Although public engagement in research is increasingly popular, the involvement of citizens living in vulnerable circumstances is rarely realized. This narrative review aims to describe and critically analyse concerns and corresponding strategies, tools, and methods that could support the inclusion of these citizens in health research. The 40 studies that are included were thematically analysed using the socioecological model. Concerns originate most often on the intrapersonal level of the socioecological model, but concerns were also identified at institutional, community, and policy levels. It is thought-provoking that there is a lack of attention for the research and policy structure in which engagement practices are designed, implemented and evaluated. More research is needed to explore how these cultures could be changed in a way that promotes rather than restrains the engagement of citizens living in vulnerable circumstances in research and policymaking.

Introduction Engaging public and patients in the decision-making processes is on the agenda of many healthcare systems towards sustainable healthcare delivery. While many engagement initiatives are performed face-to-face, an increasing number is conducted online. An example of the latter is the Dutch digital platform Gezonde Mening that engages patients, healthcare professionals and other stakeholders in the co-creation of healthcare innovations. This study aimed to evaluate the effectiveness of stakeholder engagement performed on Gezonde Mening by focusing on the process of planning, execution and transition of engagement activities. Methods A mixed-methods study was performed by conducting eight semi-structured interviews with developers and funders of Gezonde Mening and an assessment of the psychometric properties of two questionnaires administrated via Gezonde Mening to seek stakeholders’ inputs. While the interviews were analysed deductively and inductively, data from the assessment of psychometric properties were analysed in a descriptive quantitative manner. Data were interpreted through triangulation. Results Assessment of the planning of stakeholder engagement identified needs for having more stakeholders on the platform to enable subgroup analysis and robust insights. Moreover, questionnaires administered by Gezonde Mening showed low validity and reliability. Assessment of the execution of stakeholder engagement indicated that stakeholders are sufficiently informed about engagement. Assessment of the transition of engagement activities showed needs to provide direct results to stakeholders and allow their evaluation of the platform. Conclusion Gezonde Mening digital platform facilitates communication between innovators and stakeholders during engagement activities. However, the study identified room for improvement regarding the planning and transition activities.