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  • 文章类型: Journal Article
    促进赋权和参与是有意义的发展进程中的关键因素;然而,以行动为导向的研究人员在传统的供资周期和研究时间表内促进真正的赋权和有意义的参与方面面临挑战。此案例研究说明了研究人员与一个洪都拉斯非政府组织(NGO)合作采用的参与式方法,对洪都拉斯农村青年进行“实际”参与式评估。通过合作的自动仪器,确定并描述了该方法的两个组成部分。第一个组成部分-“基本要素”-包括非政府组织的变革性参与文化和组织对研究伙伴的内部/外部身份的协同作用的关注。第二个组成部分包括研究小组利用这一基础对农村青年进行参与性评估的能力。重要的是,这种能力是长期扎根和塑造的,研究伙伴之间基于信任的关系。这些关系是这个参与式倡议成功的催化剂,将确定的“基本要素”与经历的合作成果联系起来。总的来说,本案例研究有助于当前和正在进行的关于如何促进研究和评估背景下有意义的参与和能力扩展的学术讨论。
    Empowerment and participation are promoted as critical factors in meaningful development processes; however, action-oriented researchers face challenges in fostering genuine empowerment and meaningful participation within traditional funding cycles and research timelines. This case study illustrates a participatory methodology employed by researchers in partnership with one Honduran non-governmental organization (NGO) to conduct \'practical\' participatory evaluation with rural Honduran youth. Through collaborative autoethnography, two components of this methodology are identified and described. The first component - \'foundational elements\'- includes the NGO\'s culture of transformative participation and the organization\'s attention to synergies in the insider/outsider identities of research partners. The second component includes the ability of the research team to leverage this foundation for the participatory evaluation with rural youth. Importantly, this ability was grounded in and shaped by long-term, trust-based relationships between research partners. These relationships were the catalyst for success in this participatory initiative, connecting the \'foundational elements\' identified to the collaborative outcomes experienced. Overall, this case study contributes to current and ongoing scholarly discussions on how to facilitate meaningful participation and capability expansion in research and evaluation contexts.
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  • 文章类型: Journal Article
    系统思维已被认为对公共卫生政策有价值,研究和实践。评论员和评论强调,要发挥其潜力,还有许多工作要做。这里,我们强调了很多关于系统思考的论述,而对于,公共卫生支持对狭窄道路的追求,并且在所接受的系统谱系方面受到限制。我们邀请读者看到系统思维在追求更广阔道路方面的潜力,这种道路的动机是出于对减轻健康不平等的关注。这不会取代狭窄的路径,而是包含它。它引起了对转换性质的不同考虑,合作和合法性。它还邀请了一种不同的方式来参与系统思维,以及不同的概念化和管理变革的方式。宽阔的道路既需要,并有助于增强,新的做事方式,relevant,组织,了解和构建对未来公共卫生至关重要的全球关注。
    Systems thinking has been recognized as valuable to public health policy, research and practice. Commentators and reviews have highlighted that there is still much to be done to embrace its potential. Here, we highlight that much of the discourse about systems thinking in, and for, public health supports the pursuit of a narrow path and is limited with respect to the lineages of Systems that are embraced. We invite readers to see the potential of systems thinking in pursuing a broader path which is motivated by a concern for alleviating health inequalities. This does not replace the narrow path but encompasses it. It prompts different considerations with respect to the nature of the transformation, partnership working and legitimacy. It also invites a different way of engaging with systems thinking and different ways of conceptualizing and managing change. The broad path both requires, and helps enhance, new ways of doing, relating, organizing, knowing and framing which are vital for the future of public health as a global concern.
