Involving older adults in research found to have positive impacts on both older adults and the research process

Baldwin J, Napier S, Neville S, Wright-St Clair V. Impacts of older people's patient and public involvement in health and social care research: A systematic review Age and Ageing. 2019; 47(6): 801-809.

Review question

•      What are the impacts of involving older adults in health and social care research?

Background

•      Patient and public involvement (PPI) is “an active partnership between patients and the public and researchers in the research process” (UK National Institute for Health Research).

•      Today, PPI is increasingly being recognized as a key part of the research process.

•      As such, there is a growing need within the research community to understand whether conducting participatory research actually benefits research and those involved.

•      The aim of this systematic review is to investigate the impacts of involving older adults in health and social care research. Specifically, the review examines the impacts of involving older adults as co-researchers, as well as the impacts of such involvement on the research process and research outcomes.

How the review was done

•      Review authors conducted a detailed search of six research databases for eligible studies in October 2017.

•      The reference lists of relevant papers and unpublished literature were further examined to identify additional studies.

•      Search terms used included “older adult,” “participatory research,” and “community-based research.”

•      English language articles reporting the impacts of PPI, published between January 2006 and October 2017, were eligible for inclusion.

•      A total of 2,663 articles were retrieved from the initial search, of which 9 were included in this review.

•      No conflicts of interest were declared.

What the researchers found

•      All nine articles included in this review found that PPI had beneficial impacts for older adults who were co-researchers.

•      Psychological benefits for older adults who were co-researchers included increased self-confidence, intellectual stimulation, enjoyment, gaining a sense of achievement or satisfaction, being valued, feeling useful, and being able to “give something back.”

•      Social benefits for older adults who were co-researchers related to developing relationships with fellow co-researchers, academics, and with people in the community.

•      Finally, reviewers found that older adults who were co-researchers also benefitted from new learning such as gaining new knowledge, acquiring new skills, challenging previous assumptions and prejudices, and achieving personal growth. The research process also provided opportunities for activism and career progression.

•      Seven articles reported challenges associated with the PPI process. Some co-researchers described their workload as “too demanding.” There were also situations when co-researchers lacked sufficient skills or flexibility, leading to negative impacts on the research process.

•      Several articles found that co-researchers sometimes had difficulty navigating relationships with other co-researchers, academics, and project managers. Power imbalances were experienced between co-researchers and academics as well as research funders, creating feelings of disempowerment.

•      All nine articles reported benefits to the research process and outcomes. Co-researchers often facilitated recruitment and assisted with project completion. Many studies found that older adults who were co-researchers improved research quality by identifying user-focused research topics, collecting richer data, and providing new perspectives to data analysis. They built trust with study participants and made them feel comfortable, and many study participants reported benefitting from talking with the co-researchers about issues relevant to them.

•      Seven articles identified challenging impacts for research processes and outcomes. Limitations in the co-researchers’ skills were found to adversely affect interviews and data analysis. In addition, the extra time and cost required for PPI presented some logistical constraints.

•      Three themes emerged as critical success factors when involving older adults in research: 1) building relationships; 2) facilitating communication, and 3) breaking down barriers.

•      Building equal, respectful, and trusting relationships between academic and co-researchers was found to be very helpful. Using open, honest, and non-judgmental communication between research team members was also important. Strategies for this included reflection meetings, group exercises, and providing feedback to co-researchers. Finally, breaking down barriers to older adults’ participation, for example, by changing the location of research meetings, was another success factor.

Conclusion

•      Older adults’ involvement in research produces both beneficial impacts, as well as challenges. However, the benefits appeared to outweigh the challenges. Building relationships, facilitating communication, and breaking down barriers to participation were found to support successful integration of older adults in research.