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Write down your country name and a word summarizing the method/tool for citizen engagament and its benefit in the title of the post. You can elaborate your answer below the title.

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Write down a word summarizing the challenge for citizen engagement in the title of your post. You can elaborate on the strategies to overcome the challenges in your answer below the title.

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Deliberative processes allow citizens to learn about complex policy questions and mature their views and possibly change them

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Plain language summaries, patient peer-review of Cochrane systematic reviews.

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Plain language summaries, patient peer-review of Cochrane systematic reviews.

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These methods can help patients understand their conditions better and highlight or add important outcomes for systematic reviews.

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Citizen engagement in developing health policies ensures that ground level situation is reflected, accountability of public funds for the health policies are being infused and corruption is avoided or minimised

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Benefits: Building trust and relationships amongst the members and they are sharing lived experiences in very vulnerable ways.

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The method is now being developed learning from McMaster's Citizen panel for involving older adults with multiple chronic conditions and their caregivers in imrpoving transitions of care quality. Still too early to answer benefits. One challenge already though is ensuring representativeness of the wide range of older adults and caregiver groups
Opeyemi Kolade

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Public meetings are a traditional way to engage citizens in the decision-making process. They provide an opportunity for citizens to come together to discuss issues and to share their views. Myanmar Minister of health arranged a tour of the country before the military coup and COVID-19, it had mixed-results but the experience of engaging with citizen was an eyes opening experience.

zarnilynnkyaw@gmail.com

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Cochrane plain language summaries, patient peer-review of Cochrane protocols

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Cochrane plain language summaries, patient peer-review of Cochrane protocols

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A handful of people know about Cochrane in Kazakhstan.

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Patient partner initiated knowledge syntheses

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Patient partner initiated knowledge syntheses

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Conducting knowledge syntheses that are initiated by a patient partner, ie it's their project!

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involving those with lived experience as advisors in research or knowledge mobilization projects to ensure the end results meet their needs.

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Working with 'expert patients' those suffering from conditions such as Bipolar Disorder or relatives and carers of those with other serious enduring mental illnesses has enabled a better understanding of the challenges. This is usually done by group discussion with the option of individual interviews. Not sophisticated tools!

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Constitucion Politica del Estado

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Understanding the values that citizens think are important when making decisions

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We combined a methods call Emotional Touchpoint w/ the DEM QOL survey to assess the experiences of People Living with Dementia.

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can be challenging to ensure you are engaging a large variety of citizens. need to think about barriers to participation and try to reduce them where possible.

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typology for different types of citizen engagement in deliberative decision-making about policy and investment, research, development, implementation, evaluation (HTA) and monitoring

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typology for different types of citizen engagement in deliberative decision-making about policy and investment, research, development, implementation, evaluation (HTA) and monitoring

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We developed a typology for a project partnership with the Brazilian Ministry of Health to support evidence-informed decision-making to improve all social participation, public consultation and use of (real world) qualitative evidence in the health technology assessment processes implemented by the National Committee for the Incorporation of Health Technologies in Sistema Único de Saúde (Unified Health System - Brazilian Public Health System) - Conitec, which is available here: https://brasilia.fiocruz.br/aagts/wp-content/uploads/sites/4/2021/01/Relatorio_POPART_final.pdf

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A series of four one-hour webinars providing an introduction to patient preference research that over the series will explore its use in HTA.

The development of patient involvement in Health Technology Assessment (HTA) represents a shift towards increased patient-centricity in the allocation of scarce health resource.

In the past decade, the focus has been on supporting 'expert patients' or patient representatives to participate in the HTA appraisal process, with individual patients or patient organisations invited to contribute information in-person or via a structured template.

However, participation in this way is only one aspect of patient involvement: another way is the use of evidence generated from patient-centred research. Systematic approaches to studying patient needs, choices, experiences and preferences can yield important findings to help resolve uncertainties in clinical and cost effectiveness.

One form of evidence that has received increased interest in recent years is patient preference studies. These studies systematically capture qualitative and/or quantitative information on how patients value the benefits, risks and other characteristics of potential treatment alternatives using specific methods for patient preference elicitation.

Patient preference studies could help identify the outcomes and improvements that are most important to patients, while potentially addressing some of the perceived challenges with patient participation approaches, including the robustness, quality, partiality and consistency of input.

However, the role of patient preference evidence in HTA is as yet undetermined and remains a subject of continued interest and debate: how can we best embrace new forms of patient-based evidence alongside more traditional forms of input, and will patient preference evidence redefine the future of 'the patient voice' in HTA?

HTAi aims to consider each timezone, and all sessions will be recorded for subsequent viewing.

Each webinar is approximately 60-minutes long.

Introduction to Patient Preferences in HTA Decision-Making
The first of four webinars to help HTAs better understand the role of patient preferences in HTA reviews.

This webinar will provide some basic understanding of what patient preferences are, how they can be used in HTAs, and provide participants with an opportunity to raise questions to be addressed in this or subsequent webinars.
Moderators:

Simon Fifer, Director of Research and Innovation, Community and Patient Preference Research (CaPPRe), Australia

Barry Liden, Patient Engagement, MedTech Industry Executive, Edwards Lifesciences; Advocate; Adjunct Faculty, Associate Professor at Georgetown University

Panelists:

Ann Single, PCIG Chair

John Rose, University of Technology Sydney

Deborah Marshall, Professor, Cumming School of Medicine, University of Calgary and PCIG

Patient Preferences Group member

Patient Preferences Group member

Date: June 29 2020, 06:00 MDT (UTC -6)
View the recording
Designing Patient Preference Studies for HTA- Moving from Aspiration to Application in Patient Engagement

Patient and patient advocacy engagement in HTA has evolved in recent years to include consideration of patient perspectives by expert committees making recommendations on coverage. As the role of evidence from routine clinical practice, patient reported outcomes and patient experiences grows, patient values and preference data provided by patients and patient advocacy groups provide opportunity for a better appreciation of the patient experience.
Panelists:

Deborah A Marshall (Moderator), Professor, Cumming School of Medicine, University of Calgary and PCIG Patient Preferences Group member

Barry Stein (Moderator), Patient Engagement, MedTech Industry Executive, Edwards Lifesciences; Advocate; Adjunct Faculty, Associate Professor at Georgetown University

Alexandra Chambers, Manager, National Oncology Policy, Novartis Oncology

Winson Cheung, Professor of Medicine, Department of Oncology, University of Calgary; Provincial Director, Health Services Research, Cancer Control Alberta.

Date: July 24, 2020, 06:00 MDT (UTC -6)
View the recording
Patient Preferences Research in HTA Decision-Making

Webinars One and Two have introduced how patient preferences research can be undertaken to inform questions of relevance to HTA. There has been recognition that this rigorous research can provide robust patient-based evidence that could inform HTA recommendations and decision-making. However, few HTA bodies are aware of the rigour of patient preference research or where it could inform the value judgments and help resolve the uncertainties that are inherent in HTA.

Webinar Three will involve presentations from three HTA bodies across the globe and a research organization, demonstrating how patient preferences have been used in actual HTAs for different forms of health technology. Panel discussion will explore where patient preference research can add the most value in HTA,

challenges to using this type of evidence to inform decision-making and what can be done to facilitate its use in HTA.
PANELISTS:

Karen Facey (Moderator), Evidence-Based Health Policy Consultant, University of Edinburgh, Scotland

Adrian Skelly (Moderator), Global Strategic Assistant to Head of Global Patient Access, Novartis Pharma, Switzerland

Simon Fifer, Director of Research and Innovation, Community and Patient Preference Research (CaPPRe), Australia

Irina Cleemput, Senior Health Economist, Belgian Health Care Knowledge Centre (KCE), Belgium

Jacoline Bouvy, Senior Scientific Advisor, National Institute for Health and Care Excellence (NICE), UK

Nancy Sikich, Clinical Epidemiologist, Health

DATE: September 28, 2020
TIME: 6:00 a.m. - 7:30 a.m. MDT
View the recording
Patient Preferences and Values Studies in Oncology and Rare Diseases- Redefining Patient Advocacy in the HTA

Webinars One, Two and Three have examined how patient preferences research can be undertaken to inform questions of relevance to HTA and presentations from three HTA bodies across the globe and a research organization have demonstrated how patient preferences have been used in actual HTAs for different forms of health technology.

The final webinar in the series will explore how patient preferences and values research can redefine patient advocacy and move it into an era of empirical evidence. It will look at the practicalities involved in conducting preference and values research, using specific examples from oncology and rare diseases.

There will also be a summary of learnings from all four webinars and a discussion around what action can be taken to encourage patient organizations to undertake more preferences research and for how HTAs can incorporate this research more readily into their decision-making.
PANELISTS:

Eric Low (Moderator), Director, Eric Lowe Consulting, Scotland

Barry Stein (Moderator), CEO, Colorectal Cancer Canada, Switzerland

Zack Pemberton-Whiteley, Leukaemia Care UK, England

Axel Muehlbacher, Professor of Health Economics & Healthcare Management, Hochschule Neubrandenburg, Germany

DATE: October 26, 2020, 7:00 a.m. - 8:30 a.m. MDT
View the recording

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Patient and Citizen Involvement - Health Technology Assessment International (HTAi)

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patient and citizen Involvement patient citizen involvement E-Bulletins 2023 January 2023 February 2023 March 2023 April 2023 May 2023 June 2023 July 2023 2022 January 2022 February 2022 March 2022 ... Patient and Citizen Involvement Read More "

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Difficulties in sorting genuine information from pool of citizen population 

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Difficulties in sorting genuine information from pool of citizen population 

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Challenge faced in using citizen engagement is during periods of health emergencies. These are not "allowed" by certain governments when the health emergency is at its peak. It seems these are suspended. There must be a better way forward during these periods.

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We at Health CASCADE or working to make the co-creation method/methodology trustworthy and based on evidence. You can access all our resources here: https://healthcascade.eu/resources/co-creation-tools/

Questions? danielle.agnello@gcu.ac.uk

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Canada, Montreal Model
Pomey Marie-Pascale et al.,« Le « Montreal model » : enjeux du partenariat relationnel entre patients et professionnels de la santé », Santé Publique, 2015/HS S1, p. 41-50.

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Citizens may come from differing disciplines and industries than researchers and so some understanding of terms differed (e.g., dissemination). This caused hurt feelings that required careful and intentional conversations to remedy.

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Stakeholder engagement is very important when developing community resources, like food safety in traditional markets for food.  Stakeholders included consumers, market vendors, market managers and local government officials, e.g. environmental health.

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Serbia - survey + interviews+ public meetings + consensus building

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Serbia - survey + interviews+ public meetings + consensus building

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Town hall meetings: Town hall meetings are a type of public meeting where citizens can ask questions of elected officials and other decision-makers. They are often used to discuss important issues and to get feedback from the public. We conducted this in some of the ethnic regions (south east Myanmar)

Citizen advisory boards: Citizen advisory boards are groups of citizens who are appointed to provide advice to decision-makers on specific issues. They can be a valuable way to get input from a diverse range of perspectives. We had some pilot projects where citizen advisory boards are formed in some township to funnel their voices in policy decision (not yet scaled up).

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International Association for Public Participation (iap2.org) is a great tool to determine what levels of engagement should be considered depending on the desired outcome

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Our mission is to promote and advance public participation / community engagement globally through targeted initiatives that are guided by culturally adaptive standards of practice and core values.

