Participatory Health Research Research Articles

From struggle to strength in African and Middle Eastern newcomers' integration stories to Canada: A participatory health equity research study.

Newcomers (immigrants, refugees, and international students) face many personal, gender, cultural, environmental and health system barriers when integrating into a new society. These struggles can affect their health and social care, reducing access to mental health care. This study explores the lived experiences of African and Middle Eastern newcomers to Ontario, Canada. An understanding of newcomer integration challenges, successes and social justice issues is needed to improve health equity and social services. In this qualitative study, we used a participatory research approach to collect stories reflecting participants' integration perspectives and experiences. Beginning with our immigrant community network, we used snowball sampling to recruit newcomers, ages 18 to 30, originating from Africa or the Middle East. We used qualitative narrative analysis to interpret stories, identifying context themes, integrating related barriers and facilitators, and resolutions and learnings. We shared our findings and sought final feedback from our participants. A total of 18 newcomers, 78% female and approximately half post-secondary students, participated in the study. Participants described an unknown and intimidating migration context, with periods of loneliness and isolation aggravated by cold winter conditions and unfamiliar language and culture. Amidst the struggles, the support of friends and family, along with engaging in schoolwork, exploring new learning opportunities, and participating in community services, all facilitated integration and forged new resilience. Community building, friendships, and local services emerged as key elements for future immigrant service research. Utilizing a participatory health research approach allowed us to respond to the call for social justice-oriented research that helps to generate scientific knowledge for promoting culturally adaptive health care and access for marginalized populations.

IJCM_394A: Participation of Undergraduate Medical Students in Health Research and Factors Influencing It in a Medical College of Puducherry- A Cross-Sectional Study

Background: Developing, maintaining, and sustaining undergraduate medical students’ research involvement will enable future healthcare practitioners to practice more appropriate evidence-based clinical medicine. Objective: To assess the participation in health research and factors promoting it among undergraduate medical students in Puducherry. Methodology: A descriptive cross-sectional study was conducted among undergraduate medical students in Puducherry over a period of three months (August-October 2023). Systematic random sampling was applied to recruit 360 study participants based on Chellaiyan et al. A pre-tested, semi-structured questionnaire was used to collect the data, including socio-demographic characteristics, academic performance, participants’ attitudes, perceived motivational and barrier factors towards health research, and current involvement in health research. Data were entered in MS Excel 2019 and analyzed using SPSS v16.0. Results: A total of 360 participants were interviewed, of whom 51.6% were female and the majority (86.7%) were hostelers. Among the 360 study participants, only around one-tenth of the participants”41 (11.39%)” have participated in the health research. The factors of gender, competency-based medical education approach, and grade of the participants in the recent university exam were associated with participation in health research. The majority (90.4%) of the participants were highly motivated to participate in health research. The main barriers identified are lack of funds, collaboration, mentorship, time to conduct, and systematic training in the research methodology. Conclusion: Participation in health research has doubled since the introduction of competency-based medical education. Still, participation could be improved by addressing the identified barriers. Studentship programs, young researcher awards, systematic training programs integrated into the curriculum, etc. could also compute the participation in health research among undergraduate medical students.

Recovery-oriented practice in a hospital mental health service.

As part of mental health reform in Australia, new policies were introduced to support recovery-oriented practice; however, little has changed in hospital settings focused on managing risk and remediating acute symptoms. Previous studies have indicated that patients' experiences of personal recovery, during a hospital admission, may not mirror that of people living in the community, with patients being more likely to experience disconnection, hopelessness and disempowerment. Using a Participatory Health Research approach, eight mental health professionals, a patient advocate and an external researcher formed a research partnership to answer the question: How can staff enhance recovery-oriented practice in a hospital-based mental health service? The COREQ checklist was used for reporting the methods, analysis and findings. The methods comprised patient focus groups (n = 16 participants), interviews with managers (n = 7) and an online survey for staff (n = 17). Researchers analysed the feedback from the consultations using inductive thematic analysis, identifying two themes: relational recovery and recovery interventions. The findings indicate that relational recovery is key to recovery during a hospital admission and interventions that increase connectedness or reduce the impact of symptoms enhance personal recovery.