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  • 文章类型: Journal Article
    背景:2014年,英国国家卫生服务局(NHS)发布了五年前进计划1,设想将权力从卫生专业人员转移到患者和公众。作为回应,放射技师学会(SCoR)制作了“病人,影像和放射疗法中的公共和从业者伙伴关系:指导原则”(P4)文件,该文件在放射摄影实践的四个领域内实施;服务提供,服务发展,教育与研究2。该项目探讨了如何实施这些准则;以及是否需要改进质量和范围,导致提出更新文件的建议。
    方法:采用两个阶段的混合方法设计。第1阶段-探索使用P4文件指导原则的调查。没有最大数量的参与者来确保包容性。阶段2-一个焦点小组和四个领域的四个一对一访谈3。
    结果:626名参与者完成了第一阶段调查。18.85%(n=118)的参与者知道该文件,并将其用作实践参考工具,教学,和研究。81.15%(n=508)的参与者表示他们不知道该文件。第二阶段的主题;服务用户参与服务交付和评估的重要性,确保服务用户参与的资源,关于更新P4文件和使用P4文件在放射技师教育中的建议。与会者承认文件中的指导是最佳做法。他们报告了对患者需求的更多认识,以及这对放射技师支持他们需求的影响。
    结论:与会者建议提高文件的知名度。必须在射线照相实践中听到患者和公众的声音。
    结论:本研究的反馈可用于P4文件的未来发展。
    BACKGROUND: In 2014 the National Health Service (NHS) in England released the Five Year Forward plan1, envisioning a shift in power from health professionals to patients and the public. In response the Society and College of Radiographers (SCoR) produced the \"Patient, Public and Practitioner Partnership within Imaging and Radiotherapy: Guiding Principles\" (P4) document which was implemented within four domains of radiography practice; service delivery, service development, education and research2. This project explored how these guidelines were implemented; and whether improvement to the quality and scope were needed, leading to making recommendations for updating the document.
    METHODS: A mixed methods design was adopted with two phases. Phase 1 - a survey exploring use of the P4 document\'s guiding principles. There was no maximum number of participants to ensure inclusivity. Phase 2 - one focus group and four one-to-one interviews from the four domains3.
    RESULTS: 626 participants completed the phase 1 survey. 18.85% (n=118) of participants were aware of the document and used it as a reference tool for practice, teaching, and research. 81.15% (n=508) of participants stated they were unaware of the document. Themes from phase 2; importance of service user involvement in service delivery and evaluation, resources to ensure service user involvement, suggestions to update the P4 document and use of the P4 document in radiographer education. Participants acknowledged guidance in the document was best practice. They reported more awareness of patients\' needs and the effect this has on radiographers in supporting their needs.
    CONCLUSIONS: Participants recommended the document be given greater visibility. The voices of patients and the public must be heard within radiography practice.
    CONCLUSIONS: Feedback from this study can be used for the future development of the P4 document.
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  • 文章类型: Journal Article
    背景:越来越多的证据表明,酒精行业试图阻碍可能影响未来酒精销售的公共卫生政策。并行,酒精行业资助从事“负责任饮酒”运动的组织。越来越多的证据表明,此类广告系列的内容和交付服务于行业,而不是公共卫生利益,然而,这些组织仍然是与政府卫生部门合作的对象。这项研究旨在通过分析酒精行业资助的慈善机构Drinkaware在建立“无酒日”运动期间的做法,来研究这种伙伴关系的性质和潜在影响。
    方法:基于对Drinkaware之间的信息自由(FoI)请求所揭示的文档进行归纳分析的案例研究,英国公共卫生(PHE),波特曼集团,在过去的几年里,在这期间,免费饮料日运动,酒精行业资助的慈善机构Drinkware之间的合作,还有PHE.
    结果:这项研究揭示了一系列不太明显的,这种伙伴关系对政府部门和民间社会的系统级影响。观察到的紧张局势,内部和外部通信之间的差异所表现出的,强调管理和减轻负面后果的感知,以及与更广泛的酒精行业倡议和机构的联系,建议需要更广泛地考虑组织利益冲突,以及可能的间接,对决策的有害后果。这些包括其他民间社会声音的边缘化,取代更有效的政策选择,以及与其他行业游说活动的战略协调。
    结论:这些发现对公共卫生从业人员和卫生机构如何在健康促进运动的背景下更好地权衡潜在的伙伴关系权衡具有启示意义。
    BACKGROUND: There is growing evidence that the alcohol industry seeks to obstruct public health policies that might affect future alcohol sales. In parallel, the alcohol industry funds organisations that engage in \"responsible drinking\" campaigns. Evidence is growing that the content and delivery of such campaigns serves industry, rather than public health interests, yet these organizations continue to be the subject of partnerships with government health departments. This study aimed to examine the nature and potential impacts of such partnerships by analysing the practices of the alcohol industry-funded charity Drinkaware during the establishment of the Drink Free Days campaign.
    METHODS: A case study based on an inductive analysis of documents revealed by freedom of information (FoI) request regarding communications between Drinkaware, Public Health England (PHE), and the Portman Group, in the years running up to, and during, the Drink Free Days campaign, a partnership between alcohol industry-funded charity Drinkware, and PHE.