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Welcome to Cochrane Evidence Essentials

Cochrane Evidence Essentials is an introduction to Evidence Based Medicine, clinical trials and Cochrane evidence. It is designed for healthcare consumers (patients, care givers, family members), policy makers and members of the healthcare team

You will be guided through the modules by the personal learning journey of 'Eleni', a fictional consumer. The modules are presented in the form of a story, but you are free to skip this and explore the learning in any way you choose. The learning is interactive, with things to read, film and audio, quizzes, and ways to check your learning. There are links to further resources if you wish to continue learning about a particular topic.

This learning has been co-produced by healthcare consumers, researchers and specialists from Cochrane's Central Executive Team, with contributions from a range of experts in their fields.

Cochrane Evidence Essentials is free to use, with a Cochrane account ( free to sign up).

We're pleased to hear your thoughts. If you have any questions, comments or feedback about the content of this module, please contact us at support@cochrane.org.

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Cochrane Evidence Essentials is an introduction to Evidence Based Medicine, clinical trials and Cochrane evidence. It is designed for healthcare consumers (patients, care givers, family members), policy makers and members of the healthcare team You will be guided through the modules by the personal learning journey of 'Eleni', a fictional consumer.

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Those consenting to engage may be a different population then who needs to engage - e.g. if marginalized already much harder

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Ethics and other considerations related to working directly with participants under 18 years of age

Obtain and document parental consent

Separate calls needed with prospective participants to explain the project

All communication templates adapted for youth

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Challenge Selecting Methods for co-creation

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Challenge Selecting Methods for co-creation

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We found that there is little guidance on how to select and contextualize methods, so we created a tool to suport practitioners & researchers in this process. You can apply to take part in the prototyping and co-design process here - which grants you access to the full dataset: https://t.co/FXK4BS1g1e

danielle.agnello@gcu.ac.uk

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Introducing the Health CASCADE Prototype Co-Creation Methods Selector

Are you currently embarking on the design of a co-creation process? Do you find yourself facing challenges when it comes to selecting the most appropriate method? Look no further than the Health CASCADE's Co-Creation Methods Selector!

We are excited to announce this soft launch of our prototype version. We are inviting dedicated individuals or orgnaizations to apply for a chance to participate in testing its usability and content. As a valued member of our research community, we invite you to seize this opportunity by completing the form below. Upon submission, I will personally follow up with you to provide further details.

Kindly fill in the form to join our esteemed group of test users and help shape the future of co-creation methods selection and we will reach out to you.

Warm regards,

Danielle M. Agnello EU Marie-Curie PhD Fellow (ESR 3) | Health CASCADE School of Health and Life Sciences | Glasgow Caledonian University

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Testing the Prototype Co-Creation Methods Selector

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Introducing the Health CASCADE Prototype Co-Creation Methods Selector Are you currently embarking on the design of a co-creation process? Do you find yourself facing challenges when it comes to selecting the most appropriate method? Look no further than the Health CASCADE's Co-Creation Methods Selector! We are excited to announce this soft launch of our prototype version.

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While the consultation is invaluable, the expectations of participants must be manages so that they are not 'let down' when their time and contributions do not lead to immediate change or improvements for them individually

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Francis , able to collect all opinions of the citizens

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Francis , able to collect all opinions of the citizens

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Value depends on questions asked, the population sample, and the modesty of analysis.

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Lack of interest or engagement: Some citizens are not interested in participating in deliberative processes.

Difficulties in reaching marginalized groups: Some groups of citizens, such as those who are low-income or have disabilities, may be less likely to participate in deliberative processes.

Bias: Deliberative processes can be vulnerable to bias, either from the participants themselves or from the way the process is designed.

Time and resources: Deliberative processes can be time-consuming and resource-intensive, which can make it difficult to implement them.

zarnilynnkyaw@gmail.com

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In my point of view, the engagement of community / participation in policy making can be framed against a ladder of participation where information is the least, and active participation is the most appropriate. We found in a recent publication that community engagement is key in facilitating/designing interventions to improvent migrant access to SSR services https://gh.bmj.com/content/8/6/e011981.long

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Introduction Migrants' access to sexual and reproductive health (SRH) services is constrained by several individual, organisational and structural barriers. To address these barriers, many interventions have been developed and implemented worldwide to facilitate the access and utilisation of SRH services for migrant populations. The aim of this scoping review was to identify the characteristics and scope of interventions, their underlying theory of change, reported outcomes and key enablers and challenges to improve access to SRH services for migrants.

Methods A scoping review was conducted according to the Arksey and O'Malley (2005) guidelines. We searched three electronic databases (MEDLINE, Scopus and Google Scholar) and carried out additional searches using manual searching and citations tracking of empirical studies addressing interventions aimed at improving access and utilisation of SRH services for migrant populations published in Arabic, French or English between 4 September 1997 and 31 December 2022.

Results We screened a total of 4267 papers, and 47 papers met our inclusion criteria. We identified different forms of interventions: comprehensive (multiple individual, organisational and structural components) and focused interventions addressing specific individual attributes (knowledge, attitude, perceptions and behaviours). Comprehensive interventions also address structural and organisational barriers (ie, the ability to pay). The results suggest that coconstruction of interventions enables the building of contextual sensitive educational contents and improved communication and self-empowerment as well as self-efficacy of migrant populations, and thus improved access to SRH.

Conclusion More attention needs to be placed on participative approaches in developing interventions for migrants to improve access to SRH services.

