A model and measure for quality service user involvement in health research

In the UK, researchers across the health professions are increasingly being encouraged by policymakers and research commissioners to ‘involve’ service users in research. A recent review shows there is some evidence that involving patients, carers, relatives, social or community groups directly and actively as part of the research process can improve the conduct of research studies and the impact of the findings. Yet, little is known about how involvement is played out within research studies and there is a need for more critical and consistent assessment of what constitutes quality involvement. The overall purpose of this paper is to support learning about quality service user involvement in health care research. The aim is to provide service users and researchers with a structured and consistent way to reflect and report on their experiences. A range of philosophical and social theories of power and empowerment were reviewed and synthesized to create a model of quality involvement. The analysis encompassed both service user factors (what a person feels able to do, whether they feel their potential is being fulfilled and their sense of being valued) alongside research factors (research relationships, ways of doing research, research structures). A model is presented (Quality Involvement Framework), which contributes theoretically informed perspectives about the meaning and assessment of quality service user involvement in research. The model is developed as a practical measure (a Quality Involvement Questionnaire) for researchers and service users to be more reflective about the constraints and possibilities of involvement. The tools presented here could help research teams to examine personal factors and the research contexts that influence the nature and quality of service user involvement in research. They may also help to identify reoccurring issues about quality which could inform future policy, practice and research.     

Embedding consumer culture in health and social care education – a university office's perspective

Health and social care services are changing – and this change is radical. Service user and carer involvement has been a key aspect of health and social care policy for a number of years. In terms of the National Health Service (NHS), this has been significantly strengthened by the report ‘High Quality Care for All’. The NHS will no longer be a monolith dictating what services it offers. It is beginning to take seriously the views of its consumers: the patients, service users and carers. The NHS is starting to put the patient experience at the centre of everything it does, and its regulators are asking for evidence of public and patient involvement. This process may yet prove to be one of the NHS' greatest challenges as it transforms to prioritize the consumer viewpoint. Social care, though further down the line in relation to involvement, is now responding to the relatively new personalization agenda. This paper will consider what the university sector can do to embed the consumer and service culture within the education of health and social care professionals. It looks at the challenges of involvement and required culture change, highlighting the key points to address in the early and middle stages of involvement from a university office's perspective. It includes examples of consumer involvement in teaching, assessment and the selection of students and how their input is starting to make a difference. Finally, the paper outlines what is needed in a development office to establish and support effective service user and carer involvement on health and social care courses in higher education. The article concludes by acknowledging that there is much more work that needs to be done in this field to embed the work of a development office, but that early steps have been promising.     

Evaluating the impact of service user involvement on research: a prospective case study

As service user involvement in health and social care research has become more firmly embedded in health policies, both in the UK and internationally, there is increasing interest in evaluating its potential benefits and outcomes. Impact studies have highlighted a range of different types of service user involvement, using diverse research methods, within various research topics and involving different stakeholders. Potential benefits to research, researchers and the service users actively involved in research have been identified, along with the possibility of some negative consequences. Many impact studies have been criticized for being based on informal retrospective accounts of researchers and service users working together. Few have been underpinned by conceptual models, and there is a paucity of detailed accounts of the process of involvement that would enable replication. This paper reports an account of a prospective, qualitative exploration of service user involvement within a study, where the aims of the evaluation were agreed beforehand. Reflective discussions about the process and progress of service user involvement at different stages of the study were recorded, transcribed and analysed. The qualitative analysis identified perceived benefits to research, researchers and service user researchers that endorsed previous findings. The analysis also highlighted subjective and interpersonal aspects of service user involvement that have seldom been reported. This evaluation demonstrates the benefits of allowing time for structured reflection and adds to the understanding of the process and meaning of service user involvement in research.     

Does strategic involvement of mental health service users and carers in the planning,design and commissioning of mental health services lead to better outcomes?