    RESULTS: This study reveals a range of less visible, system-level effects of such partnerships for government departments and civil society. The tensions observed, as exhibited by discrepancies between internal and external communications, the emphasis on managing and mitigating the perception of negative consequences, and the links to wider alcohol industry initiatives and bodies, suggest the need for wider considerations of organizational conflicts of interest, and of possible indirect, harmful consequences to policy-making. These include the marginalization of other civil society voices, the displacing of more effective policy options, and strategic alignment with other industry lobbying activities.
    CONCLUSIONS: The findings have implications for how public health practitioners and health organisations might better weigh the potential trade-offs of partnership in the context of health promotion campaigns.
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  • 文章类型: Journal Article
    在英国,使用过的残疾设备的盈余造成了浪费,而在低收入和中等收入国家(LMICs),缺乏获得残疾设备的机会是需要解决的两个问题。为了解决这些问题,英国慈善机构翻新并将使用过的残疾设备重新分配给LMIC。迄今为止,关于LMICs如何从英国组织获得多余的残疾设备的数据很少。这项研究旨在整理和绘制设备从英国翻新和重新分配给LMIC的过程,并确定影响伙伴关系发展和可持续性的因素。采用探索性定性案例研究设计。在2022年1月至2月之间,对来自发件人(英国)和收件人(罗马尼亚)组织的参与者进行了九次半结构化访谈,并在必要时进行实时翻译。使用了智能逐字转录,并使用潜在主题分析对数据进行分析。收集的过程,从英国到LMIC组织的残疾设备的翻新和重新分配被映射。从访谈中确定了三个关键主题:(1)发展需要;(2)服务发展需要适当的工作关系;(3)流程整合和未来。坚强,组织之间诚实和透明的关系被认为是该倡议成功的基础。提高服务提供标准以满足LMIC组织的特定需求,支持开发合适的设备处方。发展类似的伙伴关系有可能减少不平等差距和浪费。需要全球合作和规划,以应对低收入国家获得残疾设备的挑战。
    多余残疾设备的翻新和再分配已经出现,并将继续发展,以应对低收入和中等收入国家(LMIC)对设备供应的迫切需求。以及减少英国国内设备的剩余浪费。发展强者,诚实,组织之间透明和持续的关系被认为是该倡议成功的基础,特别是提高服务提供标准,以满足LMIC组织的特定需求,为服务用户开发合适的设备处方。发展类似的伙伴关系有可能减少不平等差距和浪费。需要全球合作和规划,以应对低收入国家获得残疾设备的挑战。
    The surplus of used disability equipment contributing to waste in the UK and the lack of access to disability equipment in low- and middle-income countries (LMICs) are two issues in need of solution. To address such problems, UK charities refurbish and redistribute used disability equipment to LMICs. To date, there is a scarcity of data on how LMICs could access surplus disability equipment from UK organisations. This study aimed to collate and map out the process by which equipment is refurbished and redistributed from the UK to LMIC\'s and identify factors which influence the development and sustainability of the partnership. An explorative qualitative case study design was used. Nine semi-structured interviews were conducted with participants from sender (UK) and a receiver (Romania) organisation between January-February 2022, with real-time translation where necessary. Intelligent verbatim transcription was used, and data was analysed using latent thematic analysis. The process of collection, refurbishment and redistribution of disability equipment from the UK to a LMIC organisation was mapped. Three key themes were identified from the interviews: (1) Development out of need; (2) Service development requires an adequate working relationship; (3) Process consolidation and future. Strong, honest and transparent relationships between organisations was identified as underpinning the success of the initiative. Raising service provision standards to meet specific needs of LMIC organisations supports development of suitable equipment prescription. Development of similar partnerships has potential of reducing the inequity gap and waste. Global collaboration and planning are required to address challenges of access to disability equipment in LMICs.
    Refurbishment and redistribution of surplus disability equipment has emerged and continues to be developed as a response to a critical need for equipment provision in low- and middle-income countries (LMICs), as well as to reduce surplus waste of equipment within the UK.The development of strong, honest, transparent and continued relationships between organisations was identified as underpinning the success of the initiative, in particular raising service provision standards to meet specific needs of LMIC organisations to develop suitable equipment prescription for service users.Development of similar partnerships has the potential of reducing the inequity gap and waste. Global collaboration and planning are required to address challenges of access to disability equipment in LMICs.
