BACKGROUND AND OBJECTIVES: To develop a digital communication tool to improve the implementation of up-to-date COVID-19 recommendations. Specifically, to improve patient, caregiver and public understanding of healthcare recommendations on prevention, diagnoses and treatment. METHODS: Multi-stakeholder engagement design. In conjunction with the COVID-19 Recommendations and Gateway to Contextualization RecMap, we co-developed a stakeholder prioritization, drafting and editing process to enhance guideline communication and understanding. RESULTS: This paper presents the multi-stakeholder development process with three distinct plain language recommendation formats: formal recommendation, good practice statement, and additional guidance. Our case study of COVID-19 plain language recommendations PLRs addresses both public health interventions (e.g., vaccination, face masks) and clinical interventions (e.g., home pulse oximetry). CONCLUSION: This paper presents a novel approach to engaging stakeholders in improving the communication and understanding of published guidelines during the COVID-19 pandemic.

American College of Physicians Philadelphia PA USA

Citizen Chair Cochrane Consumer Network Executive Ottawa Ontario Canada

Citizen Lancaster High School Hamilton Ontario Canada

CT Lamont Centre for Primary Care Bruyere Research Institute Ottawa Ontario Canada; Interdisciplinary School of Health Sciences University of Ottawa Ottawa Canada

Czech National Centre for Evidence Based Healthcare and Knowledge Translation Brno Czech Republic

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada; Cochrane South Africa South African Medical Research Council Cape Town South Africa

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada; Department of Internal Medicine American University of Beirut Beirut Lebanon

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada; Department of Medicine McMaster University Hamilton Ontario Canada

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada; Michael G DeGroote Cochrane Canada and GRADE Centre McMaster University Hamilton Ontario Canada

Department of Health Research Methods Evidence and Impact McMaster University Hamilton Ontario Canada; Michael G DeGroote Cochrane Canada and GRADE Centre McMaster University Hamilton Ontario Canada; Department of Medicine McMaster University Hamilton Ontario Canada

Department of Medicine McMaster University Hamilton Ontario Canada

Department of Medicine McMaster University Hamilton Ontario Canada; National Institute for Health and Care Excellence Manchester UK

Department of Pediatrics Universidad de Antioquia Calle 67 No 53 108; Medellin Antioquia Colombia; School of Rehabilitation Science McMaster University 1280 Main Street West L8S 3L8 Hamilton Ontario Canada; Clinica Las Americas AUNA Dg 75B 2A 80 140 Medellin Colombia

Evidence Prime Inc Hamilton Ontario Canada

Incident Management Systems for COVID 19 and Evidence and Intelligence for Action in Health Department Pan American Health Organization Washington DC USA

Instit d'Recerca Servei D'Epidemiologia Clinica Hospital de la Santa Creu i Sant Pau Colombia

Michael G DeGroote Cochrane Canada and GRADE Centre McMaster University Hamilton Ontario Canada; Cochrane South Africa South African Medical Research Council Cape Town South Africa; Clinical Pharmacology Department of Medicine Stellenbosch University Cape Town South Africa

Postgraduate Institute of Medical Education and Research Chandigarh India

School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada; CT Lamont Centre for Primary Care Bruyere Research Institute Ottawa Ontario Canada; Interdisciplinary School of Health Sciences University of Ottawa Ottawa Canada

School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada; CT Lamont Centre for Primary Care Bruyere Research Institute Ottawa Ontario Canada; Interdisciplinary School of Health Sciences University of Ottawa Ottawa Canada; Department of Family Medicine Western University London Ontario Canada

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