title: What can a participatory approach to evaluation contribute to the field of integrated care?
abstract: Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge. Participatory approaches are characterised by a desire to use social science methods to solve practical problems and a commitment on the part of researchers to substantive and sustained collaboration with relevant stakeholders. We describe how we applied an emerging practical model of participatory research, the researcher-in-residence model, to evaluate a large-scale integrated care programme in the UK. We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms. While there is still much to learn about the benefits and challenges of applying participatory approaches in the health sector, we demonstrate how using such approaches have the potential to help practitioners integrate care more effectively in their daily practice and help progress the academic study of integrated care.
authors.affiliation: Reserach Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Eyre
authors.affiliation: School of Histories, Languages and Cultures, University of Hull, Hull, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Farrelly
authors.affiliation: Reserach Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Marshall
mesh_terms: D055812:Community-Based Participatory Research / Q000379:methods*; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated; D006282:Health Personnel; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D015397:Program Evaluation; D012108:Research Personnel; D006113:United Kingdom
keywords: Evaluation methodology; Health services research; Qualitative research; Quality improvement methodologies