Exploring the role of Patient and Public Involvement in Implementation Research using the Study of Implementation of Midwifery Continuity of Carer (SIMCA).

Background: Patient and Public Involvement (PPI) is a fundamental part of health research. The role of PPI in implementation research, which considers the transfer of evidence into practice, is often less well defined than in studies focussing on recruitment of individual patients and clinical outcomes, and there is limited guidance available. This paper uses an implementation research project, the Study of Implementation of Midwifery Continuity of Carer (SIMCA), to illustrate the types of activities, benefits, challenges and lessons learned to contribute to the development of this growing area. Methods: The main aim of the PPI work in SIMCA was to embed the service user and community perspective in the study across all phases of the research, from preparation through execution and dissemination. Members of two organisations, one international and one community based, were core members of the study management team and PPI-driven activities were conducted throughout the study, incorporating both process and content focussed input. Results: The key contributions of PPI to the study were identified as i) bringing experience and representation ii) providing connectivity between the team and the wider community iii) providing service user perspectives on study-related tasks iv) a developmental impact on the study team, improving awareness and challenging the dominant academic perspective. Several challenges are described, for example the ambiguity of the role. Discussion: The SIMCA study has been used to illustrate the significant contributions that PPI can make to an implementation study and to the study team culture, in particular the value of having different perspectives within the team to ensure the study does not become too far removed from lived experience. Dilemmas related to the blurring between PPI and data collection and the need for more theoretical understanding of PPI in implementation research to make the findings more generalisable.