A square peg in a round hole: reflecting on using a participatory health research approach during my PhD

ABSTRACT When reflecting on my years as a doctoral student, I recall several questions that often came to mind throughout my journey: what is participatory health research? Is such an approach to research truly feasible in the pursuit of a doctoral degree? Is it worth it, or have I inadvertently made things more challenging for myself? My response to these questions has evolved dramatically alongside my growth and development throughout my PhD. I was presented with an opportunity to explore an approach to participatory health research firsthand; a process which included many jumps, twists, turns, and slides, and at times, left me feeling like a square peg in a round hole. Throughout this process, navigating the breadth of challenges and opportunities presented along the way, I also learned the importance of one’s narrative – in particular, the growth and development made possible when researchers and participatory partners share our stories and reflect together. This paper is part of my story, through my account of ‘our story’. It embraces a narrative-style approach to critical reflection of the participatory process throughout my doctoral studies, emphasising the key challenges posed when working within the boundaries of traditional academic structures. I provide a reflexive account of how these challenges were navigated, which created a range of opportunities at both a theoretical and practical level. I conclude with a response to these initial questions and a hopeful call for change.

Defining acceptable data collection and reuse standards for queer artificial intelligence research in mental health: protocol for the online PARQAIR-MH Delphi study

IntroductionFor artificial intelligence (AI) to help improve mental healthcare, the design of data-driven technologies needs to be fair, safe, and inclusive. Participatory design can play a critical role in empowering...

Barriers and facilitators for recruiting and retaining male participants into longitudinal health research: a systematic review.

Successfully recruiting male participants to complete a healthcare related study is important for healthcare study completion and to advance our clinical knowledgebase. To date, most research studies have examined the barriers and facilitators of female participants in longitudinal healthcare-related studies with limited information available about the needs of males in longitudinal research. This systematic review examines the unique barriers and facilitators to male recruitment across longitudinal healthcare-related research studies. Following PRIMSA guidelines, MEDLINE, Embase, CINAHL and Web of Science databases were systematically searched using the terms recruitment and/or retention, facilitators and/or barriers and longitudinal studies from 1900 to 2023 which contained separate data on males aged 17-59years. Health studies or interventions were defined longitudinal if they were greater than or equal to 12weeks in duration with 3 separate data collection visits. Twenty-four articles published from 1976-2023 met the criteria. One-third of the studies had a predominantly male sample and four studies recruited only male participants. Males appear disinterested towards participation in health research, however this lack of enthusiasm can be overcome by clear, non-directive communication, and studies that support the participants interests. Facilitating factors are diverse and may require substantial time from research teams. Future research should focus on the specific impact of these factors across the spectrum of longitudinal health-related studies. Based on the findings of this systematic review, researchers from longitudinal health-related clinical trials are encouraged to consider male-specific recruitment strategies to ensure successful recruitment and retention in their studies. This systemic review is registered with the PROSPERO database (CRD42021254696).

Layered vulnerability and researchers’ responsibilities: learning from research involving Kenyan adolescents living with perinatal HIV infection

BackgroundCarefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/AIDS, without increasing burdens. Such studies, however, must navigate a ‘vulnerability paradox’, since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/AIDS (ALH) in Kenya, we develop an account of researchers’ responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency as ‘interacting layers’.MethodsUsing a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders’ perspectives on vulnerability and resilience of young people living with HIV/AIDS, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna’s layered account of vulnerability.ResultsALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.ConclusionsThe most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers’ responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities.

Community-Based Action Research Intervention to Promote Occupational Health Nursing of Portuguese Quarry Workers.

The northern region of Portugal has the largest number of companies manufacturing granite and stone products, which has become the region's trademark. In the municipalities of Marco de Canaveses and Penafiel, the economic activity of this area is important. However, the lack of attractiveness of this activity, combined with the high prevalence of silicosis and tuberculosis in this population, has led to a growing shortage of labor. In order for this project to be the result of collaborative, integral work centered on the people who are the target of health promotion, we used the Participatory Health Research (PHR) approach, based on the PRECEDE-PROCEED model, to implement a mixed-methods study, including participant observation, interviews and document analysis. These data were used to co-create a study design. In 2021, a total of 102 interviews were carried out and self-completion surveys were distributed: the Fantastic Lifestyle Questionnaire (FLQ) and the EQ-5D-3L. Within the scope of occupational health nursing and in the field of action of public health nurses, with the interviews and self-completed surveys carried out, we identified potential focuses for occupational health nursing intervention to promote the health of stone industry workers: adherence to protective measures, energy balance deficit, tobacco and alcohol consumption and access to health services. Data analysis made it possible to assess the prevalence of risk behaviors by order and to involve managers and workers in the co-creation of a health promotion program. The accurate identification of the focuses for nursing intervention not only improves the effectiveness of occupational health services, allowing for targeted interventions adapted to workers' needs, but also contributes considerably to health promotion in the workplace, resulting in safer working environments, a reduction in occupational diseases and, consequently, a healthier and more productive workforce. This protocol of this study was not registered.

