How and how well have older people been engaged in health care intervention design, development or delivery using co-methodologies: a scoping review with narrative summary

Co-methodological working is gaining increasing traction in health care, but studies with older people have been slower to develop. Our aim was to investigate how and how well older people have been engaged in health care intervention design, development or delivery using co-methodologies. We conducted a systematic search of four electronic databases to identify international literature published between 2009 and November 2019. We included peer-reviewed empirical research of any design. Three authors screened papers. Our review is reported in accordance with the Joanna Briggs Institute manual for scoping reviews, we have referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We data extracted to a bespoke spreadsheet and used the Co:Create Co-production Matrix to guide quality appraisal. Included studies (n=48) were diverse in nature of interventions, co-methodologies and reporting. We offer a narrative summary of included papers. Establishing how older people were engaged in co-methodological work was largely straightforward. How well this was done was more challenging, however we have identified gems of good practice and offered directions for future practice. The Co:Create Co-Production Matrix was the best fit for evaluating papers, however it is not intended as a measure per se. In essence we argue that notions of ‘best’ and ‘scores’ are an oxymoron in co-methodological working, what is important that: i) researchers embrace these methods, ii) incremental change is the way forward, iii) researchers need to do what is right for people and purpose and iv) have time to consider and articulate why they are choosing this approach and how best this can be achieved for their particular situation. Future evaluation of participant’s experience of the process would enable others to learn about what works for who and in what circumstances

Perceptions of gender equity and markers of achievement in a National Institute for Health Research Biomedical Research Centre : a qualitative study.

Background: The need to improve gender equity (GE) in academic medicine is well documented. Biomedical Research Centres (BRCs), partnerships between leading National Health Service (NHS) organizations and universities in England, conduct world-class translational research funded by the National Institute for Health and Care Research (NIHR). In 2011, eligibility for BRC funding was restricted to universities demonstrating sustained GE success recognized by the Athena SWAN Charter for Women in Science Silver awards. Despite this structural change, GE research in BRC settings is underdeveloped, yet critical to the acceleration of women’s advancement and leadership. To explore both women’s and men’s perceptions of GE and current markers of achievement in a BRC setting. Methods: Thematic analysis of data from two research projects: 53 GE survey respondents’ free-text comments (34 women, 16 men), and 16 semi-structured interviews with women affiliated to the NIHR Oxford BRC. Results: Four major themes emerged from the analysis: perceptions of the Athena SWAN Charter for Women in Science (GE policy); views on monitoring GE in BRCs; views on current markers of achievement in academia and GE; and recommendations for actions to improve GE in BRC settings. Monitoring of GE in BRCs was deemed to be important, but complex. Participants felt that current markers of achievement were not equitable to women, as they did not take contextual factors into account such as maternity leave and caring responsibilities. BRC-specific organizational policies and metrics are needed in order to monitor and catalyse GE. Conclusions: Markers of achievement for monitoring GE in BRCs should consider contextual factors specific to BRCs and women’s career progression and professional advancement. GE markers of achievement should be complemented with broader aspects of equality, diversity and inclusion

Gender parity in scientific authorship in a National Institute for Health Research Biomedical Research Centre : a bibliometric analysis

