Learning and collaboration require opportunities for authentic social interaction, which can be challenging in a digital setting. This chapter discusses the benefits and challenges of digital tools and co-production through reflection on two case studies conducted in a university setting. The first case study features an online course where students learn about co-production by developing tools with patients to guide future practice. The second involves a research context in which citizens come together to explore solutions for implementing co-production. A blended social interaction and learning framework is presented to guide the use of digital tools in the context of digital co-production. The framework enables us to make better-informed decisions about how to co-produce in both digital and blended contexts. The lessons learned and recommendations provided aim to inform the implementation of digital co-production for citizens, researchers, educators, practitioners and policymakers. Future research is recommended to explore how digital platforms and digital tools can realise co-production values and principles in practice.

This chapter explores the transformation of Swedish health and welfare services towards co-production, emphasizing the shift from doing things for citizens and patients to doing things with them. It discusses the perplexity and potential for innovation, research and education to foster new ways of understanding and acting in line with co-production principles. The authors examine various terms and traditions associated with this transition, highlighting the need to adapt to co-production in Swedish health and welfare services. The chapter also delves into the application of co-production values in research, education and innovation, stressing the importance of defining key principles and creating a conducive environment for co-production to thrive.

Co-production has the capacity to encourage meaningful engagement and create public value. Co-production can occur at various stages or throughout the entire participatory process and there is increasing application of this approach in digital settings. The use of digital tools further complicates an already complex co-production process. Applying the Engagement, Alignment, and Agreement (EAA) framework (Masterson et al., 2024) this case study explores the experiences and shared learnings gained from participating in a co-production process in physical and digital environments as well as synchronous and asynchonrous interaction (blended co-production). The case study called “Heart of the Matter” involved citizens coming together to use the EAA-framework to explore co-production. We problematized how to create a conducive environment for co-production in a digital context maintaining its values and principles, whether in real-time, synchronized dialogues, or in delayed, asynchronous dialogues throughout the blended process.

The aim is to examine the challenges and opportunities participants encountered when using digital tools for social interaction and collaborative learning in a blended co-production setting.  The analysis is ongoing, and we will present preliminary findings from this case study exploring experiences and shared learnings from undertaking co-production in a blended setting. 

This presentation seeks to advance the conversation on digital co-production by adding the perspectives of participants and provide actionable insights for those who are planning to engage in co-production involving digital tools. 

Masterson, D., Lindenfalk, B., Kjellström, S., Robert, G., & Ockander, M. (2024). Mechanisms for co-designing and co-producing health and social care: a realist synthesis. Research Involvement and Engagement, 10(1). https://doi.org/10.1186/s40900-024-00638-3 

Co-production, as an approach to research and participatory processes, has gained significant attention due to its potential to foster meaningful engagement. However, despite the growing adoption of co-production and co-creation methods, there is sometimes an overreliance on the concepts to encapsulate complex engagement processes. Co-production can occur at various stages or throughout the entire engagement/participatory process. In a realist synthesis, central elements for co-production were identified and presented in an Engagement, Alignment and Agreement (EAA) framework (Masterson et al., 2024). That EAA framework is an initial programme theory posited to guide the co-production process in a range of contexts. When co-production requires interaction in a digital setting, an additional layer of complexity is introduced. This presentation explores these complexities by reflecting on two case studies that examine co-production in both fully digital and blended environments. The research question was; How can the complexities of engagement in fully digital and blended settings be managed to achieve meaningful co-production that generates public value?

The first case study examines a fully digital online course where students co-produce tools with patients to inform healthcare practice. The second is a blended co-production process that involves citizens in a research setting exploring the EAA-framework and solutions for implementing co-production. Each case provides valuable insights into the challenges and opportunities of using digital tools to foster social interaction and collaborative learning.

In this presentation, we present a Blended Social Interaction and Learning Framework based on the lessons learned from these two case studies. This framework is intended to serve as a guide for integrating digital tools into co-production processes, offering a structured approach for making informed decisions about how to engage participants in both fully digital and blended contexts. Questions are raised about how a conducive environment for co-production can be achieved when co-production requires interaction in a digital setting and also how to make sure that the values and principles —such as inclusivity, equity, and shared decision-making— can be established and operationalised in a fully digital or blended setting, in parts or throughout an entire collaborative process. We also reflect on the application of these frameworks in the context of value co-creation in digital settings.

The findings from these case studies suggest that careful consideration must be given to the design and facilitation of the process to preserve the integrity and authenticity of the engagement. The Blended Social Interaction and Learning Framework provides a practical tool for addressing these considerations.

By examining these case studies and the accompanying framework, this presentation seeks to advance the conversation on digital co-production and provide actionable insights for researchers, educators, and practitioners seeking to design more effective participatory processes in a digital age.

Masterson, D., Lindenfalk, B., Kjellström, S., Robert, G., & Ockander, M. (2024). Mechanisms for co-designing and co-producing health and social care: a realist synthesis. Research Involvement and Engagement, 10(1). https://doi.org/10.1186/s40900-024-00638-3

The significance of leadership for organizational success is widely recognized; however, there are numerous perspectives on the best way to develop leadership. The aim of this study was to explore the factors that professionals collectively identify as crucial for enhancing leadership development in organizations. The research questions addressed are: What key principles guide well-informed decisions in organizing leadership development practices? What generic aspects are related to these principles?