WHAT IS ALREADY KNOWN ON THIS TOPIC

WHAT THIS STUDY ADDS

This review provides a taxonomy of interventions addressing different individual, organisational and structural barriers to access to SRH services care for migrant populations. This study highlights the characteristics of interventions, including outcomes, underlying theories of changes and implementation barriers and facilitators.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Specification of the review question

This scoping review aims to answer the following research questions: What is the range of interventions aimed at improving access and utilisation of SRH services by migrants? What are their characteristics (duration, participants, components and outcomes) and their reported effects, and how and under which conditions do they bring about the expected and/or unexpected outcomes? What are the enablers and challenges that facilitate or hinder their implementation and their sustainability?

Identification of relevant studies

Three electronic databases, MEDLINE via PubMed, Scopus and Google Scholar were searched for relevant studies. The eligibility criteria were as follows: empirical studies that report on interventions addressing migrants' access to SRH services published in Arabic, French or English between 4 September 1994 and 31 December 2022. The search strategy was devised using the PCC framework: 19 Population (migrants OR refugees OR asylum-seekers OR internally displaced people), Context (any country), Concept (health services accessibility AND SRH (see online supplemental file 1). We performed additional searches of the grey literature using snowball search and citation tracking and manual searches of institutional websites of health ministries and UN organisations promoting the health of migrants. Studies that reported broadly defined interventions with no description of the details (eg, participants activities) were not included in this review.

Study selection

The search strategy was designed and validated by ZB and performed by OB. The retrieved articles were imported into Mendeley Reference Manager and duplicates were removed. The quality assurance of the selection and extraction process was ensured by ZB.

Charting the data

We adopted the conceptual framework of Levesque et al as an initial framework for data extraction and coding themes. 20 The Levesque framework is a comprehensive multidimensional framework that addresses structural and organisational barriers (approachability; availability; acceptability; availability and accommodation; affordability and appropriateness) and individual factors (ability to perceive, seek, reach, pay and engage). These factors underlie access to healthcare (see online supplemental file 1). 20

To describe the general characteristics of interventions, we used a standardised extraction form adapted from the literature. 21 22 We continuously refined our extraction forms to inductively reflect on themes. The data extraction form included the following variables: author, year of publication, location of study, methods (study design, study population and settings), intervention characteristics (duration, aim, participants, programme components, educational resources, underlying theory of change, outcomes, barriers and facilitators) and the five accessibility and individual abilities dimensions.

Collating, summarising and reporting the results

Data analysis was carried out during research team meetings, and both a tabular and narrative summary of the study findings were provided. Summation and synthesis of results using thematic analysis were guided, but not restricted, by the initial Levesque framework. We were sensitive to emerging themes during the coding. Finally, we followed the reporting guidelines for scoping reviews set by Preferred Reporting Items for Systematic reviews and Meta-Analyses. 23

Consulting with experts and key stakeholders

To enhance and validate our findings, we shared our scoping review with various stakeholders (Ministry of Health and Social Protection (MHSP), Ministry of Foreign Affairs, NGOs, UNFPA and UM6SS) in a workshop organised on 17 October 2022. During this workshop, we received feedback on the relevance of intervention mapping and the contextual relevance of interventions to the context of Morocco. We also added additional grey literature following suggestions from participants. This scoping review informed the design of suitable interventions to be implemented by the MHSP in Morocco.

Search results

The database search yielded 3129 citations after removal of duplicates ( figure 1). In addition, 43 records were identified through grey literature searches. Title and abstract screening resulted in 129 references and two articles identified through manual searching. A total of 47 articles fit our inclusion criteria, of which 40 were peer-reviewed articles and seven were grey literature records. The list of excluded articles and the reasons for exclusion are presented in online supplemental file 1.

Most included studies used a quantitative study design to evaluate migrant interventions: quantitative surveys, 12 randomised controlled trials, 10 cluster-randomised studies, 1 postcontrol studies 4 and a cohort study. 4 Few studies were based on qualitative designs. 8 Only one study used a mixed-method design.

Intervention characteristics

Context of the interventions

Community and proximity places

The interventions were implemented mostly in social communities (n=20). Few were implemented in other settings (workplace (n=3) or healthcare facilities (n=4)). Some interventions comprised at least two different settings (communities and health facilities (n=4), communities and households (n=1), individuals (n=1) and multiple settings (n=2).

Reported outcomes

The majority of the included studies addressed both individual and institutional accessibility outcomes. Most interventions addressed the approachability and acceptability dimensions, and most outcomes were related to the abilities to perceive, engage and reach ( table 2).

Most reported outcomes can be summarised into individual, organisational and institutional level outcomes ( figure 2). The individual outcomes mainly included knowledge, attitudes, behaviours (KAB) and psychological outcomes. Few studies, however, addressed key psychological individual mechanisms such as self-empowerment, self-confidence and self-efficacy. 30 31

Knowledge-related outcomes included knowledge about SRH and HIV/AIDS as well as about healthcare services (eg, HIV testing sites and contraception provision services). 26 32 Behaviour-related outcomes included healthcare-seeking behaviour such as visits to healthcare facilities, getting tested for HIV and gynaecological check-ups and changes in risk behaviours (visiting brothels, multiple sexual partners) or protective behaviours (condom use). 26 28 32-34

The migrants' perception outcomes included benefit and risk perception related to HIV and protective behaviours (ie, condom use, respectively). 25 35 Some studies also measured intentions to engage in protective behaviour or share the acquired knowledge with peers or family members. 36 Only four studies measured SRH indicators such as the number of skilled births, the rate of unintended pregnancies and pregnancy complications. 37 38 At the organisational level, the scholars reported mostly programme uptake and acceptance of intervention, often used interchangeably 34 39 ( figure 2).

Taxonomy of the interventions

We can categorise interventions, according to the underlying mechanisms of change 40 into five categories of intervention: (1) educational interventions including social marketing campaigns and peer education, (2) participatory (coproduction and codesign of the intervention with recipients), (3) theory-driven interventions based on an explicit psychological or organisational theory of change), (4) implementation-oriented interventions focused on maximising outreach and screening) and (5) multifaceted or comprehensive interventions including various types mentioned above (see table 1 and online supplemental file 2 table 4).

