Embracing complexity and uncertainty to create impact: exploring the processes and transformative potential of co-produced research through development of a social impact model

Abstract

The potential use, influence and impact of health research is seldom fully realised. This stubborn problem has caused burgeoning global interest in research aiming to address the implementation ‘gap’ and factors inhibiting the uptake of scientific evidence. Scholars and practitioners have questioned the nature of evidence used and required for healthcare, highlighting the complex ways in which knowledge is formed, shared and modified in practice and policy. This has led to rapid expansion, expertise and innovation in the field of knowledge mobilisation and funding for experimentation into the effectiveness of different knowledge mobilisation models. One approach gaining prominence involves stakeholders (e.g. researchers, practitioners, service users, policy-makers, managers and carers) in the co-production, and application, of knowledge for practice, policy and research (frequently termed integrated knowledge translation in Canada). Its popularity stems largely from its potential to address dilemmas inherent in the implementation of knowledge generated using more reductionist methods. However, despite increasing recognition, demands for co-produced research to illustrate its worth are becoming pressing while the means to do so remain challenging. This is due not only to the diversity of approaches to co-production and their application, but also to the ways through which different stakeholders conceptualise, measure, reward and use research. While research co-production can lead to demonstrable benefits such as policy or practice change, it may also have more diffuse and subtle impact on relationships, knowledge sharing, and in engendering culture shifts and research capacity-building. These relatively intangible outcomes are harder to measure and require new emphases and tools. This opinion paper uses six Canadian and United Kingdom case studies to explore the principles and practice of co-production and illustrate how it can influence interactions between research, policy and practice, and benefit diverse stakeholders. In doing so, we identify a continuum of co-production processes. We propose and illustrate the use of a new ‘social model of impact’ and framework to capture multi-layered and potentially transformative impacts of co-produced research. We make recommendations for future directions in research co-production and impact measurement.Electronic supplementary materialThe online version of this article (10.1186/s12961-018-0375-0) contains supplementary material, which is available to authorized users.

Inside, outside and in‐between: The process and impact of co‐producing knowledge about autism in a UK Somali community

“…Members of AI worked with a community theatre company to develop a play called ‘Yusuf can't talk’ which was performed nationally and internationally. With growing awareness that the Somali community has a high prevalence of autism, Nura contacted Dheeraj Rai, a university researcher and psychiatrist whose research focussed on autism in migrant communities to ask about further research. Through discussion, Nura and Dheeraj submitted an idea for research to the NIHR CLAHRC West, who works with partner organizations including the NHS, local authorities and universities, to conduct applied health research and implement research evidence to improve health and health care.…”

“…As the co‐researchers shared the study findings, professionals working with Somali families began to request more resources, to increase their cultural understanding of autism, to refine and to improve the delivery of services. This led to a number of new synergies, as the team strove for a broad impact to bring about change through social learning …”

“…Beckett et al suggest that macrolevel impact can be achieved through, ‘brokering relationships and engaging with opportunities that arise from co‐produced work’. Since disseminating the research findings, opportunities have led to the formation of partnerships and synergies between AI and a range of health, social care and education providers.…”

“…Beckett et al propose that co‐produced knowledge can be ‘transformative at a broader macroscale where co‐produced research combines with other interventions, wider policies or practice priorities to create dynamic synergies’ . While it is difficult to assess the macroimpact of co‐produced knowledge, a facilitator to achieving impact at a societal level maybe achieved through presenting co‐produced knowledge in accessible and creative formats . The use of both community theatre and film is examples of how this co‐produced knowledge reached multiple audiences and disseminated knowledge widely in a lasting format.…”

Investigating the productive uses of uncertainty in knowledge co‐creation practices

“…Co‐creation practices, defined as the collaborative participation of “different social actors and articulation of multiple knowledge forms” (Phillips & Napan, , p. 4) proliferate as a means to generate knowledge. Although the promises and key elements of co‐creation practices are progressively documented (Beckett, Farr, Kothari, Wye, & le May, ), there is a need for more of an empirical understanding of informational processes facilitating knowledge emergence in those environments. Interestingly, recent research suