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However, little is known about its process and impacts, particularly in low-and middle-income countries. This opinion piece draws on the stakeholder engagement experiences from a global health research programme on Chronic Obstructive Pulmonary Disease (COPD) led by clinician researchers in Brazil, China, Georgia and North Macedonia, and presents the process, outcomes and lessons learned.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main body<\/jats:title>\n                <jats:p>Each country team was supported with an overarching engagement protocol and mentored to develop a tailored plan. Patient involvement in research was previously limited in all countries, requiring intensive efforts through personal communication, meetings, advisory groups and social media. Accredited training programmes were effective incentives for participation from healthcare providers; and aligning research findings with competing policy priorities enabled interest and dialogue with decision-makers. The COVID-19 pandemic severely limited possibilities for planned engagement, although remote methods were used where possible. Planned and persistent engagement contributed to shared knowledge and commitment to change, including raised patient and public awareness about COPD, improved skills and practice of healthcare providers, increased interest and support from clinical leaders, and dialogue for integrating COPD services into national policy and practice.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Stakeholder engagement enabled relevant local actors to produce and utilise knowledge for small wins such as improving day-to-day practice and for long-term goals of equitable access to COPD care. For it to be successful and sustained, stakeholder engagement needs to be valued and integrated throughout the research and knowledge generation process, complete with dedicated resources, contextualised and flexible planning, and commitment.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-023-10525-4","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T14:02:17Z","timestamp":1705068137000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Engaging stakeholders to level up COPD care in LMICs: lessons learned from the \u201cBreathe Well\u201d programme in Brazil, China, Georgia, and North Macedonia"],"prefix":"10.1186","volume":"24","author":[{"given":"Genevie","family":"Fernandes","sequence":"first","affiliation":[]},{"given":"Si\u00e2n","family":"Williams","sequence":"additional","affiliation":[]},{"given":"Peyman\u00e9","family":"Adab","sequence":"additional","affiliation":[]},{"given":"Nicola","family":"Gale","sequence":"additional","affiliation":[]},{"given":"Corina","family":"de Jong","sequence":"additional","affiliation":[]},{"given":"Jaime Correia","family":"de Sousa","sequence":"additional","affiliation":[]},{"given":"KK","family":"Cheng","sequence":"additional","affiliation":[]},{"given":"Chunhua","family":"Chi","sequence":"additional","affiliation":[]},{"given":"Brendan G.","family":"Cooper","sequence":"additional","affiliation":[]},{"given":"Andrew P.","family":"Dickens","sequence":"additional","affiliation":[]},{"given":"Alexandra","family":"Enocson","sequence":"additional","affiliation":[]},{"given":"Amanda","family":"Farley","sequence":"additional","affiliation":[]},{"given":"Kate","family":"Jolly","sequence":"additional","affiliation":[]},{"given":"Sue","family":"Jowett","sequence":"additional","affiliation":[]},{"given":"Maka","family":"Maglakelidze","sequence":"additional","affiliation":[]},{"given":"Tamaz","family":"Maghlakelidze","sequence":"additional","affiliation":[]},{"given":"Sonia","family":"Martins","sequence":"additional","affiliation":[]},{"given":"Alice","family":"Sitch","sequence":"additional","affiliation":[]},{"given":"Aleksandra","family":"Stamenova","sequence":"additional","affiliation":[]},{"given":"Katarina","family":"Stavrikj","sequence":"additional","affiliation":[]},{"given":"Rafael","family":"Stelmach","sequence":"additional","affiliation":[]},{"given":"Alice","family":"Turner","sequence":"additional","affiliation":[]},{"given":"Zihan","family":"Pan","sequence":"additional","affiliation":[]},{"given":"Hui","family":"Pang","sequence":"additional","affiliation":[]},{"given":"Jianxin","family":"Zhang","sequence":"additional","affiliation":[]},{"given":"Rachel E.","family":"Jordan","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"10525_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12961-018-0337-6","volume":"16","author":"A Boaz","year":"2018","unstructured":"Boaz A, Hanney S, Borst R, O\u2019Shea A, Kok M. 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All methods were carried out in accordance with relevant guidelines and regulations and informed consent was obtained from stakeholders to participate in the engagement activities.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"K K Cheng declares grant funding to his institution from NIHR GHR for current manuscript; J Correia-De-Sousa declares grant funding to his institution from AstraZeneca and GSK, advisory board and consulting fees paid to himself from Boheringer Ingelheim, GSK, AstraZeneca, Bial, Medinfar, Payment for lectures from GSK, AstraZeneca and Sanofi Pasteur, support for attending meetings from Mundipharma and Mylan, leadership role for International Primary Care Respiratory Group (IPCRG); A Dickens declares grant funding paid to his institution from NIHR GHR for current manuscript; A Farley declares grant funding paid to her institution from NIHR GHR for the present manuscript, grant funding from NIHR HTA, NIHR EME, MRC and Ethicon (Johnson and Johnson) for other work, membership on DMEC for NIHR funded e-cigarette trial (no honorarium), leadership role for International Primary Care Respiratory Group (IPCRG); N Gale declares grant funding to her institution from NIHR GHR for current manuscript; K Jolly declares grant funding paid to her institution from NIHR and MRC, participant in Data Safety Monitoring Board or advisory board for NIHR funded studies (no honorarium), Sub-committee chair of NIHR Programme Grants for Applied Health Research (payments to institution); R Jordan declares grant funding to her institution from NIHR, membership of Boehringer Ingelheim Primary Care Advisory Board, leadership role for International Primary Care Respiratory Group (IPCRG) \u2013 research sub-committee; S Jowett declares grant funding to her institution from NIHR GHR for current manuscript; S M Martins declares leadership or fiduciary role in Brazilian Society of Medicine and Family and Community; ABC School of Medicine, GEPRAPS ( respiratory group of study and research in primary care), IPCRG (International Primary Care Respiratory Group); A Sitch declares grant funding to her institution from NIHR GHR for present manuscript, NIHR Birmingham BRC and AstraZeneca; A Turner declares grant funding to her institution from NIHR GHR for present manuscript, grant funding from AstraZeneca and Chiesi for other work, payment of honoraria from GSK and Boehringer, support for attending meetings and\/or travel from AstraZeneca and Chiesi; S Williams declares grants from the University of Birmingham paid to her institution; G Fernandes, P Adab, C de Jong, C Chi, B Cooper, A Enocson, T Maghlakelidze, M Maglakelidze, A Stamenova, K Stavrikj, R Stelmach, Z Pan, H Pang, and J Zhang have no conflicts to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"66"}}