Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis

Rachel D Appelbaum; Anna Newcomb; Katherine Joseph; Morgan Hennessy; Princess Fortin; Pam J Bixby; Sue Prentiss; Alexandra McConnell-Hill; Rochelle Flayter; Michelle A Price; Rochelle Dicker; Rosemary Kozar; Elliott R Haut; Deborah M Stein

doi:10.1136/tsaco-2023-001274

Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis

Trauma Surg Acute Care Open. 2024 Feb 8;9(1):e001274. doi: 10.1136/tsaco-2023-001274. eCollection 2024.

Authors

Affiliations

¹ Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Inova Fairfax Medical Center, Falls Church, Virginia, USA.
³ American Trauma Society, Falls Church, Virginia, USA.
⁴ Cedars Sinai, Los Angeles, California, USA.
⁵ Health Alliance for Violence Intervention, Boston, Massachusetts, USA.
⁶ National Trauma Institute, San Antonio, Texas, USA.
⁷ UCSF Health, San Francisco, California, USA.
⁸ UC Health, Colorado Springs, Colorado, USA.
⁹ Coalition for National Trauma Research, San Antonio, Texas, USA.
¹⁰ UCSF, San Francisco, California, USA.
¹¹ R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
¹² Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

Introduction: Engaging trauma survivors/caregivers results in research findings that are more relevant to patients' needs and priorities. Although their perspectives increase research significance, there is a lack of understanding about how best to incorporate their insights. We aimed to capture stakeholder perspectives to ensure research is meaningful, respectful, and relevant to the injured patient and their caregivers.

Methods: A multiphase, inductive exploratory qualitative study was performed, the first phase of which is described here. Virtual focus groups to elicit stakeholder perspectives and preferences were conducted across 19 trauma centers in the USA during 2022. Discussion topics were chosen to identify patients' motivation to join research studies, preferences regarding consent, suggestions for increasing diversity and access, and feelings regarding outcomes, efficacy, and exception from informed consent. The focus groups were audio recorded, transcribed, coded, and analyzed to identify the range of perspectives expressed and any common themes that emerged.

Results: Ten 90-minute focus groups included patients/caregiver (n=21/1) and researchers (n=14). Data analysis identified common themes emerging across groups. The importance of trust and preexisting relationships with the clinical care team were the most common themes across all groups.

Conclusion: Our findings reveal common themes in preferences, motivations, and best practices to increase patient/caregiver participation in trauma research. The project's next phases are distribution of a vignette-based survey to establish broad stakeholder consensus; education and dissemination activities to share strategies that increase research engagement and relevance for patients; and the formation of a panel of patients to support future research endeavors.

Level of evidence: Level IV.

Keywords: Healthcare disparities; Research; patient-centered care; survivors.