Evaluating stakeholder involvement in building a decision support tool for NHS health checks: co-producing the WorkHORSE study

Lloyd-Williams, Ffion; Hyseni, Lirije; Guzman-Castillo, Maria; Kypridemos, Chris; Collins, Brendan; Capewell, Simon; Schwaller, Ellen; O’Flaherty, Martı́n

doi:10.1186/s12911-020-01205-y

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…Where it was possible to discern how the concepts were enacted, the type of methods reported in papers describing co-production or co-design included individual interviews, group workshops, reflection and discussion meetings, focus group discussions, social media forums, surveys, or a mix of these activities [ 47 , 48 , 52 , 55 , 62 , 63 , 84 ] (see Table 2 ). While some papers described specific activities and participatory approaches used in co-design or co-production workshops or meetings [ 25 , 30 , 70 , 72 , 104 ], most did not elaborate on their methods.…”

Section: Resultsmentioning

confidence: 99%

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Smith¹,

Budworth²,

Grindey³

et al. 2022

Health Res Policy Sys

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Background Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarized co-production approaches in use, collated outcomes and effects of co-production, and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We conducted this scoping review to systematically map recent literature on co-production in applied health research in the United Kingdom to inform co-production practice and guide future methodological research. Methods This scoping review was performed using established methods. We created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on which we described the characteristics of the articles and scope of the literature and summarized conceptualizations of co-production and how it was implemented. We extracted implications for co-production practice or future research and conducted a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. Results Nineteen articles reporting co-produced complex interventions and 64 reporting co-production in applied health research met the inclusion criteria. Lessons for the practice of co-production and requirements for co-production to become more embedded in organizational structures included (1) the capacity to implement co-produced interventions, (2) the skill set needed for co-production, (3) multiple levels of engagement and negotiation, and (4) funding and institutional arrangements for meaningful co-production. Themes for future research on co-production included (1) who to involve in co-production and how, (2) evaluating outcomes of co-production, (3) the language and practice of co-production, (4) documenting costs and challenges, and (5) vital components or best practice for co-production. Conclusion Researchers are operationalizing co-production in various ways, often without the necessary financial and organizational support required and the right conditions for success. We argue for accepting the diversity in approaches to co-production, call on researchers to be clearer in their reporting of these approaches, and make suggestions for what researchers should record. To support co-production of research, changes to entrenched academic and scientific practices are needed. Protocol registration details: The protocol for the scoping review was registered with protocols.io on 19 October 2021: https://dx.doi.org/10.17504/protocols.io.by7epzje.

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Section: Resultsmentioning

confidence: 99%

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Smith¹,

Budworth²,

Grindey³

et al. 2022

Health Res Policy Sys

View full text Add to dashboard Cite

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“…Workshop design ( n = 3) was informed by Carney/Oliver co-production principles [ 24 , 26 , 27 ]. Workshops were carefully planned using a scripted approach (example Supplementary material 1) and focused on joint decision-making between the research team, stakeholders, and consumers [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key

Schults

Kleidon

Gibson

et al. 2022

BMC Health Serv Res

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Objective To develop and validate a difficult intravenous access risk assessment and escalation pathway, to increase first time intravenous insertion success in paediatrics. Methods Mixed methods underpinned by literature and co-production principles. Iterative development of the instrument was informed through semi-structured interviews and stakeholder workshops. The instrument includes a risk assessment, inserter skill self-assessment, and escalation pathways. Reproducibility, reliability, and acceptability were evaluated in a prospective cohort study at a quaternary paediatric hospital in Australia. Results Interview data (three parents, nine clinicians) uncovered two themes: i) Recognition of children with DIVA and subsequent escalation is ad hoc and problematic; and ii) Resources and training impact inserter confidence and ability. Three workshops were delivered at monthly intervals (February–April 2020) involving 21 stakeholders culminating in the co-production of the “DIVA Key”. The DIVA Key was evaluated between May–December 2020 in 78 children; 156 clinicians. Seventy-eight paired assessments were undertaken with substantial agreement (concordance range = 81.5 to 83.0%) between the assessors. Interrater reliability of the DIVA risk assessment was moderate (kappa = 0.71, 95% CI 0.63–0.80). The DIVA Key predicted multiple insertion attempts for red (high risk) DIVA classification (relative risk ratio 5.7, 95% CI 1.2–27.1; reference low risk). Consumer and clinician satisfaction with DIVA Key was high (median (IQR) = 10 [8–10]; 8 [8–10 respectively). Conclusion The DIVA Key is a straightforward, reliable instrument with inbuilt escalation pathway to support the identification of children with difficult intravenous access.

