Do not forget the professional--the value of the FIRST model for guiding the structural involvement of patients in rheumatology research.
BACKGROUND
The FIRST model describes five practical components that enable equal collaboration between patients and professionals in clinical rheumatology research: Facilitate, identify, respect, support and training.


OBJECTIVE
To assess the value of this model as a framework for setting up and guiding the structural involvement of people with arthritis in health research.


METHODS
The FIRST model was used as a framework during the guidance of a network of patient research partners and clinical rheumatology departments in the Netherlands. A 'monitoring and evaluation' approach was used to study the network over a period of 2 years. Data were collected using mixed methods and subjected to a directed content analysis. The FIRST components structured the data analysis. During monitoring meetings, refined and additional descriptors for each component were formulated and added if new items were found.


RESULTS
The FIRST model helps to guide and foster structural partnerships between patients and professionals in health research projects. However, it should be broadened to emphasize the pivotal role of the principal investigator regarding the facilitation and support of patient research partners, to recognize the requirements of professionals for training and coaching and to capture the dynamics of collaboration, mutual learning processes and continuous reflection.


CONCLUSIONS
FIRST is a good model to implement sustainable relationships between patients and researchers. It will benefit from further refinement by acknowledging the dynamics of collaboration and including the concept of reflection and relational empowerment. The reciprocal character of the five components, including training and support of researchers, should be incorporated.
Department of Medical Humanities, VU Medical Centre, EMGO Institute, Amsterdam, The Netherlands.
Maarten P T
MP
de Wit
Athena Institute, VU Amsterdam, Amsterdam, The Netherlands.
Janneke E
JE
Elberse
Athena Institute, VU Amsterdam, Amsterdam, The Netherlands.
Jacqueline E W
JE
Broerse
Department of Medical Humanities, VU Medical Centre, EMGO Institute, Amsterdam, The Netherlands.
Tineke A
TA
Abma
D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009426:Netherlands; D010358:Patient Participation / Q000379:methods*; D012106:Research / Q000458:organization & administration*; D012108:Research Personnel; D012219:Rheumatology; D012944:Social Support
FIRST model; patient participation; patient research partners; qualitative research; rheumatology; user involvement