There is an assumption, explicit in the current government policy, that involvement of mental health service users and carers in the planning, design and commissioning of mental health services will lead to better outcomes. The aim of this study was to examine evidence from board‐level participation of service users and carers that might support this assumption. A thematic analysis of documents generated by a strategic Lancashire Mental Health and Social Care Partnership during 2007 was undertaken. Themes for the analysis were generated from priorities identified from a postal survey of mental health services users from across Lancashire. The findings indicate that whilst service user and carer involvement is a high priority, the Lancashire Partnership spent most of its time discussing process and actions. Where service user involvement resulted in better outcomes, these improved outcomes were limited to the individual service users involved, rather than better outcomes for all service users. Whilst the membership of mental health service users and carers on the Lancashire Partnership Board presents a visible commitment from senior officers and may confer greater legitimacy to the decisions made by the Lancashire Partnership, service users and carers do not appear to play the desired instrumental role. Rather, their presence may be largely symbolic. This sends out the message across the health and social care system that partnership with service users and carers and their empowerment is important and has the potential to evolve further.     

Platform quality factors influencing content providers’ loyalty

This study investigates what platform quality factors affect the contents of the loyalty of content providers to support the continued expansion and sustainability of online platforms. It analyses empirically the influence of platform quality on the satisfaction with and loyalty to the service as well as on the platform's ability to secure content providers from a survey of 222 platform users. It confirms five significant findings for platform quality and user loyalty. First, all five factors of SERVQUAL have meaningful effects on platform user satisfaction. Second, factors affecting service quality differ by gender. Third, while male users regard platform technology as most critical, female users are more concerned about platform events and interests. Fourth, female users care more about customer responses than male users do; however, the user interface is the most critical aspect for both genders. Finally, platform quality has a significant impact on satisfaction and loyalty among content providers. It identifies the importance of platform service quality as a factor to increase user (content providers) loyalty on the platform. And it also investigates differences according to user gender by subdividing platform service users and indicates how service quality effects can change according to user characteristics.     

Consumer involvement in health research: a UK scoping and survey

Consumer involvement or patient and public involvement (PPI) in health research is a UK policy imperative and a prerequisite for many funders. PPI in research is defined as research carried out with or being carried out by the public (or service users), rather than research on patients and public as subjects or participants. Despite the clear policy driver, there is relatively little empirical evidence on the extent, processes and impact of user involvement in research. This paper aims to add to the international evidence base on PPI in research by providing a key overview of current trends and impacts. In order to understand the current extent and variation of PPI in research, a scoping exercise and survey were carried out on selected UK studies. Six research topic areas (cystic fibrosis, diabetes, arthritis, dementia, intellectual and developmental disabilities, and public health) were selected to ensure a range of designs, study populations and histories of PPI in research. A total of 838 studies (non‐commercial studies and not older than 2 years) were contacted. The response rate for the scoping was 38% and the survey 28%. In the scoping, 51% of studies had some evidence of PPI and in the survey 79%. The most common PPI activity was steering committee membership and reviewing patient information leaflets. There appeared to be some blurred roles with patients participating as research subjects as well as carrying out patient involvement roles. A major finding was the limited amount of available information about PPI in publicly accessible research documents. We suggest that the invisibility of this type of involvement and the lack of routinely collected information about PPI results in a lack of shared understanding of what optimal PPI in a study should look like, with important implications for practice. Furthermore, without a framework to review PPI it is difficult to know if different approaches to PPI have a different impact on key outcomes of the research.     

Developing a model of housing support: the evidence from Merseyside

This paper examines the complexities of providing housing support services for people who have experienced homelessness. The evidence is from a qualitative study of both those receiving and those providing support services for homeless people to resettle into the wider community from homeless accommodation in the Merseyside area. Different approaches of support are considered and using narratives, a model of successful support is established. The experiences of the majority of the service users strongly suggest that support has been critical in assisting a resettled way of life after being homeless. The paper contends that a critical prerequisite of successful support is the strength of desire of the homeless person to become resettled, coupled with a degree of motivation to engage with support services. The importance of such motivation should not be underestimated. Equally important to the success of resettlement is the relationship that most clients develop with a support worker. This relationship can initially develop while attempting to resolve practical difficulties of finding suitable, permanent accommodation. Through a mutual respect between worker and client and a high degree of empathy from a worker towards a client in tandem with an individualized support package aimed at independent living successful outcomes can occur. The paper concludes that support is successful when it is provided in a flexible manner thus relying on the skill and ability of a support worker to adequately judge the exact requirements of a service user. When this delicate balance between support and service user needs is achieved, the outcome is long‐term sustainable housing solutions.     

