Evidence mapPaperPMID 40779031Full record

ArticleRheumatology international2025

The advocacy effect: a grounded theory study on the inclusion of caregivers or nearest support persons in research to better understand patient outcomes in rheumatoid arthritis.

José B Negrón, Maria A Lopez-Olivo, Loreto Carmona, Robin Christensen, Francesca Ingegnoli, Natalia V Zamora, Laura Gonzalez-Lopez, Vibeke Strand, Niti Goel, Tiffany Westrich-Robertson and 1 more

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Article in Rheumatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

José B NegrónInstituto de Investigación Social y Sanitaria, Guayanilla, Puerto Rico. negronjb@hey.com.ORCID 0000-0003-4659-5508
Maria A Lopez-OlivoDepartment of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, US.ORCID 0000-0002-5165-8393
Loreto CarmonaInstituto de Salud Musculoesqueletica, Madrid, Spain.ORCID 0000-0002-4401-2551
Robin ChristensenSection for Biostatistics and Evidence-Based Research, Copenhagen and Research Unit of Rheumatology, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.ORCID 0000-0002-6600-0631
Francesca IngegnoliDivision of Clinical Rheumatology, G Pini Hospital, Università degli Studi di Milano, Milan, Italy.ORCID 0000-0002-6727-1273
Natalia V ZamoraInstituto de Rehabilitación Psicofísica, Buenos Aires, Argentina.ORCID 0000-0002-3785-4662
Laura Gonzalez-LopezDepartamento de Fisiología y Departamento de Salud Pública, Centro Universitario de Ciencias de la Salud, Instituto de Terapéutica Experimental Clínica, Universidad de Guadalajara, Guadalajara, Mexico.ORCID 0000-0002-6517-6344
Vibeke StrandDivision of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0003-4978-4072
Niti GoelDivision of Rheumatology, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0001-5869-5157
Tiffany Westrich-RobertsonInternational Foundation for Autoimmune and Autoinflammatory Arthritis, St. Louis, MO, USA.
Maria E Suarez-AlmazorDepartment of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, US.ORCID 0000-0001-5381-5797

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo apply grounded theory to generate a substantive theory that explains the roles adopted by caregivers or nearest support persons (CoNSP) and their added value when included as patient advocates in long-term outcomes research in rheumatoid arthritis (RA).

methodsA cross-national and multi-language qualitative research study, part of an ongoing project by the Outcome Measures in Rheumatology. The data collection was carried out from March 2018 to February 2019. Initially, four participants from the United States were selected. However, after examining the data we realized that adding the CoNSP as patient advocates might be useful to gain a wider understanding. Therefore, participants were contacted again and asked if they could identify a CoNSP to participate in the study. In addition, participants from Spain and Italy with their CoNSP were included. A total of 16 interviews were conducted (eight pairs composed of a person with RA and his/her CoNSP). To generate theory, the Glaser and Straus grounded theory approach was applied.

resultsWe developed The Advocacy Effect Theory which is formed by the core category Vision which is a three-dimensional category: (i) Sharing the same viewpoint - people with RA and their CoNSP share the same viewpoint on the issues addressed, (ii) Expanding the viewpoint - people with RA and their CoNSP contributed information about the same issues, but the CoNSP provided more detailed insights on some of the topics previously shared by the person with RA, and (iii) A new viewpoint - the CoNSP provide original information about issues or topics that were not previously informed by the person with RA. This theory explains the roles of CoNSP and their added value when included as patient advocates in long-term outcomes research in RA.

conclusionsThe Advocacy Effect Theory showed that CoNSP should be included in outcomes research as patient advocates. Their knowledge and contributions are dynamic, adding value by providing access to data that might not otherwise be accessible.

Indexed as

Arthritis, RheumatoidCaregiversPatient AdvocacyAdultAgedFemaleGrounded TheoryHumansItalyMaleMiddle AgedQualitative ResearchSpainCaregiverGrounded theoryPatient advocacyPatient centered outcomes researchQualitative researchRheumatoid arthritis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.