# Consumer Engagement in Chronic Conditions Research: An Integrated Framework Informed by Recognition Theory

**Authors:** Mingming Zhou, Anne Parkinson, Leanne Watts, Julie Veitch, Hanna Suominen, Jane Desborough

PMC · DOI: 10.1111/hex.70615 · Health Expectations : An International Journal of Public Participation in Health Care and Health Policy · 2026-02-22

## TL;DR

This paper creates a framework for involving consumers in chronic condition research by using recognition theory to guide ethical and sustainable engagement.

## Contribution

The novel contribution is an integrated framework combining recognition theory with empirical evidence to support consumer engagement in chronic condition research.

## Key findings

- Relational recognition fosters trust and shared decision-making through mutual learning and communication.
- Structural recognition ensures institutional systems support consumer involvement via policies and remuneration.
- Symbolic recognition legitimizes consumer expertise through authorship and formal acknowledgment.

## Abstract

Consumer engagement ensures that health research reflects lived experiences and generates outcomes relevant to those most affected. However, frameworks guiding engagement in research about chronic conditions remain limited and often lack theoretical grounding.

To develop an integrated, evidence‐based framework to support consumer engagement in research about chronic conditions.

We integrated findings from (1) a scoping review synthesising evidence‐based resources supporting consumer engagement in research about chronic conditions (Resource Framework) and (2) a co‐designed framework for recognising consumers' contributions to research within the Australian context (Recognition Framework). Our integration deployed the relational, structural, and symbolic domains of Honneth's recognition theory as an analytical lens and used joint displays to develop a comprehensive framework.

The framework demonstrates how relational, structural, and symbolic dimensions of recognition collectively support ethical and sustainable consumer engagement. Relational recognition (e.g., mutual learning, ongoing communication) strengthens interpersonal trust and shared decision‐making; structural recognition (e.g., governance policies, remuneration, reimbursement) embeds engagement within institutional systems; and symbolic recognition (e.g., authorship, formal acknowledgement) legitimises consumers' expertise within research cultures. Together, these elements provide a comprehensive foundation for supporting meaningful engagement across research practices.

This integrated recognition theory‐informed framework offers an evidence‐based tool to inform the design and implementation of consumer engagement in research about chronic conditions. By positioning recognition for consumers' contribution as an ethical, structural, and symbolic principle, it offers a transferable framework to strengthen participatory practice and advance equity in research. While developed for chronic conditions research, the framework is likely transferable with contextual tailoring to other settings.

## Full-text entities

- **Diseases:** Chronic Conditions (MESH:D002908), multiple sclerosis (MESH:D009103), fatigue (MESH:D005221), Chronic or noncommunicable diseases (MESH:D000073296), diabetes (MESH:D003920), deaths (MESH:D003643)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12928018/full.md

## References

39 references — full list in the complete paper: https://tomesphere.com/paper/PMC12928018/full.md

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Source: https://tomesphere.com/paper/PMC12928018