Capturing learning from public involvement with people experiencing homelessness to help shape new physiotherapy research: Utilizing a reflective model with an under‐served, vulnerable population

Abstract

Introduction People experiencing homelessness (PEH) have poorer health than housed people but face barriers accessing care and being involved in research. As an often‐ignored group, their contribution to help shape research that is for and about them is essential, as it can strengthen the research proposal, in turn facilitating research and outcomes that are relevant to this vulnerable group. Methods Six people with experience of homelessness attended a PPI consultation aided by Pathway, a UK homeless peer advocacy charity, which coordinates an ‘Experts by Experience’ group. We present reflections on conducting PPI with PEH that informed the development of a physiotherapy research proposal. Kolb's Experiential Learning Cycle guided reflections across four stages: (1) describing the PPI experience; (2) reviewing and reflecting on the PPI experience; (3) learning from the PPI experience; and (4) planning and trying out learning. Results Reflections highlighted the importance of: working closely with an advocacy organisation and leader to reach under‐served people; the diversity of experiences; using familiar venues, contingency and budget planning; flexibility and ‘allowing time; talking less; listening more’; planning for early and ongoing PPI, and the potential of mobile ‘one‐off’ PPI outreach models to reach vulnerable groups. Conclusion Kolb's Experiential Learning Cycle aided team reflection on feedback from PEH, which helped refine and strengthen a physiotherapy research proposal. The project was unfunded. However, a reflective model helped maximize learning and impact including for future PPI and research. The novel application of Kolb's Experiential Learning Cycle provided structure, facilitated reflection and enhanced individual and collective learning and may benefit capturing learning from PPI with other vulnerable populations. Patient or Public Contribution We highlight how a PPI consultation with people with experience of homelessness helped shape a funding proposal. Additionally, the reflections of the experts by experience team leader are included.

Disrupting patterns of exclusion in participatory spaces: Involving people from vulnerable populations

“…Second, what kind of methods are used in projects based on these partnerships? The papers report systematic reviews, 23–25 original research using qualitative, quantitative and mixed‐methods studies 26,29–31,34–37,39–42 and reflective practice 22 . This resonates with a key finding in the wider literature about meaningful partnerships 3,4 : collaborative research orientation is the core issue rather than the nature of the methods being used.…”

“…Usher and Denis 37 and Worsley et al 26 align their work with coproduction and Heerings et al 42 with experienced‐based codesign. Other authors do not make such formal alignment with any overarching approach but describe the use of methodologies that are drawn from, or resonate with, these approaches because they are designed to support dialogues and colearning between diverse stakeholders (e.g., Pillen et al 30 describes the use of qualitative deliberative democratic methods, while Dawes et al 22 describes the use of Kolb's reflective model).…”

“…It was clear that the enactment of partnerships in these papers was shaped by physical dimensions. Dawes et al 22 highlight the value of using venues that were familiar to participants to optimize their voice in the project work. There were multiple examples too of temporal dimensions shaping involvement.…”

“…First, we consider who is in spaces for sharing decisions about research, services and policy in this special issue. There are papers with lead authors from seven countries: the United Kingdom, [22][23][24][25][26][27][28] Australia, [29][30][31][32][33] Canada, [34][35][36][37][38] the United States, 39,40 the Netherlands, 41,42 France 43 and Ecuador. 44 There are important examples involving people who experience homelessness, 22,23,34 people who have disabilities, 26,41,42 people who live in socioeconomically disadvantaged circumstances 35,37 and people who are migrants and/or from ethnic minority groups.…”

“…There are papers with lead authors from seven countries: the United Kingdom, [22][23][24][25][26][27][28] Australia, [29][30][31][32][33] Canada, [34][35][36][37][38] the United States, 39,40 the Netherlands, 41,42 France 43 and Ecuador. 44 There are important examples involving people who experience homelessness, 22,23,34 people who have disabilities, 26,41,42 people who live in socioeconomically disadvantaged circumstances 35,37 and people who are migrants and/or from ethnic minority groups. 25,31,36 There are also papers involving people with diabetes who experience stigma because of their condition 30 and COVID vulnerable populations, such as those with genetic, undiagnosed and rare disorders.…”