Objective: Scientific authorship is a vital marker of achievement in academic careers and gender equity is a key performance metric in research. However, there is little understanding of gender equity in publications in biomedical research centres funded by the National Institute for Health Research (NIHR). This study assesses the gender parity in scientific authorship of biomedical research. Design: Descriptive, cross-sectional, retrospective bibliometric study. Setting: NIHR Oxford Biomedical Research Centre (BRC). Data: Data comprised 2409 publications that were either accepted or published between April 2012 and March 2017. The publications were classified as basic science studies, clinical studies (both trial and non-trial studies) and other studies (comments, editorials, systematic reviews, reviews, opinions, book chapters, meeting reports, guidelines and protocols). Main outcome measures: Gender of authors, defined as a binary variable comprising either male or female categories, in six authorship categories: first author, joint first authors, first corresponding author, joint corresponding authors, last author and joint last authors. Results: Publications comprised 39% clinical research (n=939), 27% basic research (n=643) and 34% other types of research (n=827). The proportion of female authors as first author (41%), first corresponding authors (34%) and last author (23%) was statistically significantly lower than male authors in these authorship categories (p<0.001). Of total joint first authors (n=458), joint corresponding authors (n=169) and joint last authors (n=229), female only authors comprised statistically significant (p<0.001) smaller proportions, that is, 15% (n=69), 29% (n=49) and 10% (n=23) respectively, compared with male only authors in these joint authorship categories. There was a statistically significant association between gender of the last author with gender of the first author (p<0.001), first corresponding author (p<0.001) and joint last author (p<0.001). The mean journal impact factor (JIF) was statistically significantly higher when the first corresponding author was male compared with female (Mean JIF: 10.00 vs 8.77, p=0.020); however, the JIF was not statistically different when there were male and female authors as first authors and last authors. Conclusions: Although the proportion of female authors is significantly lower than the proportion of male authors in all six categories of authorship analysed, the proportions of male and female last authors are comparable to their respective proportions as principal investigators in the BRC. These findings suggest positive trends and the NIHR Oxford BRC doing very well in gender parity in the senior (last) authorship category. Male corresponding authors are more likely to publish articles in prestigious journals with high impact factor while both male and female authors at first and last authorship positions publish articles in equally prestigious journals

A UK based digital intervention to enable parents to keep abreast of their children’s growth and to support reductions in childhood obesity – a mixed methods study

Background: To understand the health risk of the local population and to combat rising levels of childhood obesity, Manchester University NHS Foundation Trust has developed the Children's Health and Monitoring Programme (CHAMP). CHAMP includes: (a) annual weighing and measuring for primary school children (age 4 to 11), and (b) a feedback system to convey Body Mass Index (BMI) results to parents via a secure website. Objective: To investigate how effectively CHAMP engaged with parents and supported reductions in childhood obesity. Methods: A mixed-methods design was used. Anonymised CHAMP registration and BMI data were collected between September 2013 and March 2017. BMI change over time was compared in matched cohorts of children whose parents had and had not registered with the CHAMP website. Qualitative focus groups and interviews were used to explore perspectives among 29 key informants (parents and staff) from six schools in Manchester. Results: Overweight children whose parents had not registered with the CHAMP website gained a median of 0.14 BMI centiles between measurements, whilst children of CHAMP-registered parents decreased their BMIs by a median of 0.4 UK90 centiles per year (P=0.02). Qualitative analysis revealed a minority of parents had made lifestyle changes within their families to improve their health directly in response to the feedback received from the CHAMP website. Thematic analysis yielded further subthemes concerning psychological impacts of CHAMP on families. Conclusion: CHAMP, which is unique as both a monitoring system and community based intervention, supports parents in making positive lifestyle choices which may benefit their child’s growth trajectory

The experiences and livelihood strategies of poor people living with HIV/AIDS in Kolkata, India

The international literature, policy and action up to now have concentrated predominantly on the prevention and treatment aspects of HIV/AIDS, often neglecting the support and care that poor people living with HIV/AIDS (PLHA) require. The current study addresses this gap by exploring a group of poor PLHAs’ own perceptions of their experience of living with and seeking treatment for HIV/AIDS, the adequacy of the health care services they are able to access and the support programmes for PLHA provided by NGOs and other not-for-profit organisations in the context of Kolkata - one of the largest metropolitan cities in India. Semi-structured interviews were carried out with 59 men and women from Kolkata, India. The study reveals that in the case of HIV/AIDS, it is necessary to divide the post-symptomatic phase into pre and post-diagnosis stages, because it emerged that many PLHA had experienced serious delays in obtaining an accurate diagnosis, resulting in the loss of their existing assets, further impoverishing many at an early stage of the illness trajectory. People’s ability to mobilise additional labour assets within their households to ‘earn money in new ways’ and the characteristics of their ‘household relations’ emerged as key explanations of how well households fared during the post-diagnosis phase