Measuring Meaningful Involvement of Family Physicians in Health System Design and Implementation
Bibliographic record
Abstract
Context: Family physician participation is increasing in health system design and implementation in Ontario. Therefore, it is important to determine a definition of meaningful involvement and explore the activities and processes that constitute meaningful involvement. Objective: The purpose of the study was to elicit primary healthcare leaders’ definition of meaningful involvement in the conception, design and delivery of integrated care planning and implementation as well as to identify various means to measure meaningful involvement. Study Design and Analysis: Grounded theory study using in-depth interviews via Zoom, with individual and team analysis. Setting: Ontario, Canada. Population Studied: twenty-two primary healthcare leaders (family physicians and decision-makers) affiliated with Ontario Health Teams (OHTs). Results: Participants found it challenging to provide a clear definition of ‘meaningful involvement’. However, a few participants did offer definitions that consisted of different levels of involvement. These ranged from being aware/informed; to participating in some activities; to more active involvement, including leading activities/being at the decision-making table; and some participants highlighted another level of involvement -- using the clinical services/being integrated into the clinical pathway within the OHT. All participants offered ideas about how to measure/assess meaningful involvement of family physicians while recognizing the challenges inherent in creating appropriate measures. Their suggestions ranged from relatively easy items to measure, such as attendance at meetings and counting opened emails to a more comprehensive set of activities such as involvement in the co-design/evaluation of programs. Participants believed that involving family physicians in the co-design of program implementation activities fosters ownership and empowerment, leading to improved health care delivery in Ontario. Participants articulated that the foundation for meaningful involvement of family physicians in health system change is relationship building: trust and respect are paramount. Conclusions: This study illuminates the challenges in defining and measuring meaningful involvement of family physicians in health system design and implementation. These findings are assisting the Ontario Ministry of Health as they continue to support family physicians’ involvement in the conception, design and delivery of program implementation activities.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.088 | 0.114 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".