The "PPI Hawker": an innovative method for patient and public involvement (PPI) in health research

Patient and Public Involvement (PPI) in health research entails doing research 'with' the public. Successful PPI requires a diversity of patients' perspectives and experiences. In Singapore, including the public's voice in research is still in its infancy and different ways of involving the public have to be explored.Our aims were to describe a PPI initiative that enables members of the public to share their ideas and opinions about health research, and to assess the feasibility, accessibility and utility of the initiative.

Building on the concept of the PPI Café used in the west we designed a "PPI Hawker" for Singapore. Here Hawker Centres rather than cafes are used frequently for eating and socialising, providing a one-stop destination for a wide section of society. The PPI facilitators approached people sitting at tables and joined them to discuss questions of relevance to a local research study. Observations and reflexive field notes were used to evaluate the "PPI Hawker's" feasibility, acceptability and utility in the Singaporean community.

In three "PPI Hawkers" we approached 96 people and 72 (75%) engaged in discussions about the design of a population-based research study. The majority (75%) of participants willingly discussed all of the questions posed to them by the researchers, indicating the feasibility of PPI. The PPI participants came from the three major ethnic groups in Singapore and appeared to be broad in age, suggesting "PPI Hawkers" are easily accessible. Both participants and researchers recognised the utility of the "PPI Hawker", reflecting on people's willingness to talk about the research issues, engaging in informative conversations and posing relevant questions.

The "PPI Hawkers" succeeded in engaging the public in conversations about a local population-based study. The public brought to the researchers' attention a variety of previously unheard perspectives about the research. Each event fostered connectivity between professionals and the public, generating among researchers a more positive perception of the power of public involvement."PPI Hawkers" provide an opportunity for co-informed conduct of research studies with diverse members of the public. They create a focus within a community setting for researchers to engage with the public. The resources needed (costs and preparatory time) are relatively few. Not only do "PPI Hawkers" have potential in Singapore, but also for the rest of Asia.