Dissemination and educational interventions

A variety of educational tools were used across interventions such as pamphlets, leaflets, slides, posters, theatrical role play, 35 41 game shows, 35 health provider maps, 28 smartphone applications, 29 42 videos, SMS, hotlines, face-to-face counselling, 29 use of letters sent by migrants and friends and family members. 32 36 Educational sessions were often delivered in the native language of the migrants, using appropriate language and terminology. 30 43 Most scholars considered peer-led education as a key driver to increase SRH-related KAB. 25 29 30 32 35 36 39 43-45

Participatory interventions

Most of the interventions included various forms of participatory approaches during the design and/or implementation of the SRH interventions. Communities were involved in codevelopment of culturally appropriate materials, 43 the delivery of the training to peers, 25 26 codevelopment of educational and communication materials, 43 47 recruitment of participants, 44 resource mobilisation activities and the delivery of the intervention. The majority were oriented towards communities. Few were focused on individual access challenges (see online supplemental file 2, table 2 and figure 2). Codesign of interventions with migrants is considered to be an effective strategy in health promotion and education as well as for improving participation and adherence of migrants. 33

We also found that the authors used different perspectives when referring to community participation (see table 2 and figure 1 in online supplemental file 2). We used the Arnstein ladder of participation 48 to identify what form of participation the authors refer to. The ladder describes a continuum of participation based on the extent of citizen power in adapting the programme. The ladder includes non-participatory approaches rungs (manipulation, therapy) and tokenism rungs consisting of allowing citizens to express their opinions (informing, consultation or placation). The highest participation rungs correspond to increased degrees of citizen power (partnership, delegation of power and citizen control) (see figure 3; online supplemental file 2). 48 Our review showed that most included studies used placation (placing migrant representatives in committees) as the main form of participation. 25 30-32 35 37 39 41 44 49-53 Few studies genuinely engaged in actual partnerships with power delegation to migrant populations 34 38 46 54 (see table 2, online supplemental file 2).

Communities were involved during different phases, comprising during the intervention design, codevelopment of culturally sensitive educational material, peer-education sessions and during the delivery of support services during pregnancy and after childbirth. 30 38 43 44 47 Few interventions involved communities in the sustainability of migrant SRH interventions. 55

Co-design of the intervention with communities is essential in enhancing their acceptability and appropriate use of cocreated knowledge, and it enhances common understanding of interventions and effective communication with migrants. 34

The participatory interventions included the training of migrants and refugees in delivering prevention messages, performing physical examinations, HIV testing and counselling, pregnancy delivery and antenatal care. This also includes the training of community health workers as skilled-birth attendants (SBAs), who are qualified health workers who educate refugee mothers. 37 44 Ramos et al assert that trained female migrants, known as 'promotoras' (outreach coordinators), proved successful in delivering HIV prevention counselling, referral and testing and in expanding the programme reach by using the women's own social networks. 44

Implementation-oriented interventions

Implementation-oriented interventions focus on the delivery of SRH care and maximising the outreach migrant SSR interventions. This type of intervention includes, for instance, the training of lay health workers; outreach screening; health financing and coverage; supply of products, equipment and drugs and infrastructure improvement (see table 1).

Theory-informed interventions

Only five studies described an underlying behavioural theory of change that guided the development of the design of interventions 25 31 45 46 61 (see box 1 and table 3 online supplemental file 2). Kocken et al described a peer-led AIDS education campaign designed in line with the theoretical guidance of the Health Belief Model as defined by Janz and Becker and Rosenstock et al. 62 63 They addressed individual psychological mechanisms described in the Health Belief Model, including perceived threat (susceptibility and severity), perceived benefits and barriers, self-efficacy and cues to action, and the likelihood of preventive action. 25

Martijn et al described an intervention aimed at increasing condom use among immigrants based on the theory of planned behaviour, which is considered to be a suitable theory to guide interventions for minorities and to predict condom use. 45 The authors asserted that they designed the intervention to increase knowledge of HIV transmission and alter people's attitudes, social norms and perceived behavioural control towards condom use. The authors referred to seminal work by Ajzen, 64 and to similar applications in condom use prevention programmes. 65 66

Danhua et al asserted that they used the protection motivation theory, as defined by Rogers (1975), 67 involving a combination of appraisal of threat and coping processes, in an HIV-risk reduction intervention. 61 The authors combined protection motivation theory (self-efficacy, response cost and efficacy, intention, etc) with motivational interviewing and peer counselling (see online supplemental file 2, Table 3). 67 68

Other scholars used the transtheoretical behavioural stages of change (precontemplation, contemplation, preparation, action, maintenance, relapse and termination) to design social marketing campaigns for HIV/AIDS risk reduction. 46 For instance, Olshefsky et al designed an intervention to raise the awareness of migrants regarding their risk of HIV infection (precontemplation). They used social marketing campaigns to trigger learning and motivation (contemplation). This may have led to triggering of health-seeking behaviour (preparation, actions and process of changes). The authors specifically referred to Prochaska and DiClemente et al. 69 Sanchez et al 31 used social cognitive theory to design an intervention called 'Adapted-Stage Enhanced Motivational Interviewing'. 31 The intervention was coproduced with Latino migrants living in the USA. It aimed to address personal cognitive factors (awareness of the risk for HIV/AIDS) and promote HIV testing services in four local communities.

Multifaceted interventions

Finally, there were some interventions that integrated different types of interventions (individual, organisational and institutional level interventions). These include interventions that addressed both individual knowledge, skills and behaviours, as well as organisational (eg, training health workers) and institutional barriers (eg, financial accessibility) 53 57 59 70 71 (see table 1 and online supplemental file 2, Table 4).

