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Abstract Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities—how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD’s international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals.

Background Organizations recognized the importance of workplace inclusion. However, up to date, few organizations had developed strategic initiatives to improve workplace diversity. This research examines the impact of awareness of inclusion, inclusive leadership, psychosocial capital, and meaningful engagement on employee’s inclusion in the context of Malaysia. Methods The study employed a quantitative survey approach and collected data through a questionnaire survey administered to 204 participants. Descriptive analysis, reliability analysis and multiple linear regression analysis were utilized to explore the relationships between the independent and dependent variables. Results The findings indicate a significant correlation between awareness of inclusion and psychosocial capital with employee’s inclusion. However, no significant correlations were found between inclusive leadership and meaningful engagement with employee’s inclusion. These results underscore the importance of fostering an inclusive culture and nurturing psychosocial support to enhance employee’s inclusion experiences in the workplace. Conclusion This study contributes to the knowledge by being one of the pioneer research in Malaysia that provides insights into the factors influencing employee’s inclusion in Malaysia. The findings is important for organizations, particularly small and medium enterprise in Malaysia to promote employee inclusion in a multi-racial diversity society.

Healthcare professionals have first-hand experience with patients in clinical practice and the dynamics in the healthcare system, which can be of great value in the design, implementation, data analysis and dissemination of research study results. Primary care professionals are particularly important as they provide first contact, accessible, coordinated, comprehensive and continuous people-focused care. However, in-depth examination of the engagement of health professionals in health system research and planning activities—how professionals are engaged and how this varies across national contexts- is limited, particularly in international initiatives. There is a need to identify gaps in the planning of engagement activities to inform the design and successful implementation of future international efforts to improve the responsiveness of health systems to the changing needs of patients and professionals. The aim of this study was to explore how primary care professionals were engaged in the design and implementation plans of an international health policy study led by the Organisation for Economic Co-operation and Development (OECD). The OECD's international PaRIS survey measures and disseminates information on patient-reported outcome and experience measures (PROMs and PREMs) of people living with chronic conditions who are managed in primary care. A documentary analysis of 17 written national implementation plans (country roadmaps) was conducted between January and June 2023. Two reviewers independently performed the screening and data abstraction and resolved disagreements by discussion. We reported the intended target primary care professionals, phase of the study, channel of engagement, level of engagement, and purpose of engagement. All 17 countries aimed to engage primary care professionals in the execution plans for the international PaRIS survey. While organisations of primary care professionals, particularly of family doctors, were the most commonly targeted group, variation was found in the timing of engagement activities during the different phases of the study and in the level of engagement, ranging from co-development (half of the countries co-developed the survey together with primary care professionals) to one-off consultations with whom. International guidance facilitated the participation of primary care professionals. Continuous collaborative efforts at the international and national levels can foster a culture of engagement with primary care organisations and individual professionals and enhance meaningful engagement of primary care professionals. [ABSTRACT FROM AUTHOR]