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  • 文章类型: Journal Article
    国际合作在护理信息学研究领域至关重要,以增强我们进行全球相关研究的能力,从而为政策和实践提供信息。在本案例研究中,我们描述了我们如何建立国际研究合作,以评估护士在大流行期间使用技术的经验。我们首先描述合作是如何创建的,以及与我们的工作相关的成功,在强调主持人进行国际合作之前。我们还讨论了我们在这个合作企业中遇到的挑战,使其他希望建立国际合作并从我们的经验中学习的研究人员。
    International collaboration is crucial in the field of nursing informatics research to enhance our ability to conduct globally relevant research that informs policy and practice. In this case study we describe how we have established an international research collaboration to evaluate nurses\' experiences of technology use during the pandemic. We firstly describe how the collaboration was created and the successes associated with our work, before highlighting the facilitators to make an international collaboration work. We also discuss the challenges we have encountered during this collaborative enterprise, to enable other researchers who wish to establish international collaborations and learn from our experiences.
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  • 文章类型: Letter
    背景:在整个研究过程中与消费者和社区的参与和伙伴关系产生了满足社区需求的高质量研究,并促进了研究转化为改进的政策和实践。伙伴关系对于涉及原住民和/或托雷斯海峡岛民(原住民)的研究至关重要,以确保文化安全。我们从设计中吸取教训,国家卫生和医学研究委员会资助的实施和进展为FERRitin水平较高的澳大利亚原住民患者进行血液透析(INFERR)临床试验。
    方法:该试验旨在了解澳大利亚原住民在贫血和高铁蛋白血症的血液透析中使用铁疗法的益处和危害。与潜在参与者的患者讨论了缺乏治疗证据。确保INFERR试验安全进行的关键要素是建立土著参考小组(IRG),该小组由位于澳大利亚高端和澳大利亚中部的透析患者组成。根据原住民社区和研究人员/学者对该项目有关当地文化差异和试验方法的建议,需要两个IRG。IRGs通过为研究材料提供投入并将研究结果转化为原住民透析患者的有效信息和政策,从而为文化安全的试验行为提供支持。在整个审判过程中,IRGs的作用已经发展到为本研究和更广泛的研究行为提供建议和指导的关键机制。由试验第一民族研究官员和简化研究概念的独立第一民族研究人员/学者向IRG提供的支持至关重要。IRG已经为参与者制定了反馈文件和流程,利益相关者,和肾脏单位。他们保证将试验结果纳入临床实践指南的文化安全建议,以确保基于证据的方法来管理高铁蛋白血症的血液透析患者的贫血。
    结论:积极的消费者和社区伙伴关系对于确保研究影响的研究行为至关重要。在INFERR临床试验中与消费者的牢固合作表明,原住民消费者将参与他们了解的研究,解决了他们的健康优先事项以及他们感到受到尊重的地方,听,并有权实现变革。
    在本文中,我们强调让消费者积极参与规划的重要性,在患有肾脏疾病且目前正在接受血液透析的原住民和/或托雷斯海峡澳大利亚人(澳大利亚原住民)中进行临床试验的实施和进行研究。该研究评估了透析患者在贫血和高水平血液检测铁蛋白时,在透析期间通过静脉接受铁的安全性和有效性。常规用于测量铁水平的测试。两个第一民族患者透析的消费者参考组,一个位于澳大利亚的顶端,另一个位于澳大利亚中部,得到第一民族研究官员和研究学者的支持,以确保研究以涉及的方式进行,尊重和重视第一民族的参与,文化,和知识。在这项研究中,积极的消费者和社区合作伙伴关系支持了强大的研究治理流程,我们认为这些流程对于知识转化对患者产生积极影响至关重要。
    BACKGROUND: Engagement and partnership with consumers and communities throughout research processes produces high quality research meeting community needs and promoting translation of research into improved policy and practice. Partnership is critical in research involving Aboriginal and/or Torres Strait Islander people (First Nations Peoples) to ensure cultural safety. We present lessons from the design, implementation and progress of the National Health and Medical Research Council funded INtravenous iron polymaltose for First Nations Australian patients with high FERRitin levels on hemodialysis (INFERR) clinical trial.
