Service and digital transitions create a range of solutions by combining their features and introducing both human and automated agents as intermediaries. The paper classifies non/digital product/service and explores how these transitions change user involvement. A model is proposed to assess the user's role with human (service) and automated (digital) intermediaries. Utilizing user journey phases, the model is applied to four case studies, revealing commonalities in transition occurrences. Evidence suggest a potential adoption in design identifying the key phases per each transitions.

Large organisations are designing complex technology-based tools for their staff to use. In busy workplace environments, it can be difficult to get user input about a design. This paper describes the designer and user interactions in one such organisation, gaining insights that could be useful in other similar settings. The findings are based on a set of interviews with designers and researchers within the organisation. The paper identifies the current practices and constraints involved in understanding and capturing users' needs and discusses potential solutions.

To increase access to support, an online psychosocial support tool for adults with visible differences was adapted for use without referral or supervision. This intervention combines a cognitive behavioural and social skills model of support. This study aimed to assess the usability and acceptability of Face IT@home as a self-help intervention. Eighty-one participants were recruited (32 with visible differences). Stage 1 included 14 participants (11 female, all with visible differences) who viewed two sessions of Face IT@home and undertook a semi-structured telephone interview. Stage 2 consisted of 14 think-aloud sessions (13 female, none with visible differences) with participants, supervised by researchers. Stage 3 employed 53 participants (47 female; 19 with visible differences), to view one session of Face IT@home and complete an online survey to evaluate usability and acceptability. User interviews, think-aloud studies and questionnaires identified usability and acceptability factors of Face IT@home that make it fit for purpose as a self-help tool. Participants suggested some changes to the Face IT@home program to improve usability. Participants reported that Face IT@home was a useful tool for people with visible differences and could be effective. The CBT-based model was considered a useful approach to addressing psychosocial concerns. The online self-help format will increase access to psychological support for adults with visible differences.

User involvement is increasingly common in health-care research, and the ideal is user participation and influence during all research stages. Here we describe and reflect on the processes and outcomes associated with advisory group–researcher collaboration from a person-centred perspective. When planning a study in which older adults’ experiences of reablement were investigated, older adults with previous first-hand experience of reablement participated in an advisory group. We found that the fostering of healthful relationships, in which experiential and research knowledge are considered complimentary and equitable, and all members have the power to exercise their unique roles, seems to be a prerequisite for the co-creation of knowledge. Also, practical arrangements and social relationships constitute important details that are crucial to ensuring contribution from older adults with health-related conditions. While such individuals may be unable to participate during all stages of a research project, their involvement on an advisory level during the initial stages can increase study quality and relevance. Input from the advisory group members contributed to the improvement of the language in the study information sheet, improvement of the study design, development and validation of the interview guide, and insight into how the interviews should be conducted. The personal knowledge and expertise of the advisory group members, which emanated from their immediate sensitivity, contributed to the person-centredness in the study.

Whenever there are well-publicised pressures on acute care, there is a tendency for policy makers and the media to imply that a significant number of older people may be taking up hospital beds when they do not really need the services provided there. However, evidence to back up such claims is often lacking, and existing research tends to fail to engage meaningfully with older people themselves. In contrast, this research explores the emergency hospital admissions of older people in three English case study sites, drawing on the lived experience of older people and the practice wisdom of front-line staff to explore the appropriateness of each admission and scope for alternatives to hospital. Contrary to popular opinion, the study did not find evidence of large numbers of older people being admitted to hospital inappropriately. Indeed, some of the older people concerned delayed seeking help and only ended up at hospital as a very last resort, possibly due to concerns about being seen as a burden on scarce public resources. While older people and front-line staff identified a number of suggestions to improve services in future, there seemed few clear cut, easy answers to the longstanding dilemma of how best to reduce emergency admissions. Seeking to understand and potentially reduce emergency hospital admissions is complex, and it is important to consider the experiences and expertise of older people and front-line staff.

Objectives: The aim of this study was to explore stakeholders’ points of views regarding the applicability and relevance of a framework for user involvement in health technology assessment (HTA) at the local level. We tested this framework in the context of the assessment of alternative measures to restraint and seclusion among hospitalized adults and those living in long-term-care facilities.