Consumers as researchers – innovative experiences in UK National Health Service Research

Consumer involvement is an established priority in UK health‐ and social‐care service development and research. To date, little has been published describing the process of consumer involvement and assessing ‘consumers’ contributions to research. This paper provides a practical account of the effective incorporation of consumers into a research team, and outlines the extent to which they can enhance the research cycle; from project development and conduct, through data analysis and interpretation, to dissemination. Salient points are illustrated using the example of their collaboration in a research project. Of particular note were consumers' contributions to the development of an ethically enhanced, more robust project design, and enriched data interpretation, which may not have resulted had consumers not been an integral part of the research team.     

Beyond the fad: a critical review of consumer fashion involvement

Fashion involvement has been regarded as an important research topic in consumer research. Despite the importance of this topic, no attempt has been made in the past to review, assess and consolidate extant research on fashion involvement. This study presents a comprehensive and critical review and analysis of the recent studies on involvement in the context of fashion clothing to indicate the current state and identify possible gaps. A content analysis of the current peer-reviewed journal articles published on this research topic reveals a paucity of research on a number of antecedents and consequences of involvement. Further, the findings show that the research method is biased towards the survey method as opposed to experimentation. In this paper, the results of the content analysis outlining methodologies, sample characteristics, variables and major findings are provided and analysed, followed by directions for future research, theoretical and managerial implications, and limitations.     

Determinants of collective intelligence quality: comparison between Wiki and Q&A services in English and Korean users

Although web-enabled collective intelligence (CI) plays a critical role in organizational innovation and collaboration, the dubious quality of CI is still a substantial problem faced by many CI services. Thus, it is important to identify determinants of CI quality and to analyze the relationship between CI quality and its usefulness. One of the most successful services of web-enabled CI is Wikipedia accessible all over the world. Another type of CI service is Naver KnowledgeiN, a typical and popular CI site offering question and answer (Q&A) services in Korea. Wikipedia is a multilingual and web-based encyclopedia. Thus, it is necessary to study the influence relationships among CI quality, its determinants, and CI usefulness according to different CI type and languages. In this paper, we propose a new research model reflecting multi-dimensional factors related to CI quality from user’s perspective. To test a total of 15 hypotheses drawn from the research model, a total of 691 responses were collected from Wikipedia and KnowledgeiN users in South Korea and US. Expertise of contributors, community size, and diversity of contributors were identified as determinants of perceived CI quality. Perceived CI quality has significantly influenced on perceived CI usefulness from user’s perspective. CI type and different language partially play a role of moderators. The expertise of contributors plays a more important role in CI quality in the case of Q&A services such as KnowledgeiN compared to Wiki services such as Wikipedia. This implies that Q&A service requires more expertise and experiences in particular areas rather than the case of Wiki service to improve service quality. The relationship between community size and perceived CI quality was different according to CI type. The community size has a greater effect on CI quality in case of Wiki service than that of Q&A service. The number of contributors in Wikipedia is important because Wiki is an encyclopedia service which is edited and revised repeatedly from many contributors while the answer given in Naver KnowledgeiN cannot be edited by others. Finally, CI quality has a greater effect on its usefulness in case of Wiki service rather than Q&A service. In this paper, we suggested implications for practitioners and theorists.     