Background: This manuscript is coauthored by 15 young adult Patient RESearch partners (PARES) with lived and living mental health experiences and three institutional researchers across Canada involved in a patient-oriented research (POR) study called the HEARTS Study: Helping Enable Access and Remove Barriers To Support for Young Adults with Mental Health-Related Disabilities. We share our reflections, experiences and lessons learned as we grapple with the field of POR for its lack of clarity, hierarchical structures, internalized ableism, and accessibility challenges, among others. To mitigate the difficulties of POR, we started by laying the groundwork for equality by embracing the principle of Primus Inter Pares: First Among Equals as the foundation of our approach. In this way, we began with what we know for certain: the inherent worth and dignity of young adults as equal partners, recognizing their expertise, worldviews, creativity, and capacity to contribute meaningfully and intentionally to the research that affects their lives and futures. Main Body: The manuscript underscores the need to reconceptualize meaningful engagement in POR, advocating a shift from traditional, biased paradigms that fail to address the complexities faced by young adults with mental illness. It introduces what we have termed Adaptive and Differential Engagement, underscoring the necessity of tailoring participation to individual preferences and circumstances alongside a Tripartite Compensation model that promotes fair and holistic remuneration in research collaborations. Then we discuss the approaches we have conceptualized, such as Equitable Dialogue, Trust Architecture, Community Continuum, Unity in Diversity, Shared Stewardship, and Agile Frameworks that collectively aim to overcome barriers like language intimidation, power imbalances, framework fatigue, consultation burnout, trust deficits, and systemic discrimination and exclusion. The manuscript does not seek to prescribe any universal or standardized solutions; in fact, it seeks the opposite. Instead, it offers a thoughtful and transparent contribution to the POR canon, providing resources for young adults eager to engage in research and institutional researchers aspiring to collaborate with them. Conclusion: This manuscript is a product of our collective learning and critical self-evaluation. By integrating theoretical insights with practical strategies, we present a justice-oriented blueprint for an inclusive and egalitarian approach to POR. We advocate for applications of POR that are responsive to the individualized contexts of young adult PARES, ensuring their perspectives are central to the research with the resources to take the lead should they choose. Plain Language Summary: Together with a graduate student, co-supervisors, and 15 young people from across Canada who have experience with mental health challenges, this paper looks at how research involving young adults as patient research partners can be better. We feel that the types of research that are supposed to include us are often not clear enough and make it hard to join, especially those with unique life situations and health issues. So, in this paper, we suggest a few new ways of doing things where everyone is treated equally. We call it Primus Inter PARES: First Among Equals. This means young people are just as important as anyone else in research. We want to change the old ways that do not consider our unique experiences as young people with mental health issues. We came up with new ideas like 'Equitable Dialogue' and 'Trust Architecture' to ensure everyone understands the research and feels that they can trust the process. We also suggest ways to make sure different voices are heard and that everyone has a fair chance to contribute. We do not just offer a one-size-fits-all solution; instead, we share many ways to improve research to help young adults who want to be part of research and for the researchers who want to work with us. Our paper is about making research fair and including everyone's point of view. We hope this will make the research better for everyone, especially for young adults. [ABSTRACT FROM AUTHOR]

Several systematic reviews have synthesized studies exploring the experience of homelessness. No known reviews have synthesized findings of studies exploring experiences of transitioning to housing following homelessness. To address this gap, we conducted a systematic review and meta-aggregation of qualitative evidence using the methodology developed by the Joanna Briggs Institute (JBI) following PRISMA guidelines. Of 8559 titles and abstracts screened, we included 57 studies in our meta-aggregation, and generated six synthesized findings: 1) trying to move on but facing ongoing individual and structural barriers; 2) home as a launching pad for self-discovery and emotional and spiritual growth; 3) social connection as a fundamental and often unmet need; 4) having housing that is the right fit and enables a sense of safety and avoidance of trauma; 5) meaningful activity as facilitating community integration and the journey home; and 6) the meaning of having services that are effective, caring, and responsive to the person. Our findings suggest that leaving homelessness is a complex process that does not immediately end with attaining a tenancy. Future research designed to understand the experiences of leaving homelessness for racialized and Indigenous persons, women leaving domestic violence, and persons identifying as 2SLGBTQ2 + are needed. [ABSTRACT FROM AUTHOR]

Aims: To explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers' quality of life. Background: Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. Design: An interpretive descriptive approach that incorporated the photovoice method was used. Methods: Using a purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a 4-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analysed using thematic analysis with an inductive approach. Findings: Caregivers expressed feelings of frustration, confusion and joy. Emerging themes included: (i) feeling like a 'criminal' amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories. Conclusions: The combination of visual and textual methods provided unique insight into the mental distress, isolation and intense emotional burdens experienced by caregivers during the pandemic. Impact: Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support the mental health of caregivers. Reporting Method: This work adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Public Contributions: The caregivers included in the study were involved in the cocreative process as active contributors informing the design and validation of the codes and themes. [ABSTRACT FROM AUTHOR]

