Does involvement in knowledge creation contribute to development of complex interventions? A realist review of involvement in diabetes research

Article type
Authors
Harris J1, Graue M2, Kirkevold M3, Haltbakk J2, Rokne B4, Dunning T5
1Qualitative & Implementation Research Methods, United Kingdom
2Bergen University College, Norway
3University of Oslo, Norway
4University of Bergen, Norway
5Deakin University, Australia
Abstract
Background: Systematic reviews are considered as the foundation of knowledge translation, but their quality can only be as good as the primary studies that are included in the review. Recently there have been several reviews looking at the importance of tailoring interventions to ensure they are appropriate and accessible to different population groups, but the involvement of people with the condition is not always considered when designing the intervention. Appropriateness, relevance and acceptability of interventions are not routinely considered as criteria when conducting reviews, but may contribute to variations in effectiveness.
Objectives: Our realist review aimed to develop a preliminary theory of the contexts that promote/enable patient involvement in diabetes research, and whether involvement could produce more relevant interventions. Our review questions explored how people have been involved in diabetes research, and whether involvement influenced the development and implementation of diabetes interventions.
Methods: We assembled a review team of diabetes researchers who are seeking information on involvement to inform the design and conduct of their studies. A preliminary theory for successful involvement was developed from involvement literature. We searched MEDLINE, CINAHL, EMBASE in the first instance to identify articles discussing involvement with people at risk for/with diabetes. Cluster searching identified multiple articles on the same study. Several typologies for patient involvement were tested to determine their utility as data extraction tools.
Results so far: To date we have included 79 articles. Cluster searching identified eight projects that generated multiple articles (37). Two different approaches to involvement are used: a community-based participatory approach where people are actively involved in all stages of development and implementation, and a more ‘traditional’ approach where researchers selectively involve people at specific points. Outcomes chaining is being used to identify relationships between the involvement process, uptake and attainment of diabetes-related goals.