    METHODS: The trial was designed to understand the benefits and harms of iron therapy in First Nations Australians on haemodialysis with anaemia and hyperferritinaemia. The lack of evidence for treatment was discussed with patients who were potential participants. A key element ensuring safe conduct of the INFERR trial was the establishment of the Indigenous Reference Groups (IRGs) comprising of dialysis patients based in the Top End of Australia and Central Australia. Two IRGs were needed based on advice from First Nations communities and researchers/academics on the project regarding local cultural differences and approaches to trial conduct. The IRGs underpin culturally safe trial conduct by providing input into study materials and translating study findings into effective messages and policies for First Nations dialysis patients. Throughout the trial conduct, the IRGs\' role has developed to provide key mechanisms for advice and guidance regarding research conduct both in this study and more broadly. Support provided to the IRGs by trial First Nations Research Officers and independent First Nations researchers/academics who simplify research concepts is critical. The IRGs have developed feedback documents and processes to participants, stakeholders, and the renal units. They guarantee culturally safe advice for embedding findings from the trial into clinical practice guidelines ensuring evidence-based approaches in managing anaemia in haemodialysis patients with hyperferritinaemia.
    CONCLUSIONS: Active consumer and community partnership is critical in research conduct to ensure research impact. Strong partnership with consumers in the INFERR clinical trial has demonstrated that First Nations Consumers will engage in research they understand, that addresses health priorities for them and where they feel respected, listened to, and empowered to achieve change.
    In this paper, we present the importance of actively involving consumers in the planning, implementation and conduct of research using the example of a clinical trial among Aboriginal and/or Torres Strait Australians (First Nations Australians) who have kidney disease and are currently receiving haemodialysis. The study assesses how safe and effective it is for people on dialysis to receive iron given through the vein during dialysis when they have anaemia and high levels of a blood test called ferritin, a test used routinely to measure iron levels. Two consumer reference groups of First Nations patients on dialysis, one based in the Top End of Australia and the other based in Central Australia, are supported by First Nations Research Officers and Research Academics to make sure that the research is performed in a way that involves, respects and values First Nations participation, culture, and knowledge. Active consumer and community partnership in this study has supported robust research governance processes which we believe are crucial for knowledge translation to have a positive impact for patients.
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  • 文章类型: Journal Article
    非洲发展中国家面临失业危机,许多失业青年。农业已被确定为以青年为目标创造就业的战略部门,包括那些可能没有农业相关资格的人。然而,各种挑战限制了青年参与农业价值链的有效性。该研究旨在(i)确定青年对农业价值链机会的认识,(ii)确定他们对其在价值链中的作用的看法,(iii)确定他们对针对青年的农业计划的看法,以及他们对谁负责吸引青年从事农业的意见,(iv)描述农业中青年赋权的动态。使用焦点小组讨论和在线调查收集数据,并使用SPSS和NVivo进行分析。知识贫乏,对农业价值链活动和职业的认识程度低,不符合加工和零售企业就业的最低要求被确定为主要挑战。大多数青年对农业加工等非主要活动感兴趣,与农业生产相比,劳动密集型程度较低,投资回报更快。然而,促进青年参与农业的支持服务和方案主要侧重于初级活动,这表明青年的愿望和目前的支持之间不匹配。了解青年的愿望,支持青年赋权和参与价值链的观念和动力对于促进参与和制定相关和反应迅速的政策至关重要。此外,改善信息获取和提高对农业价值链的认识对于减少进入壁垒至关重要。政策制定者应将农业和粮食系统知识纳入初等教育课程,以提高青年的认识,并唤起对农业粮食系统职业的兴趣。
    Developing countries in Africa face an unemployment crisis, with many unemployed youth. Agriculture has been identified as a strategic sector for employment creation targeted at youth, including those who may not have agriculture-related qualifications. However, various challenges limit the effectiveness of youth participation in the agriculture value chain. The study aimed to (i) determine youth awareness of agricultural value-chain opportunities, (ii) determine their perception of their role in the value chain, (iii) determine their perception of agricultural programs targeting youth and their opinions on who is responsible for attracting youth into agriculture and, (iv) to characterise the dynamics of youth empowerment in agriculture. Data was collected using focus group discussions and an online survey and analysed using SPSS and NVivo. Poor knowledge, low levels of awareness of agricultural value-chain activities and careers, and not meeting the minimum requirements for employment in processing and retail businesses were identified as key challenges. Most youth were interested in non-primary activities such as agro-processing, which are less labour-intensive and have a quicker return on investment than agricultural production. However, support services and programs for promoting youth participation in agriculture mainly focus on primary activities, signifying a mismatch between youth aspirations and current support. Understanding youth aspirations, perceptions and dynamics underpinning youth empowerment and participation in value chains is critical for promoting participation and formulating relevant and responsive policies. Additionally, improving access to information and building awareness of agricultural value chains is crucial in reducing barriers to entry. Policymakers should integrate agriculture and food systems knowledge into the primary education curriculum to promote youth awareness and evoke interest in agri-food system careers at an early age.