Participatory Health Research With Women From Refugee, Asylum-Seeker, and Migrant Backgrounds Living in High-Income Countries: A Scoping Review

Participatory Health Research (PHR) has the potential to result in more equitable health interventions and impactful research outcomes, and is an increasingly used paradigm in migrant health research. In the context of intersecting systems of social disadvantage imposed on migrant and refugee women, PHR could offer an opportunity for researchers to challenge unequal power dynamics in academic research by co-creating knowledge to improve these women’s healthcare access and use. However, there is limited information about how PHR has been conducted with migrant women, including the extent of their involvement throughout the research process. This scoping review aimed to describe and summarize current evidence on the research approaches and methods that have been used in PHR with women of migrant and refugee backgrounds living in high-income countries, and the extent of community engagement in PHR with this population. We searched MEDLINE Ovid, CINHAL, Scopus, and Web of Science databases from 1 January 2012 to 31 December 2021 to identify qualitative, quantitative, and mixed method studies adopting a PHR approach with migrant women as participants. We included 91 studies from 12 countries. Health topics of included studies included: knowledge, screening and prevention of HPV, cervical and breast cancer, mental health, nutrition and physical activity, gender-based violence, and health promotion and education. The most common PHR approaches were Community-Based Participatory Research and participatory action research. Overall, community engagement was commonly reported in most stages of research; however, participatory engagement with migrant women was more often done by proxy through community organisations or agents, rather than women themselves. We argue that more rigorous reporting of community engagement is necessary to demonstrate PHR conducted with migrant women is following the principles of equity and inclusion in community-academic partnerships.

Factors associated with attitudes toward research MRI in older Asian Americans.

South Asian (SA) and East Asian (EA) older adults represent the fastest-growing racial/ethnic groups of Americans at risk for dementia. While recruiting older SA adults into a brain health study, we encountered unexpected hesitancy toward structural brain magnetic resonance imaging (MRI) analysis and stigmatizing attitudes related to internal locus of control (LoC) for future dementia risks. We hypothesized that support for MRI-related research was influenced by these attitudes as well as personal MRI experience, perceived MRI safety, and concerns for personal risk for future dementia/stroke. We developed a brief cross-sectional survey to assess older adults' MRI experiences and perceptions, desire to learn of six incidental findings of increasing impact on health, and attitudes related to dementia (including LoC) and research participation. We recruited a convenience sample of 256 respondents (74% reporting as 50+) from the New Jersey/New York City area to complete the survey (offered in English, Chinese, Korean, and Spanish) and modeled the proportional odds (PO) for favorable attitudes toward research activities. Seventy-seven SA and 84 EA respondents were analyzed alongside 95 White, Black, or Hispanic adults. White (PO = 2.54, p = 0.013) and EA (PO = 2.14, p = 0.019) respondents were both more likely than SA respondents to endorse healthy volunteers' participation in research, and the difference between White and SA respondents was mediated by the latter's greater internal LoC for dementia risks. EA respondents had more worries for future dementia/stroke than SA respondents (p = 0.006) but still shared SA respondents' lower wish (measured by proportion of total) to learn of incidental MRI findings. SA-and EA compared to SA-older adults had low desire to learn of incidental MRI findings but had different attitudes toward future dementia/stroke risks. A culturally appropriate protocol to disclose incidental MRI findings may improve SA and EA participation in brain health research. Older Asian Americans have limited interest in incidental findings on research MRISouth Asians are most likely to attribute dementia to people's own behaviorsSouth Asians' attitudes mediate lower support for healthy volunteers in researchSouth and East Asians differ in dementia worries and research-related attitudes.

Exploring participatory health research and its application to speech and language therapy research practices.

