CanEngage

Project description, aims, design and method

Culturally and linguistically diverse (CALD) consumers of cancer services are frequently exposed to healthcare-associated harm. Effectively engaging patients in their care is recognised internationally as a strategy to enhance patient safety. Many strategies have been developed to enhance patient engagement specifically in relation to their safety, which include questioning, challenging health professionals and encouraging patient reports of errors in their care. Existing strategies are often not suitable for CALD consumers but no strategies have been developed to date specifically for (and with) CALD consumers to enhance their safety. We aim to address this by co-designing patient engagement strategies to address safety issues for and in partnership with CALD cancer service consumers in New South Wales (NSW) and Victorian (VIC) cancer inpatient, outpatient and day procedure services.

Project aims

To enhance patient safety amongst CALD consumers in Australian cancer services through the development and validation of co-designed patient engagement practices.

Design and method

The research comprises a mixed method design and demonstrates a core value of consumer engagement. Our project synthesises document review, observational, interview and documentary data to gain an in-depth understanding of CALD consumers’ use of cancer services and more specifically, the patient safety threats and opportunities for enhanced engagement. We will then workshop initial findings with system and service stakeholders, including consumers and use this information to co-design strategies in six cancer services.

A co-design process which brings health professionals and consumers together to develop the project, along with bilingual fieldworkers, will lead to multiple patient engagement strategies for patient safety that are tailored to the diverse CALD populations within each service. We will also collect feasibility and efficacy data about the strategies.

A set of principles to guide the development of patient engagement strategies for patient safety for use with CALD consumers will also be developed for use nationally.

The outcome of this project is significant improvement in the way cancer services engage with CALD consumers with regard to their safety, thereby minimising healthcare-associated harm.

Project collaborators

External project members

Kathryn Joseph, Deakin University (Research Fellow)

Principal Investigators

Professor Merrilyn Walton, University of Sydney
Professor Elizabeth Manias, Deakin University
Professor Carlene Wilson, La Trobe University
Associate Professor Holly Seale, University of New South Wales
Professor Afaf Girgis, University of New South Wales
Doctor Allan Smith, Ingham Institute of Applied Medical Research,
Doctor Melvin Chin, Prince of Wales Hospital, SESLHD

Associate Investigators

Dr Desiree Leone
Dr Helen Crowther
Dr Meron Pitcher
Monika Latanik
Nyan Tieu

Collaborators

Canteen; Austin Health; Western Health; South-East Sydney LHD; South-West Sydney LHD; Western Sydney LHD

Resources

1. CanEngage Cancer Service Slides: This set of slides were co-designed with Arabic speaking consumers and cancer service staff. The slides aim to provide consumers with information about how to connect with cancer care co-ordinators and other support services for multicultural consumers in their health service.
2. Care My Way: This resource was co-designed with consumers and healthcare staff from range of settings to improve continuity of care between GPs and specialists. This patient-held resource helps multicultural people with cancer share personal information with their treatment team.
3. Making-it-Meaningful (MiM) Tool: The MiM is a co-designed medication management tool that can be used by cancer clinicians with multicultural consumers to share information about how to manage cancer medication, possible side effects and where to get help when needed. The tool aims to enhance consumer knowledge and self-efficacy in medication management at home and thus help deliver safer cancer care.
4. Audit for Consumer Engagement (ACE) Tool: This tool can be used by healthcare staff, consumers or consumer representatives. This tool can assist in identifying opportunities for consumers to engage in a healthcare setting by auditing a given physical space.
5. Providing review and feedback as a co-author – a guide for consumers: This resource provides guidance to consumers for how to review and comment on articles in which they may be a co-author. It includes a checklist to use when they are invited to contribute as a co-author on a research paper.
6. Visual summary of a national analysis about multicultural consumer engagement practices: This infographic provides a visual overview of the research conducted with cancer service and system stakeholders to see how people are involved in their cancer care and whether these methods work for culturally diverse people.

Publications

1. Chauhan, A, Newman, B, Manias, E, Joseph, K, Leone, D, Walpola, RL, Seale, H, Smith, AB & Harrison, R 2024, 'Creating safer cancer care with ethnic minority patients: a qualitative analysis of the experiences of cancer service staff', Health Expectations, vol. 27, no. 1, e13979, pp. 1-11. https://doi.org/10.1111/hex.13979
2. Chauhan, A., Walton, M., Manias, E. et al. The safety of health care for ethnic minority patients: a systematic review. Int J Equity Health. 19, 118 (2020). https://doi.org/10.1186/s12939-020-01223-2
3. Chauhan A, Walpola RL. Ensuring medication safety for consumers from ethnic minority backgrounds: The need to address unconscious bias within health systems. Int J Qual Health Care. 2021 Oct 29;33(4):mzab145. doi: 10.1093/intqhc/mzab145
4. Chauhan, A, Walpola, RL, Manias, E, et al. How do health services engage culturally and linguistically diverse consumers? An analysis of consumer engagement frameworks in Australia. Health Expect. 2021; 24: 1747- 1762. https://doi.org/10.1111/hex.13315
5. Newman, B, Joseph, K, Chauhan, A, et al. Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety. Health Expect. 2021; 24: 1905- 1923. https://doi.org/10.1111/hex.13343
6. Harrison R, Walton M, Manias E On behalf of the CanEngage Project group, et al Codesigning consumer engagement strategies with ethnic minority consumers in Australian cancer services: the CanEngage Project protocol. BMJ Open. 2021;11:e048389. doi: 10.1136/bmjopen-2020-048389
7. Chauhan, A., Leefe, J., Shé, É.N. et al. Optimising co-design with ethnic minority consumers. Int J Equity Health 20, 240 (2021). https://doi.org/10.1186/s12939-021-01579-z
8. Joseph K, Newman B, Manias E, Walpola R, Seale H, Walton M, Chauhan A, Li J, Harrison R. Engaging with ethnic minority consumers to improve safety in cancer services: A national stakeholder analysis. Patient Educ Couns. 2022 Aug;105(8):2778-2784. doi: 10.1016/j.pec.2022.04.014  
9. Nic Giolla Easpaig B, Ní Shé É, Chauhan A, Newman B, Joseph K, Tieu NT, Harrison R. Enabling the space and conditions for co-leadership in co-design: an evaluation of co-facilitator training for culturally and linguistically diverse consumers. Public Health Res Pract. 2022;32(2):e3222214.
10. Harrison, R, She, EN, Debono, D, Chauhan, A, Newman, B. Creating space for theory when codesigning healthcare interventions. J Eval Clin Pract. 2022; 1- 4. doi:10.1111/jep.13720
11. Harrison R, Ni She E, Debono D. Implementing and evaluating co-designed change in health. Journal of the Royal Society of Medicine. 2022;115(2):48-51. doi:10.1177/01410768211070206
12. Harrison Reema, Chin Melvin, Ni She Eidin (2022) What does co-design mean for Australia’s diverse clinical workforce?. Australian Health Review. 46, 60-61.
13. Ní Shé, É, Harrison, R. Mitigating unintended consequences of co-design in health care. Health Expect. 2021; 24: 1551– 1556. https://doi.org/10.1111/hex.13308
14. Chauhan A, Newman B, Roberto E, Walpola RL, Seale H, Chin M, Harrison R. ‘Making it Meaningful’: Co-designing an intervention to improve medication safety for people from culturally and linguistically diverse backgrounds accessing cancer services.. Patient Experience Journal. 2023; 10(2):34-48. doi: 10.35680/2372-0247.1732.  ‘Making it Meaningful’: Co-designing an intervention to improve medication safety for people from culturally and linguistically diverse backgrounds accessing cancer services. (pxjournal.org)
15. Harrison, R, Ní Shé, É, Debono, D, Chauhan, A, Newman, B. Creating space for theory when codesigning healthcare interventions. J Eval Clin Pract. 2023; 29: 572-575. doi:10.1111/jep.13720
16. Newman B, Chin M, Robinson L, Chauhan A, Manias E, Wilson C, Harrison R. Improving Medication Safety in Cancer Services for Ethnic Minority Consumers: Protocol for a Pilot Feasibility and Acceptability Study of a Co-Designed Consumer Engagement Intervention. JMIR Research Protocols. 10/08/2023:49902
17. Harrison, R, Newman, B, Chauhan, A and Sarwar, M. (2023), Employing co-facilitation to balance power and priorities during health service co-design.. Health Expectations. Accepted Author Manuscript. https://doi.org/10.1111/hex.13875

Associated Publications

1. Harrison, R, Walton, M., Chauhan, A. et al. What is the role of cultural competence in ethnic minority consumer engagement? An analysis in community healthcare. Int J Equity Health. 18, 191 (2019). https://doi.org/10.1186/s12939-019-1104-1
2. Harrison, R, Walton, M, Chitkara, U, et al. Beyond translation: Engaging with culturally and linguistically diverse consumers. Health Expect. 2020; 23: 159– 168. https://doi.org/10.1111/hex.12984