Laure Perrier

BACKGROUND Co-design is a collaborative process spanning the lifecycle of a design project that uses creativity, reflexivity, and iterative learning to support feedback, adaptation, and shared understanding during intervention development. Co-design aims to involve diverse groups, including patients, caregivers, clinicians, administrators, community members, researchers, designers, and policy actors. Evidence suggests co-designed interventions may be more engaging, acceptable, and feasible to implement than those developed using traditional approaches. Despite the growing adoption of co-design, considerable variation remains in how it is understood, implemented, and reported, limiting its potential to support meaningful and equitable improvements in health interventions. OBJECTIVE To map the scope and nature of the literature describing the models, theories, and frameworks (MTFs) used to co-design complex health interventions and synthesize their key characteristics. This review constitutes Phase 1 of the Preferred Components for Co-design in Research (PRECISE) initiative, which aims to enhance conceptual clarity, methodological rigour, and transparency in reporting co-design studies for complex health interventions. METHODS A scoping review was conducted following JBI guidance and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Seven databases were searched from 1972 to 19 October 2023. Screening and data extraction were done independently and in duplicate. Publications were eligible if they reported co-design, co-production, or co-creation approaches and applied a model, theory, or framework to guide co-design of complex interventions. Extracted data were synthesized descriptively using counts and proportions. RESULTS A total of 130 publications were included. Co-design terminology use was inconsistent: 62.3% of publications used the term “co-design,” 7.7% “co-production”, 6.9% “co-creation”, and 16.2% did not use any co-approach term in their methodology. Among publications using a co-approach term, only 31.2% provided an associated citation. Fewer than two-thirds (60.0%) reported reciprocal collaboration with co-design partners. Among these, “developing the intervention” was the most commonly reported role (89.5%), while involvement in analysis and dissemination was less frequently reported. Reported co-design principles were variable, with "use participatory means" being the most prevalent (93.9%). Regarding MTFs, 70.0% of publications used a design-only MTF (e.g., pre-2021 Medical Research Council framework). Only three studies (2.3%) used a co-only MTF. Nearly half (42.3%) reported using a co + design MTF (e.g., Double Diamond). Of those using a co + design MTF, 67.3% operationalized its elements in the study context. CONCLUSIONS This scoping review reveals significant variability in how co-design is defined, conceptualized, and applied in the development of complex health interventions, with limited use of and application of MTFs. These findings highlight the necessity for clearer conceptual bases and more transparent reporting. As Phase 1 of the PRECISE guideline initiative, this review lays the empirical groundwork for developing reporting standards for co-design research. CLINICALTRIAL The Open Science Framework on June 12, 2023 (osf.io/prd3t).

Objectives This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: Primary objectives To identify, appraise, and synthesize qualitative research evidence on healthcare stakeholders' perceptions and experiences of interventions aimed at improving interprofessional collaboration. Secondary objectives To identify factors influencing the implementation of interprofessional collaboration interventions. To inform subgroup analyses for future updates of the Cochrane intervention review

