Explore the vast range of titles available.

BackgroundPatient engagement is the active collaboration between patient partners and health system partners towards a goal of making decisions that centre patient needs—thus improving experiences of care, and overall effectiveness of health services in alignment with the Quintuple Aim. An important but challenging aspect of patient engagement is including diverse perspectives particularly those experiencing health inequities. When such populations are excluded from decision-making in health policy, practice and research, we risk creating a healthcare ecosystem that reinforces structural marginalisation and perpetuates health inequities.ApproachDespite the growing body of literature on knowledge coproduction, few have addressed the role of power relations in patient engagement and offered actionable steps for engaging diverse patients in an inclusive way with a goal of improving health equity. To fill this knowledge gap, we draw on theoretical concepts of power, our own experience codesigning a novel model of patient engagement that is equity promoting, Equity Mobilizing Partnerships in Community, and extensive experience as patient partners engaged across the healthcare ecosystem. We introduce readers to a new conceptual tool, the Power Wheel, that can be used to analyse the interspersion of power in the places and spaces of patient engagement.ConclusionAs a tool for ongoing praxis (reflection +action), the Power Wheel can be used to report, reflect and resolve power asymmetries in patient-partnered projects, thereby increasing transparency and illuminating opportunities for equitable transformation and social inclusion so that health services can meet the needs and priorities of all people.

Introduction Health Equity Assessments (HEAs) are decision‐support frameworks or tools used to evaluate the equity impacts of policies, programmes and initiatives. However, HEAs are often conducted without meaningful engagement from the individuals and communities most affected by health inequities. This lack of social participation limits the relevance and effectiveness of HEAs, leaving systemic inequities unaddressed and opportunities for impactful change unrealized. An alternative is to involve people with diverse lived/living experiences in conducting and offering HEAs—so that people most impacted, and most excluded by decision‐making can offer recommendations to improve the way they access and utilise care. Methods Equity Mobilizing Partnerships in Community (EMPaCT) is a scalable, participatory citizen engagement model that integrates lived/living experiences into the HEA process. EMPaCT's Five Steps to a Community‐Engaged Health Equity Assessment (CEn‐HEA) was co‐designed with community members typically excluded from decision‐making. This process fosters psychological safety, trust‐building, and power‐sharing between underserved communities and decision‐makers. The CEn‐HEA systematically analyzes inequities across downstream (individual), midstream (community), and upstream (structural) levels to generate actionable, equity‐focused recommendations. Results The EMPaCT CEn‐HEA framework produces context‐specific recommendations that address immediate project needs while advancing long‐term, systemic change. The framework is a participatory process that centres community voices, builds trust, amplifies lived/living expertise, and fosters equity‐driven decision‐making that can lead to measurable improvements in healthcare policies, programmes, and practices. Conclusion In this paper, we examine the challenges and opportunities associated HEAs; introduce EMPaCT's CEn‐HEA framework as a co‐designed, innovative, and community‐engaged approach to health equity analysis; and discuss methods for measuring and evaluating the health equity impacts of these efforts. Patient or Public Contribution Patient and community involvement were central to the design, development and implementation of this project and resulting manuscript. Equity Mobilizing Partnerships in Community (EMPaCT), including its Community‐Engaged Health Equity Assessment (CEn‐HEA) framework, was co‐created with diverse patient partners who have lived/living experiences of health inequities. In the preparation of this manuscript, patient partners were involved in codesign sessions to define the focus, structure and language of the manuscript. They collaborated in discussions to refine key concepts, articulate challenges and highlight solutions that are grounded in their lived realities. In the preparation of this manuscript, patient partners reviewed early drafts, contributed feedback to ensure accessibility and relevance of the content and shaped the actionable recommendations. This manuscript reflects EMPaCT's commitment to justice, inclusion and meaningful change.

An increase in eating disorder hospitalizations was observed amongst Canadian adolescents during COVID-19 public health restrictions. To help understand why this may have occurred, youth with lived experience of an eating disorder share their interpretations of these findings. This article, written by youth patient partners, provides insights into how unpredictable changes to daily routines and health system challenges during the COVID-19 pandemic might have influenced eating disorder hospitalizations. The increase in hospitalizations during the pandemic, combined with our lived experience advisory, underscores gaps in current approaches to supporting young people with eating disorders. We provide suggestions for clinicians, researchers, and policymakers stemming from our patient experiences in hopes that equitable, accessible, and patient-centered support can be prioritized to improve eating disorder-related care. This collaboration establishes a precedent for incorporating the voices of youth patient partners to better translate and mobilize research. These reflections serve as an example of how youth patient partner involvement can inspire future research, healthcare, and policy to advance care for those impacted by eating disorders.

Background: How can healthcare organizations create the conditions for patients and care partners (family and friends who provide support to patients) to feel safe voicing or speaking up about their care preferences and concerns while receiving care? While health systems globally increasingly recognize the critical value of feedback and information shared by patients and care partners during care episodes; patients and care partners often hesitate to speak up or voice their suggestions and concerns – for fear of being labelled “difficult” or creating negative outcomes. When patients and care partners do not feel safe voicing, how can patients, care partners, and healthcare professionals work collaboratively to ensure patients receive care that aligns with their personal values, needs, and preferences? In this presentation, we draw from the management literature on voicing in organizational settings to unpack reasons why patients and care partners are often reluctant to voice their feedback and concerns. Methods: A systematic narrative synthesis was conducted of the health sciences literature in the form of a conceptual framework for how patient/care partner voicing in support of person-centered care can be supported in hospital settings through organizational behaviours and contextual factors (e.g., culture, climate, and tacit rules). We systematically searched three bibliographic databases for studies with qualitative data collection that sufficiently describe supportive organizational behaviours and contextual factors. Our study team includes two patient and caregiver advisors (Isra Amsdr and John Easton) – individuals with lived experience of the healthcare system who engaged in data sessions to validate preliminary findings from the narrative synthesis and collaborated to refine the components of the voicing framework. Results: This framework delineates the individual, interpersonal, functional roles, and contextual factors that support voicing – and the interactions between each of these components. Emerging insights include the need for an organizational climate that is supportive of patient and care partner voicing (e.g., creates psychological safety, where voicing feels welcomed); the creation of deliberate spaces where patient/care partner voicing is invited (e.g., family conferences, feedback box); and professionals tasked with eliciting patient/care partner voicing and translating between patient/care partner values, needs, and preferences and the healthcare system. Lessons learned: Meaningful collaboration between patients, care partners, and healthcare professionals is an important enabler of person-centered integrated care. However, person-centered care is difficult to implement across teams and organizations when patients and care partners do not openly communicate critical information. We discuss this framework’s broad applicability and relevance to various health and social care settings. In turn, we call for a turn to foundational behaviours and practices that build trust and shared understanding in therapeutic relationships. This presentation is intended to support health and social care practitioners engaged in collaborative care with patients and care partners, health services researchers, and importantly, the direct voicing activities of patients and care partners. Next steps: We will share how our team is further validating this framework through an empirical study and future dissemination plans for healthcare professional and patient/care partner audiences.