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8 September 2022

The ExCHANGE Collaboration: A realist evaluation of a collaborative model to support research co-production in long-term care settings in England

Chloe Place , University of Exeter , United Kingdom

Jo Day, University of Exeter
Kath Wilkinson, University of Exeter
Jo Thompson-Coon, University of Exeter
Vicki Goodwin, University of Exeter
Kristin Liabo, University of Exeter
Chris Marriott
Carol Abel
George Coxon, Devon Care Homes Collaborative
Geoffrey Cox, Devon Care Homes Collaborative

Abstract

Background: There are many gaps between the activities of professional researchers and the needs of people who work, live in, and care for others in care homes. We established the ExCHANGE Collaboration as an innovative way of bringing together researchers and care home stakeholders to improve mutual understanding of research and evidence-use in long-term care homes and to enable applied research that directly addressed the needs of all stakeholders.

Objectives: We conducted an internal, realist-informed evaluation of the collaboration to understand where and how the project had done well (and where it had struggled) in meeting its aims, as understood from the perspectives of all those involved.

Methods: From 2020 to 2022 we gathered data using qualitative methods including observations of events and activities; documentary analysis of risk and issues logs, a knowledge broker journal, and other relevant project delivery paperwork; and semi-structured interviews with care home providers, family members, and researchers. We used the Framework Method to analyse these data strategically, focusing on areas that would allow us to develop a theory of how the collaboration could have or did achieve change.

Results: We found the Collaboration developed the capacity of care home providers and family members to engage with, understand, and use research by developing collaborative, equitable relationships between researchers and care home stakeholders; supporting stakeholder participation in the running and decision-making of the project; and co-design and co-delivery of training workshops. To reduce inequalities between collaborators, all participants were financially compensated. The Collaboration has facilitated multi-directional knowledge flow with the support of a knowledge broker who acted as mediator between diverse stakeholders. It has also allowed identification of uncertainties on the part of care home stakeholders and translated these into answerable research questions. The reach and embeddedness of this collaboration was restricted due to impacts of the Covid-19 pandemic. By taking a flexible approach to project management, including the adaption of project activities into online formats, we ensured that the Collaboration could continue throughout the pandemic and enhanced its accessibility.

Conclusion: Our findings suggest academic-practice collaborations can provide an innovative, practice-focused model for supporting care homes to develop research capacity, mobilise knowledge, and identify research needs. This ultimately benefits the health and wellbeing of people working, living in and visiting long-term care homes. Further research in this area would increase practical and theoretical understandings of academic-practice collaborations in this field.


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