Within community-engaged research, education and social care, peer models that partner with local "insiders" are increasingly common. Peer models are composed of insider "lay" community members who often share similarities or background with a project's target population. Peers are not academically trained, but work alongside researchers and professionals to carry out specific tasks within a project, or in the truest sense of partnership, peers collaborate throughout the project from start to finish as an equal member of the team. Although peer models are used widely, the literature lacks consistency and clarity. This systematic review of literature used a qualitative thematic synthesis to examine and report how, where and why peer models have been used in research, education and social care. We examined the language and titles used to describe the peers, details of their involvement in community-engaged projects, the setting, content/topic of study, level of engagement and related benefits/outcomes of such models. Focusing on the last 10 years, we conducted a comprehensive literature search twice between September 2016 and June 2017. The search resulted in 814 articles which were assessed for eligibility. Overall, 251 articles met our inclusion criteria and were categorised into three categories: empirical (n = 115); process/descriptive (n = 93); and "about" peers (n = 43). Findings suggest that there is a wide variety of peers, titles and terminology associated with peer models. There is inconsistency in how these models are used and implemented in research studies and projects. The majority of articles used an employment peer model, while only a handful involved peers in all phases of the project. The results of this literature review contribute to understanding the use, development and evolution of peer models. We highlight potential benefits of peer models for peers, their communities and community-engaged work, and we offer recommendations for future implementation of peer models.

Background Learning Networks are distributed learning health systems that enable collaboration at scale to improve health and health care. A key requirement for such networks is having a way to create and share information and knowledge in furtherance of the work of the community. Objective We describe a Learning Exchange—a bespoke, scalable knowledge management and exchange platform initially built and tested for improving pediatric inflammatory bowel disease outcomes in the ImproveCareNow (ICN) Network—and assess evidence of its acceptability, feasibility, and utility in facilitating creation and sharing of information in furtherance of the work of the community and as a model for other communities. Methods Acceptability was assessed via growth in active users and activity. Feasibility was measured in terms of the percentage of users with a log-in who became active users as well as user surveys and a case study. Utility was measured in terms of the type of work that the Learning Exchange facilitated for the community. Results The ICNExchange has over 1000 users and supported sharing of resources across all care centers in ICN. Users reported that the Learning Exchange has facilitated their work and resulted in increased ability to find resources relevant to local information needs. Conclusions The ICNExchange is acceptable, feasible, and useful as a knowledge management and exchange platform in service of the work of ICN. Experience with the ICNExchange suggests that the design principles are extensible to other chronic care Learning Networks.

Researchers, evaluators and designers from an array of academic disciplines and industry sectors are turning to participatory approaches as they seek to understand and address complex social problems. We refer to participatory approaches that collaboratively engage/partner with stakeholders in knowledge creation/problem solving for action/social change outcomes as collaborative change research, evaluation and design (CCRED). We further frame CCRED practitioners by their desire to move beyond knowledge creation for its own sake to implementation of new knowledge as a tool for social change. In March and May of 2018, we conducted a literature search of multiple discipline-specific databases seeking collaborative, change-oriented scholarly publications. The search was limited to include peer-reviewed journal articles, with English language abstracts available, published in the last five years. The search resulted in 526 citations, 236 of which met inclusion criteria. Though the search was limited to English abstracts, all major geographic regions (North America, Europe, Latin America/Caribbean, APAC, Africa and the Middle East) were represented within the results, although many articles did not state a specific region. Of those identified, most studies were located in North America, with the Middle East having only one identified study. We followed a qualitative thematic synthesis process to examine the abstracts of peer-reviewed articles to identify practices that transcend individual disciplines, sectors and contexts to achieve collaborative change. We surveyed the terminology used to describe CCRED, setting, content/topic of study, type of collaboration, and related benefits/outcomes in order to discern the words used to designate collaboration, the frameworks, tools and methods employed, and the presence of action, evaluation or outcomes. Forty-three percent of the reviewed articles fell broadly within the social sciences, followed by 26 percent in education and 25 percent in health/medicine. In terms of participants and/or collaborators in the articles reviewed, the vast majority of the 236 articles (86%) described participants, that is, those who the research was about or from whom data was collected. In contrast to participants, partners/collaborators (n=32; 14%) were individuals or groups who participated in the design or implementation of the collaborative change effort described. In terms of the goal for collaboration and/or for doing the work, the most frequently used terminology related to some aspect of engagement and empowerment. Common descriptors for the work itself were ‘social change’ (n=74; 31%), ‘action’ (n=33; 14%), ‘collaborative or participatory research/practice’ (n=13; 6%), ‘transformation’ (n=13; 6%) and ‘community engagement’ (n=10; 4%). Of the 236 articles that mentioned a specific framework or approach, the three most common were some variation of Participatory Action Research (n=30; 50%), Action Research (n=40; 16.9%) or Community-Based Participatory Research (n=17; 7.2%). Approximately a third of the 236 articles did not mention a specific method or tool in the abstract. The most commonly cited method/tool (n=30; 12.7%) was some variation of an arts-based method followed by interviews (n=18; 7.6%), case study (n=16; 6.7%), or an ethnographic-related method (n=14; 5.9%). While some articles implied action or change, only 14 of the 236 articles (6%) stated a specific action or outcome. Most often, the changes described were: the creation or modification of a model, method, process, framework or protocol (n=9; 4%), quality improvement, policy change and social change (n=8; 3%), or modifications to education/training methods and materials (n=5; 2%). The infrequent use of collaboration as a descriptor of partner engagement, coupled with few reported findings of measurable change, raises questions about the nature of CCRED. It appears that conducting CCRED is as complex an undertaking as the problems that the work is attempting to address.

Best practices based on evidence are needed by every clinician to provide safe, effective, patient-centered care. Determining best practice for a given situation can be difficult. Ideally, the clinician understands how to critically appraise the relevant research, and integrates high-quality research with interdisciplinary clinical expertise and patient and family values and preferences to choose best care for an individual or family. At our organization, we are taking the integration of research, clinical expertise, and patient/family preferences and values to the next level by aligning the evidence work of multiple functional areas and disciplines to improve the safety and effectiveness of clinical practice. The Evidence Collaboration, an interdisciplinary community of practice, has evolved to meet the challenges of helping novices and experts of all disciplines identify, critically appraise, synthesize, and disseminate evidence to inform best practices for patients and families, staff, and institutional processes. By creating a common language for evidence work, resources such as the Let Evidence Guide Every New Decision system, and templates for dissemination, the Evidence Collaboration has moved the organizational culture toward one that encourages the use of evidence in all decisions. Our progress continues as we strive to include patients and families in the decisions about best practices based on evidence.

Background: Learning Networks are distributed learning health systems that enable collaboration, at scale, to improve health and healthcare. A key requirement for such networks is having a way to create and share information and knowledge in furtherance of the work of the community.