The National Quality Framework (NQF) was intended to drive continuous improvement in education and care services in Australia. Ten years into implementation, the effectiveness of the NQF is demonstrated by steady improvements in quality as measured against the National Quality Standard (NQS). The process of assessing and rating services is a key element in the NQF, drawing together regulatory compliance and quality assurance. This paper draws on findings from a national Quality Improvement Research Project investigating the characteristics, processes, challenges and enablers of quality improvement in long day care services, concentrating on Quality Area 1 Educational program and practice and Quality Area 7 Governance and leadership. This was a mixed-method study focusing on long day care services that had improved their rating from Working toward NQS to Meeting NQS or to Exceeding NQS. The study comprised three phases, and in this paper, we draw on Phase 3 to understand the contribution of the NQS Assessment and Rating (A&R) process to continuous quality improvement from the standpoint of providers and professionals delivering these services. Phase 3 involved qualitative case studies of 15 long day care services to investigate factors that enabled and challenged quality improvement. Data was collected during twoday site visits, using professional conversations and field notes to elicit the views and experiences of service providers, leaders and educators. In this paper, we look at how the A&R process is experienced by those involved in service provision, with a focus on the factors that enabled and challenged quality improvement. Recognizing the interchangeability of enablers and challenges, three broad themes emerged: (i) curriculum knowledge, pedagogical skills and agency; (ii) collaborative leadership and teamwork; and (iii) meaningful engagement in the A&R process. The study found that meaningful engagement in the A&R process informed priorities for ongoing learning and acted as a catalyst for continuous quality improvement. Apprised by stakeholder views and experiences of A&R, we offer a model to foster stakeholder participation in quality assurance matters through affordances of meaningful engagement. [ABSTRACT FROM AUTHOR]

Meaningful engagement of people living with health conditions means actively incorporating them in all stages of health decision-making. Despite efforts by global health agencies and governments towards meaningful engagement of people living with noncommunicable diseases (PLWNCDs), many opportunities for participation are tokenistic. PLWNCDs often report feeling excluded from technical discussions and outnumbered by other stakeholders. Participation in decision-making is a human right, and PLWNCDs must continue advocating for a "nothing about us without us" approach. They should be respected as decision-makers with voice, agency, voting power, rights, and duties. This article highlights four key themes: (1) both tokenistic participation and exclusion of PLWNCDs from technical discussions are still common; (2) the "patient" label implies passivity and can perpetuate limited participation, whereas the identifier of PLWNCDs connotes valuable knowledge associated with lived experience; (3) meaningful participation of PLWNCDs in health decision-making processes should be considered a human right; (4) PLWNCD should be empowered to continue to advocate for inclusion and be respected as decision-makers. [ABSTRACT FROM AUTHOR]

Dementia progressively affects cognitive functioning, including the ability to communicate. Those who struggle to communicate are often considered unable to relate to other people. Frontline care workers are in a position to connect with residents. However, we know little about their perspectives. The aim of this study was to understand how and when nursing home staff meaningfully engaged with residents with advanced dementia. Semi-structured interviews, supplemented by informal conversations, were conducted with 21 staff from seven nursing homes. Inductive thematic analysis identified themes in the accounts. Four themes related to how staff engaged with residents with advanced dementia (initiating meaningful engagement, recognising subtle reactions, practising caring behaviours, patience and perseverance). Two themes related to when meaningful engagement occurred (lacking time to connect, making the most of time during personal care). A key barrier to implementing formal interventions to improve care is lack of staff time. Staff overcome this by using personal care time for meaningful engagement with residents. Their approach, developed through experience, is consonant with person-centred dementia care. Building on this, future research should use participatory approaches building on practice wisdom to further develop and evaluate meaningful engagement with residents with advanced dementia. [ABSTRACT FROM AUTHOR]

The National Quality Framework (NQF) was intended to drive continuous improvement in education and care services in Australia. Ten years into implementation, the effectiveness of the NQF is demonstrated by steady improvements in quality as measured against the National Quality Standard (NQS). The process of assessing and rating services is a key element in the NQF, drawing together regulatory compliance and quality assurance. This paper draws on findings from a national Quality Improvement Research Project investigating the characteristics, processes, challenges and enablers of quality improvement in long day care services, concentrating on Quality Area 1 Educational program and practice and Quality Area 7 Governance and leadership. This was a mixed-method study focusing on long day care services that had improved their rating from Working toward NQS to Meeting NQS or to Exceeding NQS. The study comprised three phases, and in this paper, we draw on Phase 3 to understand the contribution of the NQS Assessment and Rating (A&R) process to continuous quality improvement from the standpoint of providers and professionals delivering these services. Phase 3 involved qualitative case studies of 15 long day care services to investigate factors that enabled and challenged quality improvement. Data was collected during two-day site visits, using professional conversations and field notes to elicit the views and experiences of service providers, leaders and educators. In this paper, we look at how the A&R process is experienced by those involved in service provision, with a focus on the factors that enabled and challenged quality improvement. Recognizing the interchangeability of enablers and challenges, three broad themes emerged: (i) curriculum knowledge, pedagogical skills and agency; (ii) collaborative leadership and teamwork; and (iii) meaningful engagement in the A&R process. The study found that meaningful engagement in the A&R process informed priorities for ongoing learning and acted as a catalyst for continuous quality improvement. Apprised by stakeholder views and experiences of A&R, we offer a model to foster stakeholder participation in quality assurance matters through affordances of meaningful engagement.

