Addressing Health Disparities through Community Participation: A Scoping Review of Co-Creation in Public Health

Abstract

Background: There is general agreement regarding the relevance of community involvement in public health policy, practice, and research to reduce health inequities. Objective: This review aims to analyse the experiences of community engagement in public health actions, with particular attention to methodologies used and how community participation is articulated. Method and Analysis: We searched the Web of Science, EBSCO, and ProQuest for scientific articles published in peer-reviewed journals. We recorded methodological aspects, the approach to equity, actors that participated in the actions, and participation of the community in different phases (agenda setting, design, implementation, and evaluation). Results: Of 4331 records, we finally included 31 studies published between 1995 and 2021. Twelve studies referred to Community-Based Participatory Research as the framework used. The actions addressed equity, mainly by tackling economic vulnerability (n = 20, 64%) and racial discrimination (n = 18, 58%). Workshops were the most used method. Participation was frequently observed in the design and implementation phases of the action, but it was reduced to community feedback in the evaluation. Conclusions: Co-created public health actions offer the opportunity to reduce health inequity and promote social change; yet, further effort is needed to involve communities in the entire cycle of decision making.

Co-designing adult weight management services: a qualitative study exploring barriers, facilitators, and considerations for future commissioning

“…Commissioning practices which focus on “specific objectives” and pre-determined outputs… measured by a limited set of indicators may conflict with the “messiness” of co-design [ 38 ]. Co-design focuses on what matters most to the people who use the services in order to re-align health services with community priorities [ 17 ].…”

“…Several reviews have explored the use of co-design within health services, focusing on acute health care settings [ 16 ], chronic disease prevention [ 10 ], public health [ 17 ], cardiovascular disease [ 18 ] and immigrant health [ 19 ]. None of these co-design reviews (and few of the studies included within these reviews) focused specifically on adult obesity or weight management services, reflecting a gap in the literature.…”