Stakeholder engagement in a hypertension and diabetes prevention research program: Description and lessons learned

Abstract

Background Stakeholder engagement is important from the management point of view to capture knowledge, increase ownership, reduce conflict, encourage partnership, as well as to develop an ethical perspective that facilitates inclusive decision making and promotes equity. However, there is dearth of literature in the process of stakeholder engagement. The purpose of this paper is to describe the process of increasing stakeholder engagement and highlight the lessons learnt on stakeholder engagement while designing, implementing, and monitoring a study on diabetes and hypertension prevention in workplace settings in Nepal. Methodology We identified the stakeholders based on the 7P framework: Patients and public (clients), providers, payers, policy makers, product makers, principal investigators, and purchasers. The identified stakeholders were engaged in prioritization of the research questions, planning data collection, designing, implementing, and monitoring the intervention. Stakeholders were engaged through focus group discussions, in-depth interviews, participatory workshops, individual consultation, information sessions and representation in study team and implementation committees. Results The views of the stakeholders were synthesized in each step of the research process, from designing to interpreting the results. Stakeholder engagement helped to shape the methods and plan, and process for participant’s recruitment and data collection. In addition, it enhanced adherence to intervention, mutual learning, and smooth intervention adoption. The major challenges were the time-consuming nature of the process, language barriers, and the differences in health and food beliefs between researchers and stakeholders. Conclusion It was possible to engage and benefit from stakeholder’s engagement on the design, implementation and monitoring of a workplace-based hypertension and diabetes management research program in Nepal.

Bridging research-policy gaps: An integrated approach

“…[12][13][14][15] In Nepal, this collaboration was meaningful in the hypertension and diabetes prevention research program. 16 Fostering bridges between researchers and policymakers enhances understanding and knowledge. 17 Trust is crucial for building respectful relationships, enabling effective collaboration, and connecting relevant evidence to policymakers.…”

Implementation Research in Nepal – A Scoping Review, 2015-2022

“…Two described or guided the process of translating research into practice 9,34 These articles reported identification, process, and outcome of stakeholder engagement. 9,34 Twelve research were conducted to understand what influenced implementation.…”

“…Two described or guided the process of translating research into practice 9,34 These articles reported identification, process, and outcome of stakeholder engagement. 9,34 Twelve research were conducted to understand what influenced implementation. [18][19][20][22][23][24][25][26][27][28]31,37 However, many of these articles are not specific to an EBP or implementation strategies.…”

“…20 Others explored facilitators and barriers to implementing health interventions or implementation strategies. 18,19,28,31 Five studies have not reported any theory or frameworks; 15,17,19,20,31 three reported using Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM); 29,30,33 Six have used health system building blocks framework; [22][23][24][25][26][27] one used Consolidated Framework for Implementation Research (CFIR); 38 one used performance of routine information system framework; 14 one used participatory implementation research; 16 Emerald capacity building activities; 35 two used Ray and Miller stakeholder engagement framework; 9,34 and one use health system assessment approach. 37 Most of the research was funded by the European Union, National Institute of Health USA, United States Agency for International Development (USAID), Medical Research Council UK, or the WHO; four did not report funding sources; and one stated that there was no funding (Table 2).…”

Stakeholder’s perspectives on acceptable interventions for promoting hypertension medication adherence in Namibia: nominal group technique

“…Non-adherence to chronic medication is a complex issue that affects clinical outcomes,4 health expenditure and the health system’s operation 5 6. Several implementation research studies have revealed that it is imperative to involve the relevant stakeholders to recommend interventions effectively and agree on long-term decisions to improve patient compliance 7–9…”