To assess the effects of consumer engagement in health care policy, research and services. We updated a review published in 2006 and 2009 and revised the previous search strategies for key databases (The Cochrane Central Register of Controlled Trials; MEDLINE; EMBASE; PsycINFO; CINAHL; Web of Science) up to February 2020. Selection criteria included randomised controlled trials assessing consumer engagement in developing health care policy, research, or health services. The International Association for Public Participation, Spectrum of Public Participation was used to identify, describe, compare and analyse consumer engagement. Outcome measures were effects on people; effects on the policy/research/health care services; or process outcomes. We included 23 randomised controlled trials with a moderate or high risk of bias, involving 136,265 participants. Most consumer engagement strategies adopted a consultative approach during the development phase of interventions, targeted to health services. Based on four large cluster-randomised controlled trials, there is evidence that consumer engagement in the development and delivery of health services to enhance the care of pregnant women results in a reduction in neonatal, but not maternal, mortality. From other trials, there is evidence that involving consumers in developing patient information material results in material that is more relevant, readable and understandable for patients, and can improve knowledge. Mixed effects are reported of consumer-engagement on the development and/or implementation of health professional training. There is some evidence that using consumer interviewers instead of staff in satisfaction surveys can have a small influence on the results. There is some evidence that consumers may have a role in identifying a broader range of health care priorities that are complementary to those from professionals. There is some evidence that consumer engagement in monitoring and evaluating health services may impact perceptions of patient safety or quality of life. There is growing evidence from randomised controlled trials of the effects of consumer engagement on the relevance and positive outcomes of health policy, research and services. Health care consumers, providers, researchers and funders should continue to employ evidence-informed consumer engagement in their jurisdictions, with embedded evaluation. Systematic review registration: PROSPERO CRD42018102595.

This review aimed to investigate the effectiveness of nurse-led interventions versus usual care on hypertension management, lifestyle behaviour, and patients’ knowledge of hypertension and associated risk factors. A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), Emcare (Ovid), CINAHL (EBSCO), Cochrane library and ProQuest (Ovid) were searched from inception to 15^th of February 2022. Randomised controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, and full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. A total of 37 RCTs and 9,731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (Mean difference -4.66; 95% CI -6.69, -2.64; I²= 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (Mean difference -1.91; 95% CI -3.06, -0.76; I² = 79.35; 29 RCTs; low certainty evidence) compared to usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. This review revealed beneficial effects of nurse-led interventions in hypertension management compared to usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. CRD42021274900

Objective: To introduce, describe, and demonstrate the emergence and testing of an evaluation method that combines different logics for co-designing, measuring, and optimizing innovations and solutions within complex adaptive health systems.Method: We describe the development and preliminary testing of a framework to evaluate new ways of using and implementing knowledge (innovations) and technological solutions to solve problems via co-design methods and measurable approaches such as data science. The framework is called PROLIFERATE; it is initially located within the ecological logic: complexity science, by investigating the evolving and emergent properties of systems, but also embraces the mechanistic logic of implementation science (IS) (i.e., getting evidence-based interventions into practice); and the social logic, as the study of individuals, groups, and organizations. Integral to this logic mixture is measuring person-centered parameters (i.e., comprehension, emotional responses, barriers, motivations, and optimization strategies) concerning any evaluated matter across the micro, meso, and macro levels of systems. We embrace the principles of Nilsen's taxonomy to demonstrate its adaptability by comparing and encompassing the normalization process theory, the 2 × 2 conceptual map of influence on behaviors, and PROLIFERATE.Results: Snapshots of ongoing research in different healthcare settings within Australia are offered to demonstrate how PROLIFERATE can be used for co-designing innovations, tracking their optimization process, and evaluating their impacts. The exemplification involves the evaluation of Health2Go (the design and implementation of an innovative procedure: interdisciplinary learning within an allied health service—community-based) and RAPIDx_AI (an artificial intelligence randomized clinical trial being tested to improve the cardiac care of patients within emergency departments—tertiary care).Conclusion: PROLIFERATE is one of the first frameworks to combine ecological, mechanistic, and social logic models to co-design, track, and evaluate complex interventions while operationalizing an innovative complexity science approach: the knowledge translation complexity network model (KT-cnm). It adds a novel perspective to the importance of stakeholders’ agency in the system by considering their sociodemographic characteristics and experiences within different healthcare settings (e.g., procedural innovations such as “interdisciplinary learning” for Health2Go, and tech-enabled solutions such as RAPIDx_AI). Its structured facilitation processes engage stakeholders in dynamic and productive ways while measuring and optimizing innovation within the complexities of health systems.

Background: Transdisciplinary research and knowledge translation are increasingly regarded as key concepts underpinning applied research across the health and social sciences, due to their presumed potential in addressing complex, “wicked” problems and improving the use of research in practice and policy, respectively. Despite sharing an impact mandate, the relationship between transdisciplinary research collaboration and knowledge translation remains unclear. In response, we examined the relationship between transdisciplinary collaboration and knowledge translation to generate these understandings with a view towards maximizing the impact of collaborative efforts. Methods: We undertook a realist evaluation and longitudinal case study of a 5-year National Health and Medical Research Council-funded Centre of Research Excellence in Transdisciplinary Frailty Research. Data were collected between February 2017 and March 2020 over three rounds of theory development, refinement and testing using interviews, observation, document review and visual elicitation as data sources. The Human Research Ethics Committee of the University of Adelaide approved this study. Results: Iterative analysis of narrative interviews and visual data led to the development of three overarching programme theories explicating the reciprocal relationship between KT understandings and transdisciplinary team process. These programme theories revolve around the concept of a network, which we define in alignment with extant theoretical literature on network mechanisms and complex networks as graphically representable networks of agents/people (nodes) joined by social relationships (links). Our findings demonstrate that under the right contextual conditions, transdisciplinary team members respond through an improved ability to (1) navigate the network, (2) negotiate the network and (3) mobilize the network. Conclusions: This research demonstrates the reciprocity and mutually supportive relationship between transdisciplinary research and knowledge translation. Our findings suggest that embedding a collaborative knowledge translation framework and providing resources such as facilitation and distributed leadership within a transdisciplinary team can improve collaboration and support transdisciplinary research objectives.