Only a few studies reported utilisation outcomes. 38 46 54 Miller et al reported increased antenatal care visits by migrant women following training of SBAs compared with untrained birth attendants. 38 In another study by Fernández-Balbuena et al, setting up free-of-charge testing and counselling for HIV in non-conventional settings resulted in higher attendance of vulnerable groups such as migrants and sex workers. 54 In another study, Olshefsky et al reported increased HIV testing at partner clinics following a social marketing campaign. 46

Causal loop diagramming of the behavioural theory of change

To further develop our understanding of the complex intertwined relationship between intervention components and their outcomes, and to make sense of the underlying behavioural theories of changes reported by the authors, we used the causal loop diagram (CLD) methodology. 83 In particular, we focused on individual psychological mechanisms and community empowerment as key mechanisms for increasing programme outreach and behaviour change related to SRH ( figure 3).

This CLD describes the feedback processes and interactions between multiple short-term and medium-term outcomes of the intervention in the included studies. Community empowerment emerged as an essential driver of community engagement. Engaged communities develop a sense of ownership, which in turn increases collective empowerment and their willingness to engage collectively in SRH interventions.

Our scoping review also shows that peer support and education enhance migrant self-efficacy, thereby increasing the likelihood of adopting safe SRH practices and changing risk behaviour through positive changes in the self-confidence, self-efficacy, and self-worth of migrants.

Maintaining confidentiality and discretion are essential contextual factors that trigger the effectiveness of peer education and enhance its acceptability by migrants and particularly among stigmatised minority subgroups (eg, HIV-positive individuals and sex workers).

Our review shows also that stigma negatively impacted the perceived value of peer education, thereby decreasing its acceptability. Peer pressure has also been identified as an important mechanism of behaviour change. Peer-led education often increases knowledge sharing and dissemination with peers, family members and the community, which in turn increases peer pressure to adopt safe SRH practices. This is particularly the case for high-risk subgroups such as sex workers and for seasonal male migrant workers who often develop intentions to engage in healthy practices on receiving advice and information from their spouses. In workplace settings, interventions targeting migrant workers can interfere with working hours, which leads to a loss of productivity as perceived by employers. This in turn leads to less employer support, which ultimately leads to decreased programme participation. These complex intertwined relationships are depicted in figure 3. Reinforcing feedback loops are effects that vary in a similar manner. Balancing feedback loops are interactions that counterbalance each other.

Sustainability and follow-up

Only one study had follow-up longer than 2 years. Thus, it is unclear whether any short-term benefits of most other interventions would have been sustained. In addition, cost-effectiveness analyses were rarely reported.

Strengths and limitations

Our review also has specific strengths and limitations. Most interventions measured changes in knowledge, attitudes and intended behaviours rather than measuring actual behaviours 84 (intention to action gaps). Few studies reported utilisation outcomes. 84 As described by Arksey and O'Malley, 17 we attempted to provide a broad overview of interventions addressing migrants' access to SRH services. However, we do not claim to be comprehensive as we needed to achieve a balance between the feasibility and comprehensiveness of the review. Our included studies were exclusively written in English or French. We may also have missed relevant data published in other languages, particularly in countries with large numbers of migrants (eg, Spain and Portugal). In this review, we did not assess the quality of the included evidence, as the aim was to describe the range and scope of migrant interventions and their mechanisms of change. We did, however, assess the likelihood of conflicts of interest in the included studies, as this is often associated with overestimates of outcomes in the healthcare 85-87 and social sciences. 88 With the exception of Rosenberg and Bakomeza, 39 who reported that SRH interventions were assessed by an external evaluator, most studies involved evaluators that either belong to or have been involved in a research unit funded by the implementing organisation (see table 1, online supplemental file 2). Although there is no consensus in regard to measuring conflict of interest, caution is required when interpreting the reported outcomes. 88

Another limitation of our scoping review is that only two studies reported the role of the legal status of migrants in hampering their access to health insurance 59 60 and SRH services. 59 60 Future studies will need to assess the effectiveness of SRH interventions in different subgroups of migrant populations.

Quantitative designs and RCTs were the most used study designs. Therefore, more qualitative, theory-driven evaluations, 89 multiple embedded case studies 90 and qualitative evidence synthesis are needed. These designs are better suited for unravelling the contextual barriers and facilitators, the mechanisms of change, as well as the structural and underlying power dynamics that enable or hinder the functioning of interventions.

Patient consent for publication

Not required.

Ethics approval

Not required.

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Interventions to improve migrants' access to sexual and reproductive health services: a scoping review

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Introduction Migrants' access to sexual and reproductive health (SRH) services is constrained by several individual, organisational and structural barriers. To address these barriers, many interventions have been developed and implemented worldwide to facilitate the access and utilisation of SRH services for migrant populations.

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Some sections of society are more adept of using the tools/ methods. However, the more marginalised sectors of the citizenry would have difficulty accessing the language and technology of the tools/ methods

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Ability to survey and get different evidences before sorting positive and none genuine evidences from different groups of citizenry.

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Ability to survey and get different evidences before sorting positive and none genuine evidences from different groups of citizenry.

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Unable to meet in person due to wide geography and limited budget, so doing it over Zoom. Inequitable access to data and technology has made it really challenging to use addons or other tools, so we're mostly limited to conversation via voice and Zoom chat, polls.

Recruiting participants was a challenge, even though we pay a fair wage. Tried to recruit a diverse group of people with various barriers to health equity but still avoiding a sense of "tokenism" or representing a community/population. This again has involved a lot of time for trust-building.

Next challenge will be training the research partners to engage in meaningful ways with the group.