The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under-represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society. To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field. This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field. Conclusions & Implications: PHR remains an under-represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research-practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production. What is already known on this subject PHR is increasingly attracting the attention of funders, researchers and decision-makers due to a growing body of evidence in support of this collaborative research approach. Despite its potential to bridge the research-practice gap, PHR remains significantly under-represented in the SLT research literature. What this paper adds to the existing knowledge This paper discusses the principles, benefits, challenges and impact evaluation of PHR. A recently developed evaluation framework for supporting the implementation of best engagement practices is examined. A demonstration of how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented. What are the potential or actual clinical implications of this work? Speech and language therapists play a key role in PHR, as co-researchers contributing essential context-based knowledge. It is therefore imperative that they understand the principles and practices of this approach in order to maximize their input in future participatory partnerships.

[Planning, Reflecting and Evaluating Participatory Health Research: Adaptation and Piloting of the "Community Based Participatory Research (CBPR) Model" for German-Speaking Countries].

Participatory research approaches are becoming increasingly established in both academic and practice settings. The participation of people with varied lived experiences and professional backgrounds can help academia and practitioners to learn from and empower each other. In the exchange of different perspectives, needs and ideas, it is possible to plan, reflect on, implement and evaluate projects in the health sector jointly and with attention to the needs of all stakeholders. The Community Based Participatory Research (CBPR) Model is often used internationally to guide participatory processes. However, an accessible translation has been lacking for application in German-speaking countries. To address this problem, a multidisciplinary working group composed of academic researchers and practitioners came together within the German-speaking Participatory Health Research Network (PartNet) to adapt the CBPR model for German-speaking countries and to test the adapted version with potential users. The adaptation was more than a translation, as the four model components "Contexts", "Partnership Processes", "Intervention & Research" and "Outcomes" as well as their associated contents are not directly applicable to the socio-structural and political contexts of the German-speaking countries. This article describes the process of adapting the model. This includes how translation drafts for German-speaking countries were first discussed in detail and then agreed upon as an initial template for testing in practice. Subsequently, various users reflected on the German-language model based on their experience of testing it in different projects, focusing on accuracy, comprehensibility and applicability. At the same time, the model was presented and discussed at conferences. The diverse feedback was incorporated into further revisions of the model. The result is a German-language version called "Modell für partizipative Gesundheitsforschung (PGF-Modell)".

‘Keeping it real’: A qualitative exploration of preferences of people with lived experience for participation and active involvement in mental health research in Australia

AbstractBackgroundHistorically, researchers have been apt at conducting research on, rather than with, the people who are the focus of their efforts. Such approaches often fail to effectively support and benefit the populations they are intended to. This study aimed to explore the preferences of people with lived experience for engagement with research either as research participants within studies, or through active involvement in mental health research.MethodsData for this paper were collected in three separate lived experience agenda‐setting studies conducted over a 9‐year period from 2013 to 2022; two group discussions and an open‐ended online survey. Data were combined and thematic analysis undertaken.ResultsParticipants described the inclusion of lived experience as a critical ingredient and the highest level of knowledge and expertise in mental health research that should lead to knowledge generation and research agendas. Participants discussed the importance and value of research that enables sharing experiences and stories, expressed a need for flexibility in research methods for choice and agency, and support for greater active involvement of people with lived experience across all stages of research. Participants also spoke to the need for perspective and knowledge generated from people with lived experience to have equal power in research, making space for lived experience voices across multiple aspects of research, and greater respect and recognition of the value of lived experience.ConclusionLived experience in mental health research is coming of age, but dedicated, cocreated development is needed to get it right. People with lived experience increasingly understand the value their experiential knowledge brings to the mental health research effort, and describe a wide range of ways that researchers can support them to be research participants, and to get actively involved. Power‐sharing, respect and recognition of lived experience as central to effective mental health research are the keys to ‘keeping it real’.Patient or Public ContributionPeople with lived experience of mental health problems or distress either personally, and/or as carers, family and kinship group members, were involved in the coideation and codesign of this research. All authors identify as people with lived experience.

Women Participation in Health Research of Iran: Analysis of Challenges and Strategies with Literature of Review.