First-Year Seminars (FYS) are a high-impact practice (Keup & Young, 2018; Skipper, 2017). However, outcomes of pedagogical approaches linked to those seminars have not been as well researched. An expectation of Christian higher education is to consider what kind of spiritual and personal formation is happening through classroom assignments and practices (Smith, 2021a). This qualitative study explored the impact of an assignment in which first-year students interacted in structured conversations outside of class for 10 weeks of the fall semester. Students reflected on their experiences by responding to prompts at the midpoint and end of the semester, and the researcher conducted a qualitative analysis of the responses with a focus on the question: "Have our teaching practices nudged students toward genuine engagement with the people around them?" The most common themes revealed that structured conversations functioned as a formative relational practice, which moved students to engage in meaningful ways with people with whom they previously thought they would have nothing in common. [ABSTRACT FROM AUTHOR]

Meaningful engagement is a key dimension of quality of life among persons living with dementia, yet little is known about how to best to promote it. Guided by grounded theory methods, we present analysis of data collected over a 1-year period in four diverse assisted living (AL) communities as part of the study, "Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia." Our aims are to: (a) learn how meaningful engagement is negotiated among AL residents with dementia and their care partners; and (b) identify how to create these positive encounters. Researchers followed 33 residents and 100 care partners (formal and informal) and used participant observation, resident record review, and semi-structured interviews. Data analysis identified "engagement capacity" as central to the negotiation of meaningful engagement. We conclude that understanding and optimizing the engagement capacities of residents, care partners, care convoys, and settings, are essential to creating and enhancing meaningful engagement among persons living with dementia. [ABSTRACT FROM AUTHOR]

Structural governance dysfunctions pose a major obstacle to the realisation of human rights in South Africa, particularly the socio-economic rights entrenched in the Bill of Rights. This article explores the remedial tools available to the South African courts to redress these kinds of structural human rights violations and Justice Froneman's significant contribution to the development of these tools. It commences by describing efforts to redress structural human rights violations by another apex court in the Global South, the Colombian Constitutional Court. The Colombian experience provides important insights into the unique challenges that structural human rights violations pose for litigants and the judiciary in designing and implementing effective remedies. While South African courts do not have the same doctrinal approach to structural human rights violations as in Colombia, they do enjoy a broad constitutional mandate to remedy all forms of constitutional rights violations. The article then proceeds to examine the various remedial tools that have been developed in South African constitutional jurisprudence to redress structural human rights violations. It highlights the potential of supervisory meaningful engagement remedies, and Justice Froneman's contribution to the development of these remedies. Next, this article considers how the toolbox for addressing structural human rights violations has been expanded by the innovative set of remedies handed down by Justice Froneman in the series of cases arising from an unlawful tender awarded by the South African Social Security Agency in 2011 for the administration of the payment of social grants. The final substantive part of this article draws on comparative scholarship and jurisprudence to argue that participatory structural remedies hold the most promise for redressing structural human rights violations. It argues that the essential elements of such remedies have already been constituted by two strands of the Court's remedial jurisprudence - meaningful engagement remedies and supervisory remedies incorporating independent monitoring mechanisms. The promise of participatory structural remedies can be harnessed by fusing these two strands of the Court's remedial jurisprudence This part also explores the caveats and support structures that must be in place to enhance their prospects of success. The conclusion synthesises this article's central arguments and reflects on structural human rights violations and the leitmotif of participatory democracy in Justice Froneman's jurisprudence. [ABSTRACT FROM AUTHOR]