Background: Patient navigation interventions (PNIs) can provide personalized support and promote appropriate coordination or continuation of health and social care services. Online PNIs have demonstrated excellent potential for improving patient knowledge, transition readiness, self-efficacy, and use of services. However, the characteristics (ie, intervention type, mode of delivery, duration, frequency, outcomes and outcome measures, underlying theories or mechanisms of change of the intervention, and impact) of existing online PNIs to support the health and social needs of individuals with illness remain unclear. Objective: This scoping review of the existing literature aims to identify the characteristics of existing online PNIs reported in the literature. Methods: A scoping review based on the guidelines outlined in the Joanna Briggs Institute framework was conducted. A search for peer-reviewed literature published between 1989 and 2022 on online PNIs was conducted using MEDLINE, CINAHL, Embase, PsycInfo, and Cochrane Library databases. Two independent reviewers conducted 2 levels of screening. Data abstraction was conducted to outline key study characteristics (eg, study design, population, and intervention characteristics). The data were analyzed using descriptive statistics and qualitative content analysis. Results: A total of 100 studies met the inclusion criteria. Our findings indicate that a variety of study designs are used to describe and evaluate online PNIs, with literature being published between 2003 and 2022 in Western countries. Of these studies, 39 (39%) studies were randomized controlled trials. In addition, we noticed an increase in reported online PNIs since 2019. The majority of studies involved White females with a diagnosis of cancer and a lack of participants aged 70 years or older was observed. Most online PNIs provide support through navigation, self-management and lifestyle changes, counseling, coaching, education, or a combination of support. Variation was noted in terms of mode of delivery, duration, and frequency. Only a small number of studies described theoretical frameworks or change mechanisms to guide intervention. Conclusions: To our knowledge, this is the first review to comprehensively synthesize the existing literature on online PNIs, by focusing on the characteristics of interventions and studies in this area. Inconsistency in reporting the country of publication, population characteristics, duration and frequency of interventions, and a lack of the use of underlying theories and working mechanisms to inform intervention development, provide guidance for the reporting of future online PNIs.

Background: There is increasing evidence that co-design can lead to more engaging, acceptable, relevant, feasible, and even effective interventions. However, no guidance is provided on the specific designs and associated methods or methodologies involved in the process. We propose the development of the Preferred Components for Co-design in Research (PRECISE) guideline to enhance the consistency, transparency, and quality of reporting co-design studies used to develop complex health interventions. Objective: The aim is to develop the first iteration of the PRECISE guideline. The purpose of the PRECISE guideline is to improve the consistency, transparency, and quality of reporting on studies that use co-design to develop complex health interventions. Methods: The aim will be achieved by addressing the following objectives: to review and synthesize the literature on the models, theories, and frameworks used in the co-design of complex health interventions to identify their common elements (components, values or principles, associated methods and methodologies, and outcomes); and by using the results of the scoping review, prioritize the co-design components, values or principles, associated methods and methodologies, and outcomes to be included in the PRECISE guideline. Results: The project has been funded by the Canadian Institutes of Health Research. Conclusions: The collective results of this project will lead to a ready-to-implement PRECISE guideline that outlines a minimum set of items to include when reporting the co-design of complex health interventions. The PRECISE guideline will improve the consistency, transparency, and quality of reports of studies. Additionally, it will include guidance on how to enact or enable the values or principles of co-design for meaningful and collaborative solutions (interventions). PRECISE might also be used by peer reviewers and editors to improve the review of manuscripts involving co-design. Ultimately, the PRECISE guideline will facilitate more efficient use of new results about complex health intervention development and bring better returns on research investments. International Registered Report Identifier (IRRID): PRR1-10.2196/50463

Background: Physicians are essential in health-care delivery. Physician engagement, defined as active participation in administrative and leadership activities in their organization, is a useful metric for hospital leaders to evaluate as they develop and implement strategy. The purpose of this study was to gain insight into the perspectives of senior hospital physician leaders on factors impacting physician engagement. Methods: Semi-structured interviews were conducted virtually. A purposive sample was used. Hospital physician senior leaders were recruited from Ontario public hospitals in Canada. The interviews were recorded, transcribed verbatim, and analyzed. Results: Ten participants in senior hospital physician leadership positions were interviewed. Seven themes were identified as impacting physician engagement: being seen and being heard, accountability, trust, leadership engagement, intercommunication, organizational stability, and discord within the organization. Saturation of themes was achieved. Conclusion: Two-way communication is essential to physician engagement. Physician input in decision-making processes is a vital way to improve engagement. For this to work, leadership must also be engaged. Trust and accountability are critical attributes for senior hospital physician leaders, especially during times of organizational instability. For physicians whose remuneration model is fee-for-service, new compensation models are required for them to actively participate in hospital decision-making.

BACKGROUND There is increasing evidence that co-design can lead to more engaging, acceptable, relevant, feasible, and even effective interventions. However, no guidance is provided on the specific designs and associated methods or methodologies involved in the process. We propose the development of the Preferred Components for Co-design in Research (PRECISE) guideline to enhance the consistency, transparency, and quality of reporting co-design studies used to develop complex health interventions. OBJECTIVE The aim is to develop the first iteration of the PRECISE guideline. The purpose of the PRECISE guideline is to improve the consistency, transparency, and quality of reporting on studies that use co-design to develop complex health interventions. METHODS The aim will be achieved by addressing the following objectives: to review and synthesize the literature on the models, theories, and frameworks used in the co-design of complex health interventions to identify their common elements (components, values or principles, associated methods and methodologies, and outcomes); and by using the results of the scoping review, prioritize the co-design components, values or principles, associated methods and methodologies, and outcomes to be included in the PRECISE guideline. RESULTS The project has been funded by the Canadian Institutes of Health Research. CONCLUSIONS The collective results of this project will lead to a ready-to-implement PRECISE guideline that outlines a minimum set of items to include when reporting the co-design of complex health interventions. The PRECISE guideline will improve the consistency, transparency, and quality of reports of studies. Additionally, it will include guidance on how to enact or enable the values or principles of co-design for meaningful and collaborative solutions (interventions). PRECISE might also be used by peer reviewers and editors to improve the review of manuscripts involving co-design. Ultimately, the PRECISE guideline will facilitate more efficient use of new results about complex health intervention development and bring better returns on research investments. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/50463

BACKGROUND Patient navigation interventions (PNIs) can provide personalized support and promote appropriate coordination or continuation of health and social care services. Online PNIs have demonstrated excellent potential for improving patient knowledge, transition readiness, self-efficacy, and use of services. However, the characteristics (ie, intervention type, mode of delivery, duration, frequency, outcomes and outcome measures, underlying theories or mechanisms of change of the intervention, and impact) of existing online PNIs to support the health and social needs of individuals with illness remain unclear. OBJECTIVE This scoping review of the existing literature aims to identify the characteristics of existing online PNIs reported in the literature. METHODS A scoping review based on the guidelines outlined in the Joanna Briggs Institute framework was conducted. A search for peer-reviewed literature published between 1989 and 2022 on online PNIs was conducted using MEDLINE, CINAHL, Embase, PsycInfo, and Cochrane Library databases. Two independent reviewers conducted 2 levels of screening. Data abstraction was conducted to outline key study characteristics (eg, study design, population, and intervention characteristics). The data were analyzed using descriptive statistics and qualitative content analysis. RESULTS A total of 100 studies met the inclusion criteria. Our findings indicate that a variety of study designs are used to describe and evaluate online PNIs, with literature being published between 2003 and 2022 in Western countries. Of these studies, 39 (39%) studies were randomized controlled trials. In addition, we noticed an increase in reported online PNIs since 2019. The majority of studies involved White females with a diagnosis of cancer and a lack of participants aged 70 years or older was observed. Most online PNIs provide support through navigation, self-management and lifestyle changes, counseling, coaching, education, or a combination of support. Variation was noted in terms of mode of delivery, duration, and frequency. Only a small number of studies described theoretical frameworks or change mechanisms to guide intervention. CONCLUSIONS To our knowledge, this is the first review to comprehensively synthesize the existing literature on online PNIs, by focusing on the characteristics of interventions and studies in this area. Inconsistency in reporting the country of publication, population characteristics, duration and frequency of interventions, and a lack of the use of underlying theories and working mechanisms to inform intervention development, provide guidance for the reporting of future online PNIs.

Background To confirm the reliability of a survey investigating physician engagement in quality improvement (QI) among Ontario physicians. We conducted a pilot study to test the survey on physicians, evaluate a recruitment strategy, and assess preliminary data. Methods All Ontario physicians were invited to participate in the survey through province-wide online physician and hospital organization newsletters. Results Results indicate a need for solutions and standards for training physicians interested in participating in QI initiatives. Study objectives were reached, but recruitment remains challenging. Conclusion This pilot study supports conducting a full-scale survey that would result in more robust results.