Bringing Lived Expertise to Academic Publishing Through Community Reviewers
本文介绍在HSR特刊中引入社区成员作为审稿人的实践，描述培训、审稿流程及积极反馈，证明社区审稿能提升文章的相关性和可读性，对推动学术出版包容性有参考价值。
In this special issue of HSR focused on the healthcare sector's practices and opportunities for identifying and addressing social care needs, we sought to bring community member voices into the academic peer review process. Social care research aspires to address inequities, but achieving this requires researchers to improve and deepen their partnerships with individuals and communities impacted by social needs and interventions. Those most affected by these issues are the experts of their lived experiences and should play an active role in designing solutions [1]. There is a larger movement with increasing energy to involve patients and communities across all stages and activities of the research continuum, from the conceptualization and co-design of research questions through the dissemination of findings and implications [2-5]. Yet community engagement in the critical step of academic publishing, where the content of what is prioritized for publication and decisions regarding how findings and implications for policy and practice are presented, rarely includes community members. As one part of this larger movement and our personal commitment to engaging community members in social care research, our goal in this special issue was to familiarize both researchers and patient communities with a collaborative process of reviewing special issue submissions for content, relevance, and impact. We recognized that the current system is not well-equipped to involve community members, and we sought to uncover and address the structural barriers to their participation and assess the feasibility of this process as a proof of concept. Here, we describe our process of engagement, the experiences of our community member reviewers and editorial team, and our combined recommendations for building on this effort in the future. As part of their approach to incorporating patient community voices into healthcare research and policy, The Patient Advocate Foundation's (PAF) Patient Insight Institute [6] has a standing advisory group of patients and caregivers that meets regularly to provide insights into projects related to healthcare access and affordability. The Social Interventions Research and Evaluation Network (SIREN) [7] is a partner in this work, bringing their social care research projects to a subcommittee of this group. In early 2024, over the course of two meetings, advisory committee members reviewed abstracts submitted for consideration in the HSR special issue, where discussions informed editorial decisions on which abstracts to invite to submit for a full manuscript. The group also expressed enthusiasm for reviewing the full manuscripts once they were submitted. This reinforced our decision to develop a patient/community-centered process for their continued involvement in the review process. The 21 community reviewers were recruited from this standing group of advisors of the Patient Insight Institute to review up to three manuscripts. Prior to the manuscripts being submitted, we held a training session that covered both technical aspects (how to log in and download the manuscript, how to submit the review) and how to approach their review (what community reviewers look for in a manuscript, what to focus their review on, what we didn't expect them to address, etc.). We also held open office hours and had numerous guest editors and staff willing to field questions on an as-needed basis from community reviewers. The authors received community review critiques alongside other reviewer comments, and reviewers received revised manuscripts and responses to their comments where applicable (major revisions). After community members completed their reviews, they were asked to share their experiences in a survey. The results of our survey of community reviewers were overwhelmingly positive. All participants had a positive experience being a reviewer, with 70% reporting the experience being extremely positive. Almost 3/4th (74%) of participants felt that being a reviewer was a valuable use of time. Ninety-two percent (92%) agreed that they brought a unique perspective, were heard by the PAF/SIREN teams, learned something new from experience, and were given enough time to review. They also had a mostly positive experience with the logistics of reviewing, with 86% reporting they had clear expectations about their role, felt their review was important for the journal/authors, and had enough training/support to do the review. All participants (100%) were able to access the Manuscript Central website, and 70% were able to log in on their own without technical assistance from the editorial team. Additional open responses from community reviewers were collected to gain deeper insights into their experiences. Post-review reflections revealed several key themes. First, community reviewers expressed a heightened understanding and appreciation for the peer review process. As one reviewer shared, “The process was time-consuming, but it made me realize what it is like to be a reviewer! I have submitted nine papers and had no concept of the process.” Second, reviewers underscored the significance of their contributions in providing a unique perspective to the review process—a perspective that can help researchers understand the value of their work through the eyes of community members impacted by their work, “perspectives that may have been missed or not realized.” Finally, reviewers expressed the importance of the direct role they played in ensuring that articles were patient-centered and relevant to affected communities. As one reviewer noted, “Bringing in patient and advocate perspectives ensures that the information is not only more relevant to the expanded community but also effectively engaged with.” These impacts on the articles in this HSR special issue were seen both in terms of broad impacts on community relevance through the content included as well as specific article improvements, such as enhancing the accessibility of writing and language, increasing clarity, and identifying problematic or offensive language. Overall, all community reviewers expressed a willingness to participate in future manuscript reviews and would recommend this activity to their peers. As Editors of this special issue, we also reflected on the experience of involving community members in the review process. Our editorial team unanimously found the feedback from community reviewers to be invaluable, notably in how community member feedback resulted in elevating content with perceived impact and relevance to community members as well as community member perspectives on race, specific language (e.g., removal of problematic language and unnecessary jargon or abbreviations), and visual graphics to result in clearer and person-centered communication of findings. We also reflected on key areas where greater structure or clarity on our part as editors could have been beneficial. We found it challenging to articulate to community reviewers what their expertise entailed and how to embrace it, as the goal was not to train them to become researchers. We observed that community reviewers did not always feel empowered to be critical, often deferring to the expertise of researchers, highlighting the need to better support and encourage a fuller expression of their viewpoints and expertise. We also struggled to balance community members' unique insights with the existing structure and expectations of the academic review process. Reflecting on our experience in this special issue, we offer recommendations based on our experience as editors and feedback from community reviewers for including community reviewers moving forward (Table 1). The learnings from this experience we are committed to taking forward in our own work. It is our genuine hope that these learnings will contribute to the movement of the larger scientific community seeking to create spaces and lift up community voices in academic peer review. We wish to express our gratitude to the patient and community reviewers who dedicated their time to participating as community reviewers in the peer review process for this HSR special issue and sharing their insights into their review process. The authors declare no conflicts of interest. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.