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Mechanisms for co-designing and co-producing health and social care: a realist synthesis
Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. The School of Health Sciences, University of Skövde, Skövde, Sweden.ORCID iD: 0000-0003-4364-9814
Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0003-0123-6392
Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0001-8952-8773
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Florence Nightingale Faculty of Nursing, Midwifery & amp; Palliative Care, King’s College London, London, United Kingdom.ORCID iD: 0000-0001-8781-6675
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2024 (English)In: Research Involvement and Engagement, E-ISSN 2056-7529, Vol. 10, no 1, article id 103Article in journal (Refereed) Published
Sustainable development
00. Sustainable Development, 3. Good health and well-being
Abstract [en]

Objectives: Analyse reported processes of co-design and co-production in the context of health and social care to explore the underlying mechanisms that enable inclusive and reciprocal engagement.

Search strategy: Peer review research was obtained from a prior scoping review searching eight databases consisting of all methodologies relevant to co-design or co-production in the context of health and social care services and involving service-users.

Methods of selection: Articles were included for synthesis if they reported a process of dialogue, with mutuality, insight and clarification in their engagement process. Ninety-three peer-review articles informed our programme theory development.

Analysis: Data relating to co-design and co-production processes were extracted and analysed through inductive, abductive, and deductive analysis leading to the development of an initial programme theory.

Main results: This realist synthesis finds that co-design and co-production can occur at different times, in part or all of the research and participatory process. There is an over reliance on the term ‘co-design’ or ‘co-production’ to convey complex engagement or participatory processes. We identified six mechanisms (intention, assets, dialogue, documentation, interpretation and understanding). Interaction between these six identified mechanisms in context, even if only brief, is important for supporting meaningful engagement, alignment and agreement within a co-design or co-production process.

Implications for practice: The initial programme theory presented in this article provides clarity by identifying essential mechanisms which can guide the design and implementation of a range of participatory approaches. Rather than relying on a single label to convey complex participatory methods or processes, the values and principles of co-design or co-production, in combination with this programme theory, could be applied to guide implementation and reporting of specific activities within a range of research or participatory methods.

Patient and public contribution: The initial programme theory was presented and piloted in a series of collaborative workshops between May 2023 and March 2024 with patient and public contributors, health professionals and researchers. This engagement process is currently underway to refine the programme theory and it is anticipated that this next phase will be completed in September 2024.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 10, no 1, article id 103
Keywords [en]
Co-design, Co-production, Dialogue, Healthcare, Mechanisms, Participatory design, Participatory research, Realist synthesis, Social care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-66447DOI: 10.1186/s40900-024-00638-3PubMedID: 39390518Scopus ID: 2-s2.0-85206391185Local ID: GOA;;979021OAI: oai:DiVA.org:hj-66447DiVA, id: diva2:1907090
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018 − 01431Available from: 2024-10-21 Created: 2024-10-21 Last updated: 2025-01-05Bibliographically approved

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Masterson, DanielLindenfalk, BertilKjellström, SofiaRobert, GlennOckander, Marlene

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Research Involvement and Engagement
Health Care Service and Management, Health Policy and Services and Health Economy

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