Objective:The purpose of this article is to analyze a structural remedy model developed by the Constitutional Court of South Africa, called Meaningful Engagement, which can minimize the impact of traditional objections to structural litigation, as it increases community participation and interinstitutional dialogue between the various actors responsible for the solution of the problem. Methodology: As a research methodology, in addition to the traditional bibliographic research around the doctrine developed on the subject, a more in-depth analysis of the two paradigmatic cases that served as the basis for the development of the South African institute, Olivia Road and Joe Slovo, was carried out. Results: It is concluded that are intrinsic and extrinsic reasons for seeking inspiration in the Meaningful Engagement model. The South African model, by valuing institutional dialogue and public participation, mitigates the usual criticisms to structural litigation. Contributions: From the results, it is observed that: a) in dialogic structural remedies, affected communities are treated with dignity and can influence the formulation of public policies that concern them.; b) public participation guarantees the structural injunctions transparency and, to the judges, greater technical capacity, since only with the inclusion of the social segments affected by the problem that is intended to be overcome will the judge be able to produce measures consistent with the real needs the concrete case; c) finally, public participation and institutional dialogue also collaborate to mitigate the criticisms usually made of structural processes.

Migrants with dementia living in residential care may be at risk of disengagement. To synthesize research relating to the meaningful engagement of migrants with dementia who are living in residential care. Mixed studies systematic review following PRISMA guidelines. Nine electronic databases were searched for relevant studies. Studies were eligible for inclusion if they reported original research relating to meaningful engagement of migrants with dementia living in residential aged care and were published in English. Two independent reviewers screened the title and abstracts, full texts of eligible studies and conducted a quality appraisal of included texts. A convergent qualitative synthesis approach was used. From 1460 articles, 14 papers representing 12 studies were included. Facilitators of meaningful engagement included: the presence of cultural artefacts in the care environment, the use of multimodal communication and a shared but flexible understanding of residents' culture. Barriers were the absence of a common language and a task-orientated approach to care. Migrants with dementia who are living in residential care are at increased risk of disengagement. Our review highlights the need for culturally congruent residential care to go beyond issues of language and to consider how occupations can be tailored to support ongoing participation and engagement. [ABSTRACT FROM AUTHOR]

Objectives: Meaningful connections promote the quality of life of people living with advanced dementia in nursing homes. However, evidence internationally suggests people living with advanced dementia in nursing homes spend the majority of time alone, with little contact with anyone. Frontline care workers are in powerful positions to meaningfully engage with residents, yet research to date has not focused on their experiences. The aim of this study was to explore the experiences of nursing home staff, specifically, what care workers feel enables them to meaningfully engage with residents living with advanced dementia.Methods/design: Semi-structured interviews were conducted with 21 staff from seven nursing homes. Inductive thematic analysis was used.Results: Four themes were important for facilitating care workers to meaningfully engage with residents with advanced dementia: support from managers and nurses, support from experienced care workers, a caring culture and an appropriate physical environment.Conclusion: Effective leadership was the key thread that ran throughout. It was evident that meaningfully engaging with residents with advanced dementia was hard, particularly for new or inexperienced care workers. Those with experience (of care work and the residents they cared for), as well as those in formal leadership positions played key roles in facilitating care workers to: perceive it was their role to connect, understand, accept and empathise with residents, understand the importance of getting to know residents' and express their own caring attributes. Future research should focus on empirically testing leadership models that promote meaningful engagement. [ABSTRACT FROM AUTHOR]

