必须整合这些能力建设举措，推动加拿大初级保健的未来发展，使其具有包容性、以患者为中心，并能应对不断变化的人群需求。