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Myanmar - Strategies to overcome challenges.

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Myanmar - Strategies to overcome challenges.

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Making the process accessible and inclusive: This can be done by providing translation services, making the process available online, and tailoring the process to the needs of specific groups like ethnic groups.

Building trust and rapport: This can be done by involving citizens in the design of the process, being transparent about the goals of the process, and respecting the views of all participants.

Using a variety of tools and methods: This can help to reach a wider range of citizens and to engage them in a way that is meaningful to them.

Building capacity: This can be done by providing training and support to participants and facilitators.

zarnilynnkyaw@gmail.com

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engagement takes time, you need to build it into project plans from the start and plan for more time then you think so you don't have to rush and can avoid tokenistic engagement

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first modify the public policy for the fight against zoonoses, ETA's and RAM, after actions. patricia.nogales@yahoo.com BOLIVIA

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first modify the public policy for the fight against zoonoses, ETA's and RAM, after actions. patricia.nogales@yahoo.com BOLIVIA

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Community engagement in Benenfit package in Colombia

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Community engagement in Benenfit package in Colombia

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Colombia, community engagement in the inclusion of technologies in the benefits plan allows greater legitimacy of decisions and accountability

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Serbia, overcoming biases: round table discussions, triangulation, more sources

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Serbia, overcoming biases: round table discussions, triangulation, more sources

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We created an online forum for better collaboration. zarnilynnkyaw@gmail.com

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The Community of Practice - Myanmar is a forum for health and humanitarian practitioners focused on Myanmar (Burma) to share knowledge, practice and experience, and support improved decision-making for and implementation of health and humanitarian initiatives.

The forum is accessible to verified users on application. To apply to join, please sign up in the forum:

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The Community of Practice - Myanmar is a forum for health and humanitarian practitioners focused on Myanmar (Burma) to share knowledge, practice and experience, and support improved decision-making...

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Comprehensive and utilization of the tools is a huge challenge, especially among the people who are extremely at the lower side of the demographic here in Africa

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Comprehensive and utilization of the tools is a huge challenge, especially among the people who are extremely at the lower side of the demographic here in Africa

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Engaging stakeholders with evidence and uncertainty

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Engaging stakeholders with evidence and uncertainty

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Also the tool to address some of the challenges in engagement - as Laura mentioned about uncertainty

https://cedilprogramme.org/publications/cedil-methods-working-paper-4/

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CEDIL-Centre of Excellence for Development Impact and Learning

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Sandy Oliver, Laurenz Langer, Promise Nduku, Hayley Umayam, Kate Conroy, Charlotte Maugham, Tamsin Bradley, Mukdarut Bangpan, Dylan Kneale, Chris Roche
Approaches for engaging stakeholders with policy decisions or research tend to favour either generalisable evidence from research or context-specific evidence, including local data and tacit knowledge.

Some international development and humanitarian organisations are leading the way with practice and guidance for combining generalisable and context-specific evidence for local action around the world. Some local non-governmental organisations who base their learning on local evidence alone acknowledge their lack of attention to generalisable evidence as a shortcoming. Listening to both groups has resulted in a publicly available toolkit for bringing together generalisable evidence and local knowledge.

CEDIL's Methods Working Paper 4, ' , offers a new framework that helps choose appropriate stakeholder engagement methods while conducting research and supporting decision-making. The framework provides the foundation for a Engaging Stakeholders with Evidence and Uncertainty: Developing a Toolkit'toolkit that distinguishes major differences in stakeholder engagement, illustrates pathways for choosing appropriate methods for stakeholder engagement, signposts evidence and practical tools to support stakeholder engagement, and guidance for identifying and understanding stakeholders and their relationships.

Suggested citation: Oliver, S., Langer, L., Nduku, P., Umayam, H., Conroy, K., Maugham, C., Bradley, T., Bangpan, M., Kneale, D., Roche, C. (2021) 'Engaging Stakeholders with Evidence and Uncertainty: Developing a toolkit' CEDIL Methods Working Paper 4. Centre of Excellence for Development Impact and Learning (CEDIL), London and Oxford. Available at: https://doi.org/10.51744/CMWP4
Download CEDIL Methods Working Paper 4 Download CEDIL Methods Brief based on this paper View toolkit

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Engaging stakeholders with evidence and uncertainty: developing a toolkit | CEDIL-Centre of Excellence for Development Impact and Learning

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This working paper offers a new framework that helps choose appropriate stakeholder engagement methods while conducting research and supporting decision-making.

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Lack of awareness about the benefit of innovation for businesses and quality of life in territories.

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We always included 'lay' participants in our R+D and research ethics meetings, in the UK NHS. This ensured that a more 'feet on the ground' opinion was aired. Carers and relatives were also consulted in protocol development

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Canada has had several...failed...efforts at building int citizen engagement nationally to inform public policy...including Canadian Policy Research Network (CPRN) and Health Council of Canada. Both were sacrificed at the alter of political expediency. What can be done to insulate such accountability mechanisms from the vagaries of politics...legislative protections? Third party ...philanthropic funding? What's worked elsewhere?

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es importante tener presente que no existe equidad, aún no se puede acceder a un seguro de salud que evite el gasto de bolsillo de los ciudadanos de menores recursos

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we co-create with citizen adapted diagnostic frameworks to facilitate the dissemination of technologies and non-technological innovations.

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Dr. José Garay. Universidad de San Martin de Porres. Integrated communitarian participation, a strategy that I performed almost 20 years ago and that was very useful to put the community and maternal services working together to reduce the maternal mortality ratio by a best negociation of conditions for a more safe and cultural-adapted delivery.

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Dr. José Garay. Universidad de San Martin de Porres. Integrated communitarian participation, a strategy that I performed almost 20 years ago and that was very useful to put the community and maternal services working together to reduce the maternal mortality ratio by a best negociation of conditions for a more safe and cultural-adapted delivery.