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Background: Internationally, person-centred care (PCC) is embedded in the language of regulations and mandated to be practised in residential aged care (RAC). Despite this, PCC has not been fully adopted in RAC in Australia and internationally, and concerns about the quality of care persist. Over the past 2 decades, Montessori for dementia and ageing has been introduced in RAC to support and inform a cultural change towards PCC. This study aimed to examine the intersection between the goals and approaches of Montessori and PCC in RAC., Methods: This qualitative descriptive study reports on a secondary analysis of qualitative data from focus groups (FGs) and interviews with residents, family-members, staff, and volunteers from eight RAC homes in Victoria, Australia. Sixteen FGs and 36 interviews were conducted. A qualitative deductive approach using researcher-developed Montessori for dementia and ageing framework for data analysis was applied., Results: Findings provide support for the intersection between PCC and Montessori with participants' descriptions of PCC aligning with many of the goals and approaches of Montessori. Participants most commonly described Montessori approaches of engagement in daily tasks with purposeful roles and promoting cognitive abilities through multi-sensory stimulation. Least frequently-described approaches included focusing on residents' strengths/abilities, maintaining function, using familiar objects, and guided repetition., Conclusions: Findings have important implications for practice to use Montessori as a vehicle that supports and upskills the workforce to deliver care that is person-centred. Future research must examine the resources required to support the implementation and sustainability of Montessori as a vehicle for PCC., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Digital mental health interventions, or digital therapeutics, have the potential to transform the field of mental health. They provide the opportunity for increased accessibility, reduced stigma, and daily integration with patient's lives. However, as the burgeoning field continues to expand, there is a growing concern regarding the level and type of engagement users have with these technologies. Unlike many traditional technology products that have optimized their user experience to maximize the amount of time users spend within the product, such engagement within a digital therapeutic is not sufficient if users are not experiencing an improvement in clinical outcomes. In fact, a primary challenge within digital therapeutics is user engagement. Digital therapeutics are only effective if users sufficiently engage with them and, we argue, only if users meaningfully engage with the product. Therefore, we propose a 4-step framework to assess meaningful engagement within digital therapeutics: (1) Define the measure of value (2) Operationalize meaningful engagement for your digital therapeutic (3) Implement solutions to increase meaningful engagement (4) Iteratively evaluate the solution's impact on meaningful engagement and clinical outcomes. We provide recommendations to the common challenges associated with each step. We specifically emphasize a cross-functional approach to assessing meaningful engagement and use an adolescent-focused example throughout to further highlight developmental considerations one should consider depending on their target users.

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Despite the growing interest in public and patient involvement in research, best practices in the leprosy context have yet to be explored. This mixed-method study aimed to explore the interpretation, barriers and opportunities of meaningful engagement of persons affected by leprosy in research through: (i) an exploratory phase consisting of key informant interviews with experts in public and patient involvement (n = 2) and experts-by-experience (i.e., persons affected by leprosy; n = 4), and (ii) an in-depth phase among leprosy researchers consisting of an online survey (n = 21) and key informant interviews (n = 7). Qualitative data were thematically analyzed. Basic descriptive statistics were used to summarize the survey data. Key informant interviewees unanimously agreed to the importance of engagement in research. Survey results indicated that the level of engagement differed across research stages. Identified barriers included a lack of skills for or awareness of engagement among both experts-by-experience and researchers, stigma and limited time and resources. Opportunities included capacity strengthening, creating a shared understanding, building rapport, and establishing a safe environment. In conclusion, this exploratory study emphasized the importance of engagement of experts-by-experience in leprosy research and identified ways forward that include, but are not limited to, the acknowledgement of its value and creating a shared understanding.

While governments in Canada have a duty to act honourably in the development of legislative actions that may affect Aboriginal or treaty rights, Indigenous peoples' input and knowledge have largely been excluded from the process. The Ontario provincial government recently sought to remedy this failure by engaging with Indigenous groups in the development and implementation of the Great Lakes Protection Act. Using qualitative data, this article explores the successes, challenges and lessons learned during Crown–Indigenous engagement in the development of this Act. The article concludes with recommendations on ways to strengthen processes of engagement between government and Indigenous groups. [ABSTRACT FROM AUTHOR]

Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; IQR = 33.4). The majority of studies evaluated interventions for the development of life skills (n = 9; 81.8%), and all were conducted in the USA. Several of the included studies were exploratory evaluation and feasibility studies, and all were quasi-experimental in design. Only three studies (27.2%) incorporated a control group. Intervention strategies included (1) integrated group and individual life skills interventions (n = 6); (2) group-based life skills interventions (n = 3); and (3) psychosocial and consultative interventions (n = 2). Research evaluating occupational therapy interventions aimed at supporting homeless individuals as they transition to housing is in an early stage of development. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Although South African courts have handed down progressive judgments concerning the right to access to adequate housing, they have failed failed to do so from a feminist point of view. The trajectory of housing jurisprudence emanated from a sequence of evictions that occurred in Cape Town and the Johannesburg inner city. This article provides an analysis of four pertinent cases, namely Grootboom, Olivia Road, Blue Moonlight and Dladla. A gendered perspective was absent from the arguments before the court and from the court's interrogation and analysis of matters that came before it. This failure was a shortcoming, given the harsh lived realities that affect women who experience eviction based on their race, gender and class. It is against the backdrop of the failures of Constitutional Court cases that lawyers use feminist litigation approaches and courts in housing adjudication. [ABSTRACT FROM AUTHOR]