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“…We also have two academic papers relating to workshop 1 outcomes and workshop co-production methodology. 42,43 Details of all dissemination can be found in the Acknowledgements.…”

Section: Dissemination and Outputsmentioning

confidence: 99%

Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users

O’Flaherty

Lloyd-Williams

Capewell

et al. 2021

Health Technol Assess

Self Cite

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Background Local authorities in England commission the NHS Health Check programme to invite everyone aged 40–74 years without pre-existing conditions for risk assessment and eventual intervention, if needed. However, the programme’s effectiveness, cost-effectiveness and equity impact remain uncertain. Aim To develop a validated open-access flexible web-based model that enables local commissioners to quantify the cost-effectiveness and potential for equitable population health gain of the NHS Health Check programme. Objectives The objectives were as follows: (1) co-produce with stakeholders the desirable features of the user-friendly model; (2) update the evidence base to support model and scenario development; (3) further develop our computational model to allow for developments and changes to the NHS Health Check programme and the diseases it addresses; (4) assess the effectiveness, cost-effectiveness and equity of alternative strategies for implementation to illustrate the use of the tool; and (5) propose a sustainability and implementation plan to deploy our user-friendly computational model at the local level. Design Co-production workshops surveying the best-performing local authorities and a systematic literature review of strategies to increase uptake of screening programmes informed model use and development. We then co-produced the workHORSE (working Health Outcomes Research Simulation Environment) model to estimate the health, economic and equity impact of different NHS Health Check programme implementations, using illustrative-use cases. Setting Local authorities in England. Participants Stakeholders from local authorities, Public Health England, the NHS, the British Heart Foundation, academia and other organisations participated in the workshops. For the local authorities survey, we invited 16 of the best-performing local authorities in England. Interventions The user interface allows users to vary key parameters that represent programme activities (i.e. invitation, uptake, prescriptions and referrals). Scenarios can be compared with each other. Main outcome measures Disease cases and case-years prevented or postponed, incremental cost-effectiveness ratios, net monetary benefit and change in slope index of inequality. Results The survey of best-performing local authorities revealed a diversity of effective approaches to maximise the coverage and uptake of NHS Health Check programme, with no distinct ‘best buy’. The umbrella literature review identified a range of effective single interventions. However, these generally need to be combined to maximally improve uptake and health gains. A validated dynamic, stochastic microsimulation model, built on robust epidemiology, enabled service options analysis. Analyses of three contrasting illustrative cases estimated the health, economic and equity impact of optimising the Health Checks, and the added value of obtaining detailed local data. Optimising the programme in Liverpool can become cost-effective and equitable, but simply changing the invitation method will require other programme changes to improve its performance. Detailed data inputs can benefit local analysis. Limitations Although the approach is extremely flexible, it is complex and requires substantial amounts of data, alongside expertise to both maintain and run. Conclusions Our project showed that the workHORSE model could be used to estimate the health, economic and equity impact comprehensively at local authority level. It has the potential for further development as a commissioning tool and to stimulate broader discussions on the role of these tools in real-world decision-making. Future work Future work should focus on improving user interactions with the model, modelling simulation standards, and adapting workHORSE for evaluation, design and implementation support. Study registration This study is registered as PROSPERO CRD42019132087. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 35. See the NIHR Journals Library website for further project information.

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Evaluating stakeholder involvement in building a decision support tool for NHS health checks: co-producing the WorkHORSE study

Cited by 10 publications

References 29 publications

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key

Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users

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