Methods: Twenty stakeholders (health managers, user representatives, and clinicians) from seven regions of Quebec participated in a semi-structured interview. A thematic analysis of the transcribed interviews was performed.

Results: The findings highlighted the relevance and applicability of the framework to this specific HTA. According to interviewees, direct participation of users in the HTA process allows them to be part of the decision-making process. User consultation makes it possible to consider the views of a wide variety of people, such as marginalized and vulnerable groups, who do not necessarily meet the requirements for participating in HTA committees. However, some user representatives emphasized that user consultation should be integrated into a more holistic and participatory perspective. The most frequent barrier associated with user involvement in HTA was the top-down health system, which takes little account of the user's perspective.

Conclusions: The proposed framework was seen as a reference tool for making practitioners and health managers aware of the different mechanisms of user involvement in HTA and providing a structured way to classify and describe strategies. However, there is a need for more concrete instruments to guide practice and support decision making on specific strategies for user involvement in HTA at the local level.

In recent years there has been a distinguishable trend towards user involvement in ageing research. Researchers and policy makers both are increasingly convinced that user involvement is necessary to adapt research questions and methods to meet the needs of older people. Little is known, however, about the quality of collaborations between older people and researchers. This study systematically evaluates a collaboration undertaken between two academic researchers and three older people acting as co-researchers in an effort to identify the conditions required for equal collaboration. To evaluate the collaboration the co-researchers and academic researchers took part in individual in-depth interviews (after six months) and two reflection meetings (after six and 12 months). Throughout the collaboration, field notes were taken by both academic researchers and co-researchers. A detailed description of the collaboration is provided here, using the metaphor of a journey to illustrate the dynamics and the learning process of the participants. Interim reflection meetings – at which mutual expectations were expressed along with a frank discussion of prejudices, tasks and role divisions, and the sharing of personal and project-related needs and information – were found to be fruitful in achieving a positive working relationship and fostering an effective collaboration. We conclude that a learning perspective on participation can be a resource for learning and adaptive change.

This article reviews the consultation process during the development of a local dementia strategy. The processes of involvement by the range of stakeholders involved and how their different views shaped the strategy are considered. Particular attention is paid to the involvement of people with dementia as they are the recipients of the services to be shaped by the strategy and also form the group most difficult to reach. This article demonstrates the value of including a wide range of stakeholders in the development of local policy and the importance of involving people with dementia in policy development.

Service user involvement in the planning and provision of mental health services has been growing over the last two decades, especially in countries and areas where institutional service provision has been changed to a community-orientated model of care. However, the material involvement of service users in mental health research is still in its infancy. The aim of this paper is to attempt to place these developments in a conceptual context, to summarise the ethics-based and evidence-based reasons why it has to be considered as necessary, and to illustrate some of the emerging evidence which shows the advantages to be gained from it. In particular the results of recent studies are briefly reported, showing that outcomes data rated by service users in some cases are more important than those rated by staff. The reduction in patient-rated unmet needs in the social domain was the strongest predictor of an increase in subjective quality of life. The importance of including service user preferences within the content of the research questions is exemplified by the results of a recent study that showed that joint crisis plans can significantly reduce the use of compulsory admission during crises and by a review that demonstrated that the use of an explicit service user perspective produced distinctive insights into the long-term effects of Electro-Convulsive Therapy (ECT).

Declaration of Interest: none.

Aims – Best practice emphasises user involvement. This exploratory study addresses the views of teenage clients and their parents on service delivery in a specialist Child and Adolescent Mental Health Service (CAMHS) serving a population of 250,000. It aims to explore some of the complexities inherent in children's services when parents are integral to modes of treatment. Methods — Twenty-seven teenage clients from specialist CAMHS were recruited with their parents (n=30). All were white British, 11 boys and 16 girls, from a range of socioeconomic backgrounds. Focus groups were employed using a series of structured interactive technique to elicit information, preceded by home visits. Analysis of interview data followed standard approaches to qualitative data analysis. Descriptive statistics were generated from both home interview data and focus groups. Results – Three themes emerged: the core values implicated in establishing a therapeutic alliance; the style of therapy and mode of practice (i.e. its inclusiveness of different family members). Practice implications – Core therapeutic skills are of fundamental importance. Our paper supplements a model of organisational user involvement with a model of therapeutic user involvement for use in negotiating mode of practice. Conclusions – This exploratory study was a collaboration between service users, researchers and health professionals exploring three important themes of therapy and the complexities inherent in children's services. The process of eliciting views was therapeutic in itself leading to the formation of a parent-led self-help group. The design can be replicated in other specialist CAMHS to achieve attuned practice.