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  • 文章类型: Journal Article
    背景:协作方法的概念涉及社区居民参与联合决策过程,以维持或增强其物质和社会条件。在COVID-19期间,公共服务部门看到了与社区积极合作并让居民参与决策过程的好处。由于社区拥有资源和资产,他们处于有利地位,可以为发展当地的健康和福祉举措做出贡献。跨学科和国家资助的三阶段研究方案,“动员社区资产解决健康不平等问题”,是为了利用当地的,文化,和自然资产来支持健康和福祉。本研究旨在综合研究小组在该计划第一阶段获得资助所收集的证据,包括学术和非学术,健康和社会护理,自愿和社区合作伙伴。
    方法:与来自英国各地的研究团队进行了十个在线焦点小组,探索合作的成功和挑战,以社区为基础的研究合作方法来解决健康不平等问题。八个焦点小组问题分为伙伴关系工作和健康不平等。
    结果:主题和内容分析产生了185个子主题,从中确定了12个主题。代表编码答复数量高于平均水平的主要主题是研究证据;资金;与合作伙伴的关系;健康不平等和剥夺;社区参与;以及卫生服务和综合护理系统。次要主题是将工人与社会处方联系起来;培训和支持;基于地点的因素;计划的寿命;建立和扩大计划;和心理健康。
    结论:成功包括采用基于实践和基于艺术的方法,作为通常不参与研究的人的研究项目的一部分,民主分享资金,建立在已建立的关系上,以及当地资产在社区参与中发挥的重要作用。挑战包括缺乏可持续的财政支持,资金的短期性质,在帮助最贫穷的人方面的不一致,获得正确的研究证据,取得足够的研究进展,与已经负担过重的医护人员建立关系,并纠正有利于社区的权力平衡。尽管面临挑战,参与者主要乐观地认为,集体方法和有意义的联合制作将为未来与社区的研究伙伴关系创造机会。
    BACKGROUND: The concept of collaborative approaches involves community residents in joint decision-making processes to maintain or enhance their material and social conditions. During COVID-19, public services saw the benefits of actively collaborating with communities and involving residents in decision-making processes. As communities have resources and assets, they are well-placed to contribute to developing local health and wellbeing initiatives. An interdisciplinary and nationally funded three-phase research programme, \"Mobilising community assets to tackle health inequalities\", was established with the objective of utilising local, cultural, and natural assets to support health and wellbeing. The current study aimed to synthesise evidence collected by research teams awarded funding in phase one of the programme, comprising academic and non-academic, health and social care, voluntary and community partners.
    METHODS: Ten online focus groups were conducted with research teams from across the UK exploring the successes and challenges of partnership working to tackle health inequalities using collaborative approaches to community-based research. Eight focus group questions were split between partnership working and health inequalities.
    RESULTS: Thematic and content analysis produced 185 subthemes from which 12 themes were identified. Major themes representing an above average number of coded responses were research evidence; funding; relationships with partners; health inequalities and deprivation; community involvement; and health service and integrated care systems. Minor themes were link workers and social prescribing; training and support; place-based factors; longevity of programmes; setting up and scaling up programmes; and mental health.
    CONCLUSIONS: Successes included employing practice-based and arts-based methods, being part of a research project for those not normally involved in research, sharing funding democratically, building on established relationships, and the vital role that local assets play in involving communities. Challenges involved a lack of sustainable financial support, the short-term nature of funding, inconsistencies in reaching the poorest people, obtaining the right sort of research evidence, making sufficient research progress, building relationships with already over-burdened health care staff, and redressing the balance of power in favour of communities. Despite the challenges, participants were mainly optimistic that collective approaches and meaningful co-production would create opportunities for future research partnerships with communities.
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