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Background: The scale-up of evidence-based innovations is required to reduce waste and inequities in health and social services (HSS). However, it often tends to be a top-down process initiated by policy-makers, and the values of the intended beneficiaries are forgotten. Involving multiple stakeholders including patients and the public in the scaling-up process is thus essential but highly complex. We propose to identify relevant strategies for meaningfully and equitably involving patients and the public in the science and practice of scaling up in HSS.
Methods: Design: We will adapt our overall method from the RAND Appropriateness Method. Following this, we will perform a two-component study design (knowledge synthesis and Delphi study) grounded in an integrated knowledge translation (iKT) approach. This approach involves extensive participation of a network of stakeholders interested in patient and public involvement (PPI) in scaling up and a multidisciplinary steering committee. Knowledge synthesis: We will conduct a systematic scoping review following the methodology recommended in the Joanna Briggs Institute Reviewers Manual. We will use the following eligibility criteria: 1) Participants - any stakeholder involved in creating or testing a strategy for PPI; 2) Intervention - any PPI strategy proposed for scaling-up initiatives; 3) Comparator - no restriction; 4) Outcomes: any process or outcome metrics related to PPI; and 5) Setting - HSS. We will search electronic databases (e.g., MEDLINE, Embase, Sociological Abstract), hand searching relevant websites, screen the reference lists of included records, and consult experts in the field. Two reviewers will independently select and extract eligible studies. We will summarize data quantitatively and qualitatively and report results using the PRISMA extension guidelines. Delphi study: We will conduct an online Delphi survey to achieve consensus on the relevant strategies for PPI in scaling-up initiatives in HSS. Participants will include stakeholders from low-, middle-, and high-income countries. We anticipate that three rounds will allow an acceptable degree of agreement on research priorities.
Discussion: Our findings will advance understanding of how to meaningfully and equitably involve patients and the public in scaling-up initiatives for sustainable HSS.