Declaration of Interest: none.

Objectives: The aim of this study was to suggest an acceptable and generic theoretical framework for involving various types of users in the medical device technology (MDT) development process (MDTDP).

Methods: The authors propose a theoretical framework suggesting different routes, methods and stages through which various types of medical device users can be involved in the MDTDP.

Results: The suggested framework comprises two streams of users’ involvement in MDT development, that is, what might be called the end users’ stream and the professional users’ stream for involving these two groups respectively in the process of developing both simple and more complex and innovative medical devices from conceptualization through to the market deployment. This framework suggests various methods that can be used for users’ involvement at different stages of the MDT lifecycle. To illustrate the application of the framework, several MDT development scenarios and device exemplars are presented.

Conclusions: Development of medical devices from users’ perspectives requires not only the involvement of healthcare professionals but also that of the ultimate end users, that is, patients, people with disabilities and/or special needs, and their caregivers. The evidence shows that such end users quickly discard devices that do not fulfill their personal expectations, even though both manufacturers and healthcare professionals may consider those end users’ requirements met. Developers and manufacturers need to recognize this potent potential discrepancy between the parties involved, and involve end users and professional healthcare staff directly in the MDTDP. The framework, the authors contend, is a step forward in helping medical device manufacturers plan and make decisions about users’ involvement at different stages of the MDTDP.

Objectives: This study investigated the benefits of and barriers to user involvement in medical device technology development and evaluation.

Methods: A structured review of published literature in peer-reviewed journals was conducted.

Results: This literature review revealed that the main benefits of user involvement were an increased access to user needs, experiences, and ideas; improvements in medical device designs and user interfaces; and an increase in the functionality, usability, and quality of the devices. On the other hand, resource issues, particularly those of time and money were found the key impediments to involving users in the development and evaluation of medical device technologies. This study also has categorized both the benefits of and barriers to user involvement.

Conclusions: The involvement of users in medical device technology development and evaluation requires resources, which are limited; however, this involvement is essential from both users and manufacturers perspectives.

Opportunities for older people to take part in decision making about public policies and services are expanding in the United Kingdom and elsewhere. This paper considers the potential of older people's participation in policy processes for both transforming the policy process and for achieving socially just outcomes. It argues that the way in which such participation takes place, in particular the nature of the deliberative processes, affects both who will feel able to take part and the capacity to develop new policy discourses which can challenge official perspectives and assumptions. It draws from critical perspectives on deliberative democracy to provide a theoretical framework. This work emphasises the importance of story telling and forms of exchange designed to offer recognition to others, as well as the rational argument more usually associated with deliberation on matters of public policy. The argument is illustrated with examples of participation initiatives that have involved ‘active’ older people and those who are users of social care services. Different styles and processes of exchange are distinguished in the three case studies. In one, active facilitation enables individual stories of ageing and of service use to be woven into collective narratives that offer an alternative vision of care services. In another, a strong emphasis on ‘greeting’ enables conflicting views to be expressed without participants falling out. In the third, styles of exchange familiar in formal debate limit the development of an alternative discourse. The conclusion suggests that attention needs to be given to the process of participation as well as to outcomes.

The extension of user involvement in different aspects of service delivery in health and social care has been a central element of care in the community policy. Purchasers and providers of such services for older people have been exploring ways of tailoring services to meet individual need and ensure that the quality of the service reflects user preference rather than service-provider requirements. This article describes a project involving residents from a random proportionate sample of nursing homes and residential homes for older people in the City of Manchester. The project was designed to bring user views about quality into the service contract specification for the purchase of residential and nursing home care. The process and the outcomes are described. Factors which appear to promote the movement of user involvement into the mainstream of service specification and service development are identified. The role of small-scale initiatives is discussed.