Engaged and empowered? A realist review of user involvement with inclusion health populations in complex interventions in health and social care research

Research problem: While user involvement is recognised as important for improving health and social care accessibility, quality, and outcomes, the specific mechanisms by which it contributes to, or detracts from, intervention success are unclear.

This knowledge gap is evident for marginalised, underserved and socially excluded members of society, referred to as "inclusion health populations", who experience health and social inequities.The purpose of this review is to understand and describe key underlying causal mechanisms of user involvement with inclusion health populations in complex interventions in health and social care research, in terms of which interventions work or do not work, how, why and in what circumstances.

Primary research question: How and why does user involvement with inclusion health populations work or not work in complex interventions in health and social care research?Secondary research questions:1.

What types of user involvement have been used with inclusion health populations in complex interventions in health and social care research?2.

Which contextual conditions facilitate user involvement with inclusion health populations to achieve the intended outcomes?Method: Using a realist review, we will systematically review and synthesise relevant sources from academic databases, the Swecris database - which compiles Swedish-funded research projects from several research funders, as well as grey literature.

To promote relevance and transferability, two workshops will be held with a Local Reference Group (people with lived experience of inclusion health issues or working with inclusion health populations). Additionally, an External Reference Group of academics will be consulted during the review process.

Data will be analysed using a realist approach and findings will be presented in a scientific article with recommendations, and a summary report.Societal relevance and utilisation: By identifying key underlying causal mechanisms of user involvement, this review will provide insights to support more coordinated, needs-based and person-centred interventions for inclusion health populations.

Thus, addressing critical service gaps and promoting more equitable, user-centered interventions which in the long run can contribute to more equal health and social care services.