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Is there a risk that all that works is not reflected as only those who have an issue or challenge agree to contribute - the good is taken for granted

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Serbia, time constraint: step-by-step approach 

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Serbia, time constraint: step-by-step approach 

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Deben ser escuchadas y respetadas en sus usos y costumbres respecto a sus propias evidencias que sean malician en políticas de salud

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We also use this kind of forum to CSO groups via CSO forum. zarnilynnkyaw@gmail.com

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When working in African countries our researchers liaised with community leaders such as Chiefs. It is important to ensure all participants provide individual, informed consent to participate and were not under undue pressure to do so by community leaders.

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Nous avons d’abord créé un mouvement citoyen dénommé COMVID COVID19 regroupant une diversité de population. Ensuite crée des cellules citoyennes de veille (CCVS) dans chaque quartier/secteur. Ces acteurs ont été formés sur la COVID19 ( symptômes, mode de transmission, mesures de protection). Ces acteurs ont été formés par les autorités sanitaires et La Croix rouge. Ils ont principalement mené des activités de sensibilisation et d’identification des cas. Ce qui a favorisé la mise en œuvre des activités était l’implication des autorités sanitaires, politiques, religieuses et les populations. Les acteurs du mouvement travaillaient comme des bénévoles ce qui fini par les démotiver

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ISSaQ 4.0 tool. Currently used by a research team and filled by citizens to evaluate the scalability of health innovations. Translation in English available soon. Link: https://ssaquebec.ca/nouvelles/issaq-4-0-un-questionnaire-auto-administre-sur-le-potentiel-de-mise-a-lechelle-des-innovations-en-sante-et-en-services-sociaux/

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Le présent outil est le résultat du projet " Développement d'un outil d'évaluation du potentiel de mise à l'échelle des innovations en soins de santé communautaires de première ligne (outil validé par un Delphi) ", financé par l'Unité de Soutien SSA Québec dans le cadre des projets de transition 2021-2022. Le projet a été mené en collaboration avec la Chaire de recherche du Canada sur la décision partagée et l'application des connaissances, de l'Université Laval, et a reçu le soutien du Centre de recherche en santé durable - VITAM.

ISSaQ 4.0 : un outil basé sur les données probantes

L'outil ISSaQ 4.0 permet aux équipes des innovations en santé et en services sociaux d'évaluer le potentiel de mise à l'échelle de leurs innovations. Il s'agit d'un questionnaire auto-administré contenant 37 énoncés distribués en 12 composantes du potentiel de mise à l'échelle.

En utilisant cet outil, les innovatrices et innovateurs seront en mesure de prendre une décision éclairée sur la poursuite de la mise à l'échelle. En outre, l'outil leur permettra de visualiser les points faibles de leurs projets et de les améliorer pour une mise à l'échelle réussie. La fiabilité de l'outil est fondée sur son processus de construction rigoureux, systématique et basé sur des données probantes.

Un outil qui encourage l'engagement patient et citoyen

ISSaQ a été construit dans l'approche de l'application des connaissances intégrée et a reçu des contributions des patienr(e)s et citoyen(ne)s partenaires dans toutes les étapes de sa construction. Ainsi, l'outil encourage l'engagement des patientes et patients et des citoyens et citoyennes à la mise à l'échelle. Toutefois, cet engagement nécessitera des efforts de la part des équipes d'innovation pour mener des discussions dans un langage accessible et pour bien cerner les compétences des patient(e)s et des citoyen(ne)s qui peuvent contribuer à l'évaluation du potentiel de mise à l'échelle de son innovation.

L'outil ISSaQ a été conçu pour être utilisé pour toute personne ou organisation qui œuvre en santé dans les domaines de la recherche, des soins ou des services sociaux avec et pour les patientes et patients.

Compte tenu de la complexité du processus de mise à l'échelle et de la spécificité de certains énoncés, nous recommandons que l'outil soit utilisé avec la participation de l'ensemble de l'équipe d'innovation.

Cette équipe, à son tour, doit établir des collaborations avec toutes les parties prenantes de la mise à l'échelle, c'est-à-dire les personnes représentantes des utilisateurs et utilisatrices, des bénéficiaires, des organisations qui œuvre en santé dans les domaines de la recherche, des soins ou des services sociaux, des organismes subventionnaires et des décisionnaires qui doivent contribuer à partir de leurs perspectives au développement de la mise à l'échelle de l'innovation.

Ainsi, l'organisation des données et des informations, ainsi que les réflexions, peuvent être partagées entre les membres du groupe, en fonction de leur expérience et de leurs possibilités.

Vous pouvez utiliser ISSaQ lors des différentes étapes de la mise à l'échelle de l'innovation:

Avant l'implantation de l'innovation pilote

Avant la mise à l'échelle de l'innovation

Pendant ou après la mise à échelle de l'innovation

Glossaire de l'outil ISSaQ

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ISSaQ 4.0: un questionnaire auto-administré sur le potentiel de mise à l'échelle des innovations en santé et en services sociaux | Unité soutien SSA Québec

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ISSaQ 4.0 permet aux équipes d'évaluer le potentiel de mise à l'échelle de leurs innovations. Il s'agit d'un questionnaire auto-administré.

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Dr. José Garay. Universidad de San Martin de Porres. I think there are two challenges for these tools/methods:

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Dr. José Garay. Universidad de San Martin de Porres. I think there are two challenges for these tools/methods:

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1) Do believe in the potential of the action research based on strategics models performed by multidisciplinary teams to demonstrate that the tools/methods works, works.
2) Convince financists that the investment in research about communitarian strategies, considered into models of health systems research, is the most cost-effective decision.