Throughout her career, Rosalie Kane made a major impact in her efforts to improve quality of life for persons living in nursing homes. Near the end of her career, she suggested that it was time to "re-imagine long term care and to produce livable age-friendly nursing homes." This brief review focuses on the role of meaningful engagement and person-centered care as the next step in enhancing nursing home care. The importance of activities that strengthen cognitive and/or physical function is stressed, as well as improving socialization to reduce loneliness. [ABSTRACT FROM AUTHOR]

This paper describes a wise practice for collaborative change through the Trauma- Informed and Culturally Safe Emergency Care for Nuu-chah-nulth Elders project. For decades, Nuu-chah-nulth Elders have been avoiding emergency care due to colonial trauma and a lack of culturally safe care. To begin addressing this community priority, the First Nations Health Authority, in partnership with Island Health and university partners, organized a two-day workshop in September 2017 with Nuu-chah-nulth Elders, community members, and health partners. Key to ensuring the process was culturally sensitive was following the guidance of the West Coast General Hospital Cultural Safety Committee, a partnership between Nuu-chah-nulth people and health providers. Respect and trust were developed by centring the voices of Elders and giving them a safe space for discussion before developing recommendations with health partners. Feedback from participants was gathered from notes and audio recordings and thematically analyzed into eight major recommendations (i.e., increase engagement and relationship building; develop action plans; increase education and awareness; increase advocacy and support; incorporate First Nations medicine, healing, and foods; provide culturally safe spaces; develop policy and protocol; and link to comprehensive community support), with attention to preserving Elder voices. The recommendations were validated by returning and new participants at a gathering in June 2019. Elders noted that while experiences of unsafe care continue, noticeable improvements in cultural safety are being made and they feel heard. [ABSTRACT FROM AUTHOR]

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Background: Studies exploring the occupational experiences of homeless persons have grown in the past twenty years, and there is a need to identify, evaluate, and aggregate existing studies to direct future research. Objectives: To capture the scope and quality of literature exploring the occupational experiences of homeless persons in high-income countries, and to aggregate the findings of these studies to inform future research efforts. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal, and meta-aggregation of themes in existing qualitative literature. Results: Fifteen studies were included and were of high quality (Mdn = 8/10; IQR = 2). Meta-aggregation resulted in four themes (n = 335 participants) describing the occupational experiences of homeless persons: 1) Restrictions on time use and activity engagement; 2) Activity as a means of belonging; 3) Institutional processes as determining time use; and 4) Transcending the self through doing. Conclusions: Homeless persons in high-income countries face multiple challenges to engaging in meaningful activity, which we argue is a disabling experience. Simultaneously, homeless persons demonstrate resilience by finding ways to engage in activities of meaning, and opportunities to connect with others in the face of multiple barriers. Significance: Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Highlights: CBPR strategies for meaningful engagement in researchNeed to address health disparities experienced by Latinx immigrants through meaningful engagement in researchPopulations experiencing marginalization as co‐creators of knowledge Community psychologists have contributed significantly to the body of literature on community‐based participatory research (CBPR) and its application in understanding and addressing health and community participation disparities. At the core of CBPR are mutually beneficial partnerships with communities, whereby community members' voices are heard and they become co‐researchers, helping guide the research process. In this article, I argue that for community psychologists to change the landscape of community participation, health, and well‐being disparities experienced by many vulnerable populations who often face multiple forms of oppression, CBPR needs to be transformative and emancipatory. Stakeholders must be meaningfully involved as co‐creators of knowledge and promoters of social justice embracing a human rights agenda. Drawing from work conducted with Latinx immigrant families with youth who have disabilities, I propose the following strategies moving forward: promoting meaningful participation of community members as co‐creators of knowledge; promoting meaningful conversations that matter to communities; promoting civic engagement, activism, and advocacy; promoting an assets‐ and strengths‐based approach to research; and promoting culturally relevant interventions. Community psychologists have the opportunity to make significant contributions to addressing disparities when community residents' knowledge is valued and recognized. [ABSTRACT FROM AUTHOR]