Recent evidence provides the facts behind the perceptions about women researchers participating in health research (HR). Women scientists as almost half of active researchers in HR fields have important and fundamental role. The present study aimed to analyses the situation of women participation in HR of Iran. The present study comprised three complementary phases intended to identify and analysis challenges and problems of women participation in health research in Iran (2021-22). Following a review phase, using the content analysis approach through semi-structured interviews data gathered from key stakeholders of health research. At final step, aimed to aggregate and conclude the main key findings, through an expert panel all of the results analyzed to clarify the main messages of the study, focus on reflection to the target group. The results reveal considerable gender differences in research contribution between Iranian men and women. The need for legal infrastructure and support for the active participation of women in HR was the main extracted point of study. The need for transparent documentation and implementation of related research that demonstrates the necessary challenges and gaps was another major point. Findings may help illuminate policy makings to promote participation of women in the country research. The optimal management of HR require facilities can play an important role in improving the quality and quantity of health studies and achieving scientific competitive positions at the regional and global levels.

Understanding the evolution of trust in a participatory health research partnership: A qualitative study.

Advancements in evaluating the impact of participatory health research (PHR) have been made through comprehensive models like the community-based participatory research (CBPR) conceptual model, which provides a useful framework for exploring how context and partnership processes can influence health research design and interventions. However, challenges in operationalising aspects of the model limit our understanding and evaluation of the PHR process. Trust is frequently identified as an important component of the CBPR model, which supports the development of key partnership outcomes, such as partnership synergy. However, trust continues to be limited to a binary view (as present or absent), which is problematic given its inherently dynamic and temporal nature. The aim of this qualitative study is to understand the evolution of trust in the national public and patient involvement (PPI) network in Ireland. Participants from the PPI network (n = 15/21) completed a semistructured interview discussing the evolution of trust by reviewing four social network maps derived from a previous longitudinal study. Following Braun and Clarke, we used reflexive thematic analysis, to iteratively develop, analyse and interpret our mediated reflection of the data. Participants described the evolution of trust as a function of three contextual factors: (1) the set-up and organisation of the network, (2) how people work togetherand (3) reflection on the process and outcomes. Their descriptions across these themes seemed to vary depending on partnership type with National Partners and Site Leads having more opportunities to demonstrate trust (e.g., via leadership roles or more resources), compared to Local. Thus, visibility and the opportunity to be visible, depending on the set-up and organisation of the network and how people work together, seemingly play an important role in the evolution of trust over time. Based on these findings, we provide important questions for reflection across themes that could be considered for future PHR partnerships. Given that the opportunity and visibility to build and maintain trust over time may not be equally available to all partners, it is important to find ways to invest in and commit to equitable relationships as the key to the success (i.e., longevity) of partnerships. We reflect on/offer important implications for those engaging in PHR partnerships and those who fund such research. A Research Advisory Group comprising four research partners (representing academic, serviceand community organisations) from the PPI Ignite Network provided input and approval for the research objectives of this study as well as previously published work informing this study. Informal consultation occurred with members of this group to discuss findings from this study, assisting with the way findings are presented and described, to be accessible for diverse audiences. Two Research Advisory Group members were involved in the interpretation of the results, and one is a co-author of this manuscript (Zoe Hughes).

Representativeness in health research studies: an audit of Greater Manchester Clinical Research Network studies between 2016 and 2021

BackgroundThere are increasing concerns that participants in health research in the UK are not representative of the UK population, risking widening health inequities. However, detailed information on the magnitude of the problem is limited. Therefore, we evaluated if the health research conducted in the Greater Manchester region was broadly representative of its diverse population.MethodsWe conducted an audit of all health  research studies conducted exclusively in Greater Manchester, using data from a national research network. Two researchers selected studies that were (1) an interventional or observational study of a health outcome; (2) ‘closed’ for recruitment between May 2016 and May 2021 and (3) human research. They extracted study information (dates, contacts, sample recruited, clinical speciality). Participant characteristics were sourced from published and unpublished manuscripts and requested directly from principal investigators and named study contacts.Data were extracted, summarised and compared to the Greater Manchester population for the following metrics: ethnicity, sex, age, deprivation and smoking status. A weighted mean age estimate was calculated to account for variation in age reporting. Too few studies provided patient-level deprivation data so, using the area code of the recruitment site, the area level multiple deprivation, health deprivation and disability index and decile was derived. These data were geo-mapped using QGIS 3.26.ResultsOverall, 145/153 (95%) studies met inclusion criteria and participant information was sourced for 85/145 (59%) studies, representing 21,797 participants. Participant information was incomplete for all metrics. Where ethnicity (N = 10,259) data were available and compared to Greater Manchester estimates there was evidence that ethnic minorities were under-represented (6% versus 16%). Most of the recruitment occurred in central Manchester (50%) and with NHS hospital settings (74%).ConclusionsGreater Manchester health research in 2016–2021 was centralised and under-represented ethnic minorities. We could not report which ethnic minority group was least represented because sourcing detailed participant information was challenging. Recommendations to improve the reporting of key participant characteristics with which to monitor representativeness in health research are discussed.