The use of visual warnings in social marketing: The case of tobacco

Despite strong interest on the part of tobacco health practitioners, the effect of graphic warnings inserted on cigarette packs is unclear on several levels. First, the most effective themes for such messages have not been clearly identified by researchers. Second, no research has identified the ideal combination of self-efficacy and fear appeal warnings that should be inserted on cigarette packs, according to Protection Motivation Model principles. The exploratory study we conducted with French consumers to test the effectiveness of new graphic warnings proposed by the European Union in 2004 clearly demonstrates that visual messages, as opposed to text warnings, are more effective. This study also enabled us to identify the most effective themes of the European set: health warnings and social messages. Regarding future public health applications, if fear appeals are used, they need to be combined with self-efficacy and cessation support messages since they provoke avoidance reactions.     

Developing the evidence base of patient and public involvement in health and social care research: the case for measuring impact

While patient and public involvement (PPI) in health and social care research has progressed successfully in the last decade, a range of difficulties with the evidence base exist, including poor understanding of the concept of impact, limited theorization and an absence of quantitative impact measurement. In this paper, we argue that a paradigm change towards robust measurement of the impact of involvement in research is needed to complement qualitative explorations. We argue that service users should be collaboratively involved in the conceptualization, theorization and development of instruments to measure PPI impact. We consider the key advantages measurement would bring in strengthening the PPI evidence base through a greater understanding of what works, for whom, in what circumstances and why.     

An integrated model of service experience design improvement

Service experience design, addressing an overall experience problem with user-centered design thinking is a critical issue. This study proposes an integrated model of service experience assessment that addresses the relationship between user value and experience based on the importance and satisfaction concept. Refined improvement index of this study was developed for the determination of improvement priority. The paper then presents an empirical study of 3C (computer, communication, consumer-electronics) retail stores in which the proposed model was used to identify the critical servicescape items requiring improvement, and ranked on the strategies of improvement. The model requires a systematic approach to (i) examine the performance of these retail service processes; (ii) determine the items to be improved; and (iii) select appropriate and feasible strategies to improve these items. This integrated model is valuable for practical implementation in service firms to investigate and prioritize service design actions based on user experience data gathered from service sites.     

Public partnerships,governance and user involvement: a service user perspective

This paper explores public partnerships and governance from a service user perspective, drawing both on the author's own involvement in service user organizations and movements and on material associated with and produced by these organizations and movements. It addresses the ambivalent relationship between service user organizations and movements and the idea and practice of ‘partnerships’, and explores their preference for ideas of ‘alliance’. It charts the different approaches to and ideologies underpinning user involvement and their implications for partnership between state and service users and their organizations. It offers a set of components for improving such partnerships as well as highlighting the growing interest of service users' organizations and movements in developing and extending alliances.     

Facilitation Methods for Collaborative Modeling Tools

This paper presents results of an ongoing research effort to support effective user involvement during modeling and analysis meetings. Productivity and user participation of traditional group meetings have been limitations imposed by chauffeured facilitation and single-user tools. These tools have been designed for analysts rather than for direct use by non-analyst users. Recently, electronic meeting systems (EMS) modeling tools that allow users to work in parallel to contribute directly during meetings have been developed. Such tools allow more domain experts to participate directly and productively during model development meetings than is possible using the traditional approach. Although previous research has demonstrated that EMS modeling tools may be used to develop some model content, little research had been done on collaborative facilitation methods that employ these tools. This paper presents a comparison of modeling approaches for use with EMS modeling tools and proposes an approach that overcomes significant problems inherent in other approaches. It leverages the productivity enhancement afforded by direct group access and still results in production of complete, integrated, high quality models. This approach allows models to be developed two to four times faster than with traditional modeling support and yet avoids model ambiguities and inconsistencies.     

Antecedents of emotional attachment of social media users

Emotional attachment has been documented to be an effective basis for consumer loyalty behaviors in many contexts; however, not much has been offered for new service formats enabled by information technology. This study explores the emotional attachment of social media users in terms of personality traits of users and websites. Drawing on literature on brand personality and brand–self congruence, this research proposes that a match between user’s individual personality and the personality traits of the digital artifacts promotes affective connection to social media websites. The social media, to which the user becomes emotionally attached, therefore becomes part of one’s self-definition and representation in the digital world. Self-expressiveness is also investigated as a motivational driver that helps users form such an emotional bond. Individuals with higher motivation to express themselves are more likely to develop an emotional attachment to social networking sites, exhibit loyal behavior, and experience a stronger effect than self-website congruence on emotional attachment. Results of this research provide support to the proposed relationships. Theoretical and managerial implications are elaborated in the discussion.     