Resource constraints and high staff turnover are perceived as substantial barriers to high quality residential aged care. Achieving relationship-focused, person-centered care (PCC) is an ongoing challenge. This paper reports on an international project that explored how residential care leadership understand meaningful engagement for residents with dementia from culturally and linguistically diverse (CALD) backgrounds. This paper critically appraises the process, and outcomes, of an adapted Delphi method. Participants were the residential care leadership (i.e. staff in supervisory capacity) from four international facilities. Participation in the Delphi process was limited even though surveys were designed to require minimal time for completion. No participants opted for the alternative option of being interviewed. Findings indicate that residential care leadership recognised the importance of meaningful engagement for residents from CALD backgrounds. Limitations of time, resources and policy infrastructure were cited as barriers to achieving PCC. These findings suggest that facility leadership understand the importance of PCC, but identify multiple barriers rather than enablers for delivering PCC. Alternative methods, such as collecting data in interactive sessions allowing real-time discussion should be initiated to more effectively engage residential care leaders for a collaborative approach to explore PCC practices. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Participation in meaningful activities has psychological, physical, social and cognitive benefits for older adults living in continuing care homes. The subjective experiences of the process of participation for cognitively competent older adults living in a continuing care home and how personal and environmental features influenced the process were explored. Methods: Using a constructivist grounded theory approach to collection and analysis in the tradition of Charmaz, data were gathered with observation and a series of in-depth, semi-structured interviews with nine older adults (aged ≥ 70 years). Results: Participants actively engaged in an individualized, activity-specific process of positioning themselves to make choices and enact core values through meaningful activities. Personal and environmental barriers to participation could sometimes be managed through this process, although at other times barriers resulted in activity loss. Discussion: These findings reinforce the importance of participation in the lives of older adults living in a continuing care home, and present a model of how participants were actively occupied in a continuous process of negotiating opportunities for meaningful activity engagement. Implications address possible ways to facilitate this process of participation by care partners. [ABSTRACT FROM AUTHOR]

Occupational therapists promote meaningful engagement in occupations and associated role continuity, and encourage agency and citizenship. A lack of engagement can be understood as occupational deprivation, alienation and marginalisation, which are concepts associated with occupational injustice. However, occupational injustices associated with collectives, such as residential aged care settings, receive little professional attention. This article encourages the occupational therapy profession to research and develop practice addressing occupational injustice within collectives, specifically in residential aged care settings. Proposed key considerations include environmental adaptations, creating occupational spaces and upskilling staff to promote citizenship, agency and self-determination for residents. [ABSTRACT FROM AUTHOR]

Introduction This study aimed to explore the experience of staff and residents of mental health residential care facilities, using iPads as a medium to engage in meaningful occupation. Method A mixed method was used, which combined descriptive quantitative and thematic qualitative analysis. The Pan Occupational Paradigm was used as a theoretical framework, to maintain an occupational perspective. Residents participated in semi-structured interviews, and staff completed surveys and participated in a focus group or individual interview. The responses were then coded and analysed for their description of ‘doing’, ‘being’, ‘becoming’ and ‘belonging’ experiences. Findings Analysis found that residents engaged in personally meaningful occupations with the iPads, often with staff facilitation. The study also found that staff and residents responded positively to the iPads, particularly regarding developing positive connections and opportunities for growth and mastery. However, barriers associated with resource availability (particularly hardware and infrastructure) were also identified. Conclusion The use of iPads in these facilities provided opportunities for residents to engage in meaningful occupation, and overcome the occupational limitations inherent in the service setting. iPad use also enabled residents to engage in the community outside the facility. [ABSTRACT FROM AUTHOR]

This article evaluates the meaningful engagement doctrine in the education rights jurisprudence of the Constitutional Court in the light of a set of normative principles developed by Susan Sturm for evaluating participatory public law remedies. It commences by identifying four principles for evaluating participatory remedies appropriate to South African constitutional law and jurisprudence. Thereafter the relevant jurisprudence is analysed and evaluated in the light of these principles. The article concludes by making proposals for the development of meaningful engagement as a participatory remedy in educational rights disputes. These proposals seek to ensure a better alignment between the meaningful engagement remedy and the four remedial principles identified.