Effects of transdisciplinary research on scientific knowledge and reflexivity

Abstract Transdisciplinary research (TDR) is conceptualized as not only providing societal effects but also benefiting academia. However, recent literature on the evaluation of TDR has focused almost entirely on the societal effects of TDR. A discussion of the scientific effects of TDR is needed to do justice to the potential of this research mode. To date, little empirical research has focused on the effects of TDR on science. Our explorative study addresses this gap. The empirical basis are qualitative interviews with scientists engaged in transdisciplinary research and anchored in three sub-disciplines: environmental sociology, sustainable chemistry, and participatory health research. We identify as main effects of the transdisciplinary research mode: changes in the understanding of scientific problems, changes in the quality of scientific insights, and the promotion of a reflexive turn in science.

A 5-day codesign sprint to improve housing decisions of older adults: lessons learned from Sweden and the Netherlands

ABSTRACT The use of codesign methods is becoming increasingly common practice to involve and engage research participants in health research. Through codesign, end-users and stakeholders can contribute their own perspectives and experiences to solve a common problem. This article describes how a 5-day codesign sprint can be used to find solutions to improve housing decisions of older adults. Based on case studies in Sweden and the Netherlands, we identified similarities, differences, and patterns across the two contexts. By sharing methodological experiences across projects, opportunities are created for other researchers to build on the method and to integrate a creative process into traditional health research methods. We conclude that a 5-day codesign sprint can effectively and efficiently engage older adults and people with dementia in creative housing decision solutions, and we provide recommendations for future codesign sprint projects.

Widening participation – recruitment methods in mental health randomised controlled trials: a qualitative study

BackgroundBarriers to mental health research participation are well documented including distrust of services and research; and stigma surrounding mental health. They can contribute to a lack of diversity amongst participants in mental health research, which threatens the generalisability of knowledge. Given the recent widespread use of the internet in medical research, this study aimed to explore the perspectives of key partners on the use of online (e.g. social media) and offline (e.g. in-person) recruitment as an approach to improving diversity in mental health randomised controlled trials (RCTs).MethodsFace-to-face and online interviews/focus groups with researchers working in mental health and Patient and Public Involvement partners in the United Kingdom. Recordings were transcribed and analysed using a combination of inductive and deductive thematic analysis.ResultsThree focus groups and three interviews were conducted with a total N = 23 participants. Four overarching themes were identified: (1) recruitment reach; (2) Demographic factors that affect selection of recruitment method; (3) safety of technology, and; (4) practical challenges. Five main factors were identified that affect the choice of recruitment method: age, complexity of mental health problem and stigma, cultural and ethnicity differences and digital divide. The use of online methods was considered more accessible to people who may feel stigmatised by their mental health condition and with a benefit of reaching a wider population. However, a common view amongst participants was that online methods require closer data monitoring for quality of responders, are not fully secure and less trustworthy compared to offline methods that enable participants to build relationships with health providers. Funding, staff time and experience, organisational support, and technical issues such as spam or phishing emails were highlighted as practical challenges facing online recruitment. All participants agreed that using a hybrid approach tailored to the population under study is paramount.ConclusionsThis study highlighted the importance of offering a flexible and multifaceted recruitment approach by integrating online with offline methods to support inclusivity and widening participation in mental health research. The findings will be used to develop considerations for researchers designing RCTs to improve recruitment in mental health research.

Migration health ethics in Southeast Asia: a scoping review

Background: Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations. Methods: We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria.  Data were subsequently imported into NVivo 14, and thematic analysis was conducted. Results: We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were ‘capability, agency, dignity’, ‘vulnerability’, ‘precarity, complicity, and structural violence’ (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants. Conclusions: More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.