Engaging under- and/or never-engaged populations in health services: A systematic review

Abstract

Patient engagement is a mechanism used to facilitate person-centred care, however, has not been realized in all patient populations. Often, many marginalized populations still remain under-and/or never-engaged. The purpose of this systematic review was to: 1) identify methods or interventions that have been used to engage under-and/or neverengaged populations in health services and 2) identify outcomes that are associated with engaging under-and/or neverengaged populations in health services. A comprehensive search using the Ovid MEDLINE, EMBASE and CINAHL databases was conducted to examine literature between January 2002 and January 2015. Twenty-nine studies met the inclusion criteria. Data was extracted from these studies and findings are synthesized based on discrete themes that map to the research objectives. The majority of studies were quantitative, repeated-measures designs and concentrated in the United States. Hispanic and Latino/a populations were most frequently included in these studies. The main methods of recruitment included: 1) referral from a healthcare provider, 2) patient self-referral after seeing advertisements on mass media or targeted media, 3) directly approached by researcher in-person or telephone, and 4) administrative databases. Interventions occurred primarily at the individual-level, however some system-level interventions were identified. Five main outcomes resulted from the interventions, including: 1) behavioural change, 2) physiological, 3) psychosocial, 4) system and 5) process. Finally, culture-specific components were embedded in the interventions, both as surface and deep structures. This study provides future direction for patient engagement related projects, as it relates to under-and never-engaged population in healthcare. KeywordsPatient-centred care, patient and family engagement, health equity, patient participation, health services research, systematic review

Refining a capability development framework for building successful consumer and staff partnerships in healthcare quality improvement: A coproduced eDelphi study

“…Hence, the framework is consistent with literature that has identified that effective CCI is predicated on values and relationships, 32 positive attitudes, and behaviours 31 . The enhanced emphasis on trusting relationships, colearning, and valuing different perspectives as key mechanisms for success, is compatible with coproduction research, 33 and literature regarding CCI with diverse and under‐engaged populations 9,34 . It also reinforces that in addition to their lived experience of healthcare, consumers bring much knowledge, skill, and experience to CCI activities 35‐37 .…”

“… 31 The enhanced emphasis on trusting relationships, colearning, and valuing different perspectives as key mechanisms for success, is compatible with coproduction research, 33 and literature regarding CCI with diverse and under‐engaged populations. 9 , 34 It also reinforces that in addition to their lived experience of healthcare, consumers bring much knowledge, skill, and experience to CCI activities. 35 , 36 , 37 The addition of the purpose and principles statements further increases the prominence of CCI core values.…”

“…The average age of participants was 51.11 years, more than 70% identified as female, all had a high level of English language proficiency, and over 55% had a Masters's degree or higher, which may limit study generalizability. However, as called for previously, 9 , 34 the eDelphi panel and Research Advisory Group included people with diverse backgrounds which assisted in gaining multiple perspectives. Further research regarding applicably to indigenous cultures is required as only two people with an Australian Aboriginal heritage were included, one in the Research Advisory Group and one on the panel.…”

“…The average age of participants was 51.11 years, more than 70% identified as female, all had a high level of English language proficiency, and over 55% had a Masters's degree or higher, which may limit study generalizability. However, as called for previously, 9,34…”

Associated Factors with Delay in Prehospital Myocardial Infarction

“…In addition to education, interventions that address psychosocial factors are necessary. This may involve providing emotional support, counseling, and access to mental health services to help individuals overcome fear, denial, and other emotional barriers that impede timely action [38].…”