Advancing complexity-informed health promotion: a scoping review to link health promotion and co-creation

Abstract

Summary A complexity-informed approach has recently been proposed as a hopeful revolution for health promotion (HP), requesting appropriate ways of tackling the complexities of health, equity and well-being. In addition, co-creation has gained traction as an approach to tackle complexity. HP and co-creation are established concepts that have long been enacted in practice. Although each concept is premised on similar approaches to value-creation such as participation and collaboration, little has been done to link the two approaches. To advance complexity-informed HP, this scoping review presents findings from peer-reviewed articles, published in English, between 2009 and March 2020. Articles were identified through searches of academic databases. Twenty-seven articles met the inclusion criteria, explicitly linking HP and co-creation. Included articles were charted by descriptive information and main focus, and advanced by a thematic analysis. Four themes suggest a potential avenue for advancing complexity-informed HP: (i) dealing with complexity, (ii) value creation, (iii) the value of the values and (iv) benefits and challenges. While current links between HP and co-creation are scarce they are increasing and promising. Based on the findings from the review, propositions to advance complexity-informed HP is outlined and discussed. Overall it is argued that co-creation and HP are mutually beneficial concepts, providing a framework for participative, collaborative, context-sensitive and knowledge-based practice that reflects the complex nature of health. More research is needed to highlight potential and challenges of integrating co-creation in HP, especially related to health equity and sustainable development.

Relational welfare: a socially just response to co-creating health and wellbeing for all

“…Although the cocreation approach adds to existing logics in the public sector and democracy, it simultaneously tends to clash and create tensions with institutionalised government norms and practices. this development of the co-creation logic is closely connected to ideas and principles that have shaped HP since the mid-1980s [10]. In the same way HP represents a 'paradigm shift' in public health, co-creation is presented as an equivalent radical change of approach in the public sector.…”

“…We are aware that it is impossible to provide a complete answer to this question. However, if welfare is essentially co-created [56], in which health and wellbeing for all as public values are created in the nexus between actors in complex, adaptive systems [10,29] and lenses then contour and colour how we see such 'systems' must also be revisited in a reimagination of welfare creation. empirical research and theoretical guidance can provide some insight to formulate common themes that combine co-creation, HP and social justice, suggesting that health and wellbeing for all might be achieved through advancing relational welfare.…”

“…Health promotion (HP) has been presented as a viable approach to widen the scope of public health beyond a biomedical approach to disease prevention, and explicitly links the value of equity to health and wellbeing as human rights [4,[7][8][9]. Co-creation logic has recently gained traction in HP research, policy and practice [10], with co-creation presented as a viable path to tackle the complexities inherent in creating conditions for health, wellbeing and equitable outcomes [10][11][12][13]. Co-creation logic represents a participatory, collaborative, deliberative, multi-stakeholder and boundary-spanning approach to public value creation.…”

“…Co-creation is about 'getting things done' through collaboration [18], while HP aims to achieve health and wellbeing for all, leaving no one behind [2,4,7,9]. Although co-creation is suggested as a viable path to strengthen HP [10], research has shown that co-creation ideologies may in fact increase inequities in health and wellbeing [19]. both Ostrom [20] and Steen et al [21] argue that co-creation approaches fail to capture, and buffer, the effects on inequity.…”

“…both Ostrom [20] and Steen et al [21] argue that co-creation approaches fail to capture, and buffer, the effects on inequity. Moreover, HP fails to describe adequately equitable and socially just processes of successful co-creation [10]. the nordic approach to welfare states is suggested as an ideal societal model in HP [22].…”