Engaging Stakeholders in Rehabilitation Research: A Scoping Review of Strategies Used in Partnership and Evaluation of Impacts

Camden, C., Shikako-Thomas, K., Nguyen, T., Graham, E., Thomas, A., Sprung, J., Morris, & C., Russell, D.J. (2014). Engaging stakeholders in rehabilitation research: A scoping review of strategies used in partnership and evaluation of impacts. Disability and Rehabilitation, 37(15), 1390-1400. http://informahealthcare.com/doi/pdf/10.3109/09638288.2014.963705
Purpose: To describe how stakeholder engagement has been undertaken and evaluated in rehabilitation research. Methods: A scoping review of the scientific literature using five search strategies. Quantitative and qualitative analyses using extracted data. Interpretation of results was iteratively discussed within the team, which included a parent stakeholder. Results: Searches identified 101 candidate papers; 28 were read in full to assess eligibility and 19 were included in the review. People with disabilities and their families were more frequently involved compared to other stakeholders. Stakeholders were often involved in planning and evaluating service delivery. A key issue was identifying stakeholders; strategies used to support their involvement included creating committees, organizing meetings, clarifying roles and offering training. Communication, power sharing and resources influenced how stakeholders could be engaged in the research. Perceived outcomes of stakeholder engagement included the creation of partnerships, facilitating the research process and the application of the results, and empowering stakeholders. Stakeholder engagement outcomes were rarely formally evaluated. Conclusions: There is a great interest in rehabilitation to engage stakeholders in the research process. However, further evidence is needed to identify effective strategies for meaningful stakeholder engagement that leads to more useful research that positively impacts practice. Implications for Rehabilitation:

  • Using several strategies to engage various stakeholders throughout the research process is thought to increase the quality of the research and the rehabilitation process by developing proposals and programs responding better to their needs.
  • Engagement strategies need to be better reported and evaluated in the literature.
  • Engagement facilitate uptake of research findings by increasing stakeholders’ awareness of the evidence, the resources available and their own ability to act upon a situation.
  • Factors influencing opportunities for stakeholder engagement need to be better understood.

This paper is about stakeholder engagement. Beyond dissemination, strong knowledge mobilization requires good engagement with the various stakeholders in the research. Stakeholders may include intermediary organizations and end users such as policy makers, practitioners, service providers, clinicians as well as potential beneficiaries of the research including patients, parents, students, farmers etc. The authors write, “The most important reason may be that collaborating with stakeholders leads to the identification of more relevant research questions, which results in the creation of knowledge that is more readily transferable, relevant and usable to solving real-world problems….Knowing how best to involve stakeholders could accelerate the uptake and implementation of knowledge to improve interventions, evidence-based practice and policies influencing the research and care for individuals with disabilities.”
This article uses a scoping review of the literature to map the key concepts of a research area in order to describe:

  1. Effective strategies for engaging stakeholders in research
  2. The factors that influence (positively and negatively) engagement
  3. The impacts of stakeholder engagement

Strategies for Stakeholder Engagement
Identifying Stakeholders: the literature showed that when recruiting stakeholders for volunteer or paid roles research can employ and open or a targeted strategy. Targeted recruitment occurs when the researcher directly invited individuals and/or organizations to participate either on working groups, committees or other forms of engagement. In open strategies researchers asked organizations to disseminate the opportunity for engagement to their own members. In both cases the individual stakeholder needs to be cognisant whether s/he is representing his/her own interests or that of his/her organization (or both).
Roles/Committees: engaging stakeholders on committees was a commonly used strategy.
Supporting Stakeholders: Stakeholders needed to be supported in order to understand research and fulfill their role. Formal training and courses were used to build skills around different research components (e.g. research design, collecting data, facilitating meetings). This is more critical the more engaged you are with your stakeholders. If your stakeholders are co-researchers they will certainly need training on research methods and data collection.
Factors Influencing Engagement
Communications/Culture: Ensure that there is clarity and a shared understanding of roles at the beginning or the project. This should include spaces for stakeholders to voice their concerns and mutually agreed on risk management strategies. Use clear language and avoid scientific jargon. Invite stakeholders to co-host meetings (i.e. give them an active role). To overcome communications and cultural barriers build in time for consultation.
Power sharing: Researchers need to acknowledge that power is expressed through control of questions, methods, funding and dissemination. “Stakeholders, and especially those from vulnerable populations, need to feel entitled to contribute at the same level of the researchers. Researchers’ willingness to share control over the research process and their previous experiences with participatory processes were reported as facilitator for stakeholders’ engagement.”
Time, funding and resources: This is related to power and might have better been incorporated into the power section above. Part of sharing power means compensating stakeholders for their costs of participation including paying their time away from the office. Researchers have protected time for research. Stakeholders rarely do.
Impacts Related to Stakeholder Engagement
Creating partnerships and building value: Both researchers and stakeholders gain valuable knowledge about each other’s lived, political and systems experiences. Building on this shared experience, stakeholder engagement can grow to partnerships which can grow to sustained collaborations.
Knowledge is made more relevant and more accessible: While this is a positive impact of effective stakeholder engagement; however, “benefits were questioned when stakeholders were consulted only at the end of the project”.
There is only a brief paragraph on evaluating these impacts because only six studies they reviewed collected data to demonstrate the impacts of stakeholder engagement. That in itself is telling about our ability to evaluate impacts of knowledge mobilization activities. The best the literature indicates is “Evaluations consisted of post-hoc analysis of focus groups about stakeholders’ engagement, debriefing and interviewing stakeholders about their satisfaction with the involvement process and interviews and questionnaires about perceived outcomes around stakeholders’ engagement.” While thin on detail the literature does agree that interviews (=qualitative evaluation) is the method of choice for evaluating impact. That means you have to stay in touch with partners and stakeholders in order to fund out the impacts of the work.
In summary: provide training (to both academic and non-academic partners) to involve stakeholders meaningfully in the research from inception to impact.
However, there is a gap in the article in that the literature describes strategies for involving stakeholders up to and including dissemination, but what about after dissemination? If impact occurs because stakeholders are using and acting on the information co-produced during the research then perhaps we need to move our thinking from stakeholder engagement in research to researcher engagement in impact. When a researcher is a practitioner (social work, nurse, physician, urban planner etc.) there may be researcher involvement up to and including impact. But when there is a “hand off” of research to partners how do we (should we?) keep researchers involved in the processes that lead to partner uptake and implementation into products, policies and services that ultimately have an impact on the end beneficiaries of the research.
Questions for brokers:

  1. What efforts are you using to produce materials that remove scientific jargon and facilitate stakeholder engagement? Are you writing in clear language such as ResearchSnapshot clear language research summaries?
  2. Is it the role of researchers to remain active beyond dissemination? How might researchers remain active in the uptake of research by partners, their implementation of that research to inform new products, policies and services and then their eventual impact on end beneficiaries of research?

ResearchImpact-RéseauImpactRecherche (RIR) is producing this journal club series as a way to make evidence on KMb more accessible to knowledge brokers and to create on line discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read this open access article. Then come back to this post and join the journal club by posting your comments.