Delight the experts,but never dissatisfy your customers! A multi-category study on the effects of online review source on intention to buy a new product

Online reviews are a pervasive form of electronic word-of-mouth (eWOM) that potentially accelerate—or slow down—the diffusion of recently launched services in the marketplace. While empirical research largely supports the effects of online reviews on attitudinal and behavioral outcomes, less is known about the impact the source of the review—i.e., if it comes from a peer consumer or an expert—has on the recipient. Two experiments that combine reviewer- (expert, consumer), service type- (mobile package, restaurant, car repair), consumer- (level of general innovativeness), and review-related (positive, negative) characteristics reveal a challenging interaction between the review’s source and its valence: while—compared to an established baseline—a positive expert review seems more effective in increasing the recipient's intention to purchase than a review by a peer consumer, a negative consumer review lowers the recipient's intentions to a larger extent than a negative expert review. We further find effects of the consumer's innovativeness and the service category across the experiments. Our research contributes to the topical and increasing body of empirical research on the effects of involved characteristics within online reviews across several product types.     

The Effectiveness of Brand- and Customer-Centric Content Strategies at Generating Shares, ‘Likes’, and Comments

Brands are constantly competing for user attention on Facebook and are trying to encourage fans to share, click ‘like’, and comment their posts. Yet, it remains unclear what content strategies are successful at encouraging those behaviors. Noting that the effectiveness of brand content strategies still remains an uncharted research area, this study adopts a discovery-oriented approach and employs workshops, quantitative content analysis, and episodic interviews, to link desired user responses (namely clicks share, ‘like’, and comment) to brand content strategies. This study reveals that customer-centric content strategies are the most effective at encouraging user responses. Managers can use provided recommendations to engage their customers by adopting content strategies that result in desired behavioral reactions.     

Business Incubation Centers and New Firm Growth in the Basque Country

The purpose of this article is an attempt to identify those factors related to human capital and organizational resources which help in overcoming barriers to survive during the infancy period of firm start-ups. The paper aims to find out the extent to which the support received by entrepreneurs from incubator centers is critical to ensure firm life. Primary data have been used to conduct an empirical analysis on a sample of 114 start-up firms participating in a business assistance program (i.e., business incubation centers). Results from regression analyses suggest that human capital attributes of entrepreneurs and certain start-up firm characteristics seem to be critical to explain business success. An important implication of this study is that, despite the economic advantages derived from this policy based on the promotion of business incubation centers policy makers should be cautious in its application. Empirical evidence from our study suggests that a portion of new firms being nurtured in business incubation centers may cause the exit of more efficient incumbent firms not receiving such policy support.     

An evaluation of consumer participation in hospital breast services

Community expectations and research demonstrate that consumers play an important role in shaping services for women with breast cancer. Consumer contribution has been mandated recently in Victoria, Australia, to ensure the inclusion of consumer involvement in the planning and decision‐making processes within health organizations. As part of the redevelopment of breast services in Victoria, Southern Health has been funded to plan local improvements to care co‐ordination for women diagnosed with breast cancer in the southern metropolitan area of Melbourne. The establishment of effective consumer participation in breast services is an integral aspect of this project and a range of initiatives has been undertaken to achieve meaningful consumer involvement including the appointment of a consumer advisor; appointment of staff with extensive knowledge in women's health and community development to the project; establishment of a consumer reference group; and plans made to improve the receptivity of health service systems to consumer input. A preliminary evaluation of this ongoing project has indicated that a productive role for consumers in service practice review and policy and planning activities has been established and some change and engagement of staff has occurred. There is still work to be done to promote the involvement of a wider range of health professionals and to increase the level of trust between consumers and staff.