Research

Incorporating ‘mediated Patient and Public Involvement (mPPI)’ in Realist Synthesis: When It Takes More Than Two to Tango

25 June, 11 AM (GMT+1), Online

Realist synthesis has gained considerable traction over the last few years as a theory-driven approach to evidence synthesis that extends beyond the mere question of ‘what works’ to providing comprehensive explanations of how interventions work, for whom they work, as well as why they may work in particular circumstances and not in others. Described as an inherently stakeholder-driven approach, realist synthesis often relies on the involvement of non-researcher contributors (e.g., policy makers, experts, patients and the public) both in ‘validating’ emerging findings and in dissemination activities. Current evidence suggests, however, that stakeholder involvement, and in particular patient and public involvement (PPI), can easily get lost in realist reviews, as the exact nature and impact of their involvement might often be difficult to disentangle. In this presentation, I will discuss the process of involving a seldom-heard group of contributors, namely adults with intellectual disabilities, in a realist synthesis aiming to unpack the mechanisms by which lifestyle modification interventions work in this group. PPI in this case was mediated by a support worker, who assumed various – often, conflicting – roles throughout the project, including: educator (increasing researchers’ knowledge on how to best interact with the PPI group); interpersonal mediator (building rapport and promoting trust between the researchers and the PPI group); and system mediator (ensuring efficient use of time and keeping the PPI group to the project’s agenda and milestones). As the role of PPI in health and social care research will continue to expand, this presentation will critically reflect on the implications of incorporating ‘mediated PPI’ in evidence synthesis and offer lessons learnt from our experience.

About Evi: 

Evi is a Reader in Qualitative Methods for Health Research at the University of Glasgow, where she leads the Incorporating Perspectives and Experiences (IPE) research theme within the Health Economics and Health Technology Assessment (HEHTA) group. Her work focuses on addressing a fundamental challenge in health technology assessment: meaningfully integrating patient and public perspectives into decision-making, moving beyond tokenistic consultation towards the genuine inclusion of lived experience. With a background in Psychology and Health Communication, her research spans both primary qualitative studies and qualitative evidence synthesis across a range of disease areas and contexts. Prior to joining the University of Glasgow as a Lecturer in 2017, she held a Swiss National Science Foundation Advanced Postdoctoral Research Fellowship, based at the University of Exeter Medical School’s Institute of Health Research and later at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Evi has advised HTA agencies in the UK and Greece, consulted for the World Health Organization, and contributes internationally through her role on the HTAi Patient Preferences Project Sub-Committee. She also served between 2021 and 2026 as a Steering Committee Member for the NIHR Methodology Incubator and Co-Lead of its Qualitative Workstream, and she is an active academic reviewer and Editorial Board member of the International Journal of Technology Assessment in Health Care.