Cochrane’s new Thematic Groups: Person-Centred Care, Health Systems and Public Health
The concept of Cochrane’s new Thematic Groups was developed at a grass roots level by the Cochrane community in 2021. Throughout a year-long consultation process, the community shared the collective goal of giving Cochrane’s content and methods experts a central and significant place in our new production model. Last month, Cochrane announced the first of 20 new Thematic Groups designed to fulfil this key role.
‘Thematic Groups will provide vital subject knowledge and practical know-how to internal and external stakeholders, including guideline developers, government agencies, policy makers and disease associations,’ says Cochrane’s Editor in Chief, Karla Soares Weiser. ‘They will also ensure that our new Cochrane Evidence Synthesis Units and the Central Editorial Service have access to the right topic expertise that maps to key global challenges. Our new Thematic Groups represent a really significant positive step in Cochrane’s organizational transformation and focus on critical global challenges, now and into the future.’
In the first of a series on our new Thematic Groups, Rebecca Ryan and Simon Lewin share the origins and aims of Cochrane Person-Centred Care, Health Systems and Public Health.
Characterised by close collaboration and cross-disciplinary expertise, Cochrane’s new Person-Centred Care, Health Systems and Public Health Thematic Group is drawn from a mighty trio of Cochrane Review Groups - Cochrane Consumers and Communication (CCC), Cochrane Effective Practice and Organisation of Care (EPOC), and Cochrane Public Health (CPH).
Rebecca Ryan
Led by Rebecca Ryan (CCC, La Trobe University Australia), Luke Wolfenden (CPH, University of Newcastle, Australia), Simon Lewin (EPOC, Norwegian University of Science and Technology) and Sasha Shepperd (EPOC, University of Oxford), the new Group has its sights set on bringing quantitative, qualitative and mixed methods expertise to evidence applied across diverse clinical areas, populations and contexts. ‘We know the UN Sustainable Development Goals (SDGs) highlight the interconnectedness between health and public health systems and personal, social and environmental contexts,’ Rebecca Ryan explains. ‘But to date Cochrane hasn’t been well placed to engage with this cross-cutting agenda. Establishing this Thematic Group offers a really timely and promising opportunity to begin doing so. We are really looking forward to working together on this.’
‘With our longstanding shared interests in methods, topics and complex reviews, Cochrane CCC, EPOC and CPH have enjoyed the benefits of close collaboration for many years. We now want to enable Cochrane to take forward evidence syntheses that span these complex areas and contribute to the delivery of the SDGs and improvement of global health outcomes.’
‘Working more closely as a coordinated Thematic Group will enable cross-cutting priority topics to be identified, along with overlapping areas where research waste might be reduced. There will also be scope to explore effective and efficient ways of providing content input through new Evidence Synthesis Units and the Central Editorial Service. There are so many possibilities.’
Person-Centred Care
Person-centred approaches are a key part of ensuring that health and public health systems interventions, and their implementation strategies, meet the needs of patients, family members, carers and other stakeholders by identifying priority topics and outcomes that are mutually beneficial.
‘Person-centred approaches can lead to more sustainable and resilient services and systems that are better able to meet individual and community needs. They promote engagement, empowerment and equity and are increasingly recognised as necessary for safe, high-performing health systems,’ Rebecca says. ‘There are many examples of improvements where health and public health systems have adopted a person- centred approach. On the other hand, when health care organisation and delivery is less focused on people we know the outcomes can be dire – for example leading to antibiotic resistance due to poor prescribing , increased medication errors, fragmented care and risks to patient safety, increased maternal mortality, and inappropriate and unresponsive end of life care.’
Bringing together evidence on person-centred care and evidence from the fields of health and public health systems will contribute to ensuring that Cochrane evidence addresses these critical issues and meets the needs of diverse communities around the world.’
Health Systems and Public Health
The COVID-19 pandemic continues to highlight the urgent need for resilient health and public health systems that effectively engage people within and across communities. In response, the Person-Centred Care, Health Systems and Public Health Thematic Group will support the integration of evidence-based interventions into health and public health systems to improve outcomes for patients and communities globally. To do so, the Group will draw on a range of disciplines including health services research, behavioral and implementation sciences, stakeholder engagement and participatory methods, qualitative research, and quality improvement.
‘A health system includes the policies, organizations and activities that have the primary purpose of promoting, restoring or maintaining the health and wellbeing of individuals and the public,’ Rebecca explains. ‘They are complex structures spanning local, national and global contexts and involve a multiplicity of delivery platforms – so for example health facilities of all sorts, schools, communities and households - and an even wider range of service users and other stakeholders.’
‘We know interventions focused on health and public health systems can have substantial effects on peoples’ lives. We need high quality evidence to identify effective health or public health policies, programmes and services and maximise their benefits. We also need evidence-based strategies to support their implementation in feasible ways that meet the needs of consumers and key stakeholders.’
Global scope, focus on low- and middle-income countries (LMICs)
Simon Lewin - pictured here advemturing on the Norwegian Coast
Collectively, this new Thematic Group brings over two decades of substantial experience working with LMIC-based partners to identify priority topics, conduct syntheses, disseminate key findings and strengthen capacity.
‘We look forward to building on the strong representation of LMIC-based editors and other partners in the months and years ahead,’ says EPOC’s Simon Lewin. ‘For example, our group currently has five LMIC-based editors and associate editors. We also have a number of strategies in place that will help to ensure we support the development and use of evidence relevant to LMICs. Our Internal Reference Group and International Advisory Panel will include strong participation from LMIC-based partners, and we will work closely with LMIC-based Cochrane geographic entities, several of which have expressed support for this Thematic Group.’
‘We also look forward to engaging with key organisations, such as the WHO HQ and relevant WHO regional offices, to identify priority synthesis topics for LMIC settings. Our knowledge translation approach will consistently consider ways of reaching LMIC-based policy users and other stakeholders.’
Next steps
‘As one of the first Thematic Groups, we plan to dedicate time to engaging with the wider Cochrane community to understand our role and set priorities that align with important global health topics’, Rebecca says. ‘We will also build on our relationships with funders across our geographic contexts and topic areas to explore funding opportunities and options.’
‘We have a real interest in further developing and extending our methods of working with consumers and other stakeholders so that we can build expertise and capacity in a wider range of approaches and activities. Cochrane CCC, CPH and EPOC all have established networks of stakeholders and substantial experience in working effectively with them. Activities include active involvement in priority setting for research and review topics, community engagement to inform sharing of research findings directly with policymakers, and co-production of research including co-authoring Cochrane reviews. We intend that these kinds of activities will continue, alongside new and evolving opportunities to contribute to Cochrane and evidence synthesis activities.