Employing a participatory research approach, we collected and analyzed data in collaboration with professionals working with leadership development in 17 municipalities and 10 regions in Sweden. The data were gathered by recording collaborative work during workshops, analyzed using reflexive thematic analysis and interpreted using paradox theory. Our main theoretical contribution consists of nine key principles that guide well-informed decisions in organizing leadership development practices. These principles are structured within key questions that go beyond perspectives on the best way to develop leadership, addressing inevitable paradoxical tensions. Additionally, we identify three generic aspects for managing these tensions and enhancing leadership development practices in organizations: systematic deliberation, integration and continuous improvement. Based on these findings, we present two practical tools to help professionals strengthen leadership development as a cohesive support system. Rather than seeking a single best curriculum or framework, professionals can be supported by aligning the responses to Why? What? How and when? Who? and What works?, always related to Where? and by continuously applying systematic deliberation, integrating leadership development with business strategies and HR activities and pursuing continuous improvement.

I dagens digitala samhälle tillbringar ungdomar en stor del av sin vardag på nätet, där sociala normer, roller och beteenden formas. Digitalt engagemang erbjuder möjligheter till meningsfull delaktighet och social interaktion, men innebär också risker såsom nätmobbning, trakasserier och destruktiva beteenden. Dessa erfarenheter kan ha allvarliga konsekvenser för ungas psykiska hälsa och långsiktiga välbefinnande (1, 2). Med utgångspunkt i FN:s barnkonvention (3) och erfarenheter från det FORTE finansierade projektet Samskapa (4) syftar detta samskapandeforskningsinitiativ (5) till att undersöka hur ungdomar i åldern 13–17 år upplever trygghet i digitala miljöer, samt vilket stöd de behöver för att kunna navigera dessa på ett säkert sätt.Projektet genomförs i samverkan mellan Jönköping University, Länsstyrelsen i Jönköpings län och Region Jönköpings Län. Under våren 2025 genomfördes fokusgrupper med ungdomar för att fånga deras erfarenheter och perspektiv på vad som skapar trygghet på nätet. Dessa insikter utgör grunden för ett kommande samskapande forskningsprojekt där ungdomar aktivt kommer att delta i forskningsprocessen – från idéutveckling till design av insatser. Det innovativa i projektet ligger i att ungdomarna själva är med och skapar forskningen, vilket möjliggör lösningar som är förankrade i deras verklighet. Projektet strävar efter bred inkludering, särskilt av ungdomar från utsatta grupper och områden, för att säkerställa att forskningen speglar en mångfald av röster. Genom att sätta ungdomars perspektiv i centrum avser projektet belysa viktiga aspekter av samskapande forskning såsom jämlik maktfördelning, delaktighet och potentialen att skapa verklig samhällspåverkan för att möta den stora samhällsutmaning som ungdomars utsatthet på nätet innebär.

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.

Context: Participation in SCI research with caregivers of children and adolescents with spinal cord injury (SCI) can occur in a range of different ways. This review explores the extent to which caregivers’ participation is connected to what might be called a voice.

Objectives: To explore the voice of caregivers by collating available research with the participation of caregivers of children and adolescents with SCI, and synthesizing how the research has been conducted.

Methods: The databases CINAHL, ERIC, MEDLINE, PsycInfo, and Scopus were searched for articles published between January 2008 and March 2022. Descriptive and narrative information was extracted and factors describing how caregivers participated were identified using an inductive approach.

Results: Twenty-nine articles were identified, of which 28 had affiliations connected to the USA, and 25 to Shriners Hospitals for Children. In most of the articles, the caregivers were invited to participate in the research to complete or develop measures. Information from the caregivers was often captured using close-structured questions and summarized quantitatively with little or no exploration of the perspectives of the caregivers.

Conclusion: The voice of caregivers of children and adolescents with SCI in research is limited by representativeness, the pre-determined emphasis, a lack of involvement in the process, and the reported narrative. By reflecting on voice, caregivers can have their experiences and perspectives acted upon to a greater extent to bring change, ultimately leading to improved care and health for children and adolescents with SCI.

Leadership development (LD) plays a significant role in achieving high-quality performance and business results, but there is little research on how leadership development itself evolves as the organization develops. This study explores how a leadership development system evolved over 30 years, during a time when the organization became increasingly high performing. Through reflexive thematic analysis of organizational documents and interviews with top managers and practitioners, the study provides a rich longitudinal description of the evolvement. The results revealed three pervasive changes of the leadership development system: 1) from a system for business-specific learning to one for system-wide learning; 2) from a system for personal development to one for customer-oriented quality development; and 3) from a leadership development system consisting of leadership development programs to one that is integrated into regular meetings and uses simple rules. These changes supported the gradual transformation of the leadership development from being independent to becoming integrated in the wider system, supporting the business system. The findings offer a unique insight into how an organization transitioned from individual leader development towards promoting collective aspects of leadership development. The study provides two main theoretical contributions that support the perspective of viewing leadership development as integrated within organizational development. Firstly, we present a more multifaceted way of understanding leadership development, wherein managers and employees, customer outcomes, and business advancement are seen as mutually developing. Secondly, we introduce two new critical points that complement previous descriptions of an advanced leadership development system: It is system wide (not only business specific) and customer oriented (not only leader/participant oriented).