Benjamin J Oldfield1,2,3, Marcus A Harrison4, Inginia Genao4, Ann T Greene5, Mary Ellen Pappas6, Janis G Glover7, Marjorie S Rosenthal8,5. 1. Department of Medicine, Yale School of Medicine, New Haven, CT, USA. benjamin.oldfield@yale.edu. 2. Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA. benjamin.oldfield@yale.edu. 3. National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA. benjamin.oldfield@yale.edu. 4. Department of Medicine, Yale School of Medicine, New Haven, CT, USA. 5. National Clinician Scholars Program, Yale School of Medicine, New Haven, CT, USA. 6. General Patient and Family Advisory Council, Yale-New Haven Hospital, New Haven, CT, USA. 7. Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA. 8. Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
Abstract
BACKGROUND: Patient-centeredness is a characteristic of high-quality medical care and requires engaging community members in health systems' decision-making. One key patient engagement strategy is patient, family, and community advisory boards/councils (PFACs), yet the evidence to guide PFACs is lacking. Systematic reviews on patient engagement may benefit from patient input, but feasibility is unclear. METHODS: A team of physicians, researchers, and a PFAC member conducted a systematic review to examine the impact of PFACs on health systems and describe optimal strategies for PFAC conduct. We searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and Social Science Citation Index from inception through September 2016, as well as pre-identified websites. Two reviewers independently screened and abstracted data from studies, then assessed randomized studies for risk of bias and observational studies for quality using standardized measures. We performed a realist synthesis-which asks what works, for whom, under what circumstances-of abstracted data via 12 monthly meetings between investigators and two feedback sessions with a hospital-based PFAC. RESULTS: Eighteen articles describing 16 studies met study criteria. Randomized studies demonstrated moderate to high risk of bias and observational studies demonstrated poor to fair quality. Studies engaged patients at multiple levels of the health care system and suggested that in-person deliberation with health system leadership was most effective. Studies involving patient engagement in research focused on increasing study participation. PFAC recruitment was by nomination (n = 11) or not described (n = 5). No common measure of patient, family, or community engagement was identified. Realist synthesis was enriched by feedback from PFAC members. DISCUSSION: PFACs engage communities through individual projects but evidence of their impact on outcomes is lacking. A paucity of randomized controlled trials or high-quality observational studies guide strategies for engagement through PFACs. Standardized measurement tools for engagement are needed. Strategies for PFAC recruitment should be investigated and reported. PFAC members can feasibly contribute to systematic reviews. REGISTRATION AND FUNDING SOURCE: A protocol for record eligibility was developed a priori and was registered in the PROSPERO database of systematic reviews (registration number CRD42016052817). The Department of Veterans Affairs' Office of Academic Affiliations, through the National Clinician Scholars Program, funded this study.
BACKGROUND:Patient-centeredness is a characteristic of high-quality medical care and requires engaging community members in health systems' decision-making. One key patient engagement strategy is patient, family, and community advisory boards/councils (PFACs), yet the evidence to guide PFACs is lacking. Systematic reviews on patient engagement may benefit from patient input, but feasibility is unclear. METHODS: A team of physicians, researchers, and a PFAC member conducted a systematic review to examine the impact of PFACs on health systems and describe optimal strategies for PFAC conduct. We searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and Social Science Citation Index from inception through September 2016, as well as pre-identified websites. Two reviewers independently screened and abstracted data from studies, then assessed randomized studies for risk of bias and observational studies for quality using standardized measures. We performed a realist synthesis-which asks what works, for whom, under what circumstances-of abstracted data via 12 monthly meetings between investigators and two feedback sessions with a hospital-based PFAC. RESULTS: Eighteen articles describing 16 studies met study criteria. Randomized studies demonstrated moderate to high risk of bias and observational studies demonstrated poor to fair quality. Studies engaged patients at multiple levels of the health care system and suggested that in-person deliberation with health system leadership was most effective. Studies involving patient engagement in research focused on increasing study participation. PFAC recruitment was by nomination (n = 11) or not described (n = 5). No common measure of patient, family, or community engagement was identified. Realist synthesis was enriched by feedback from PFAC members. DISCUSSION: PFACs engage communities through individual projects but evidence of their impact on outcomes is lacking. A paucity of randomized controlled trials or high-quality observational studies guide strategies for engagement through PFACs. Standardized measurement tools for engagement are needed. Strategies for PFAC recruitment should be investigated and reported. PFAC members can feasibly contribute to systematic reviews. REGISTRATION AND FUNDING SOURCE: A protocol for record eligibility was developed a priori and was registered in the PROSPERO database of systematic reviews (registration number CRD42016052817). The Department of Veterans Affairs' Office of Academic Affiliations, through the National Clinician Scholars Program, funded this study.
Authors: Thomas P O'Toole; Kaytura Felix Aaron; Marshall H Chin; Carol Horowitz; Frederick Tyson Journal: J Gen Intern Med Date: 2003-07 Impact factor: 5.128
Authors: Giselle Corbie-Smith; Alice S Ammerman; Mira L Katz; Diane Marie M St George; Connie Blumenthal; Chanetta Washington; Benita Weathers; Thomas C Keyserling; Boyd Switzer Journal: J Gen Intern Med Date: 2003-07 Impact factor: 5.128
Authors: Evelyn Y Ho; Robert R Agne; Trilce Santana; Nicole Thompson; Genevieve McClendon; Eliza Ng; Shannette Merrick; Felicia Gonzalez; Tenaya Smith; Kathleen Drewke; Amalia Gutierrez; Gary Floyd; Maria T Chao Journal: J Gen Intern Med Date: 2021-09-30 Impact factor: 6.473
Authors: Julie M Baughn; Hannah G Lechner; Daniel L Herold; Virginia A Brown; Wendy R Moore; Cameron D Harris; Heidi I Stehr; Channing M Sorensen; Eric J Cleveland; James D Akason; Timothy I Morgenthaler; Robin M Lloyd Journal: J Clin Sleep Med Date: 2020-07-15 Impact factor: 4.062