The Choosing Healthcare Options by Involving Canada’s Elderly (CHOICE) Knowledge Synthesis Project

While patient and citizen engagement has been recognized as a crucial element in health care reform, limited attention has been paid to how best to engage seniors - the largest growing segment of the population and Canada’s greatest users of the health care system. To improve the system for this population, seniors and their families need to be engaged as active partners in health care research and planning, and in decision-making for their care.

The Choosing Healthcare Options by Involving Canada’s Elderly (CHOICE) project will address this issue by synthesizing current knowledge on patient, family, and caregiver engagement to develop best practice guidelines and recommendations for engagement older patients and their families and caregivers in health care research, planning, and clinical decision making. Through a realist synthesis we will learn from other patient and citizen engagement initiatives, from previous research, and most importantly, from seniors, families and caregivers themselves.

Study approach

Phase 1. Clarify scope

In realist synthesis, this stage involves in-depth discussion with stakeholders and the commissioners of the review (TVN) to refine the review question and purposes of the review, and to find and articulate
relevant theories. This will also involve some initial searching to identify
candidate theories and frameworks.

Phase 2. Search for evidence

Extensive, purposive search of peer-reviewed and grey literature

Phase 3. Appraise primary studies and extract data

Extract data from studies using judgment and customized abstraction forms. Assess findings for relevance and rigour.

Phase 4. Synthesize evidence and draw conclusions

Synthesize findings to refine theory in light of evidence

Phase 5. Disseminate, implement and evaluate

Engage stakeholders to review findings, and to develop guidelines and
recommendations for engagement strategies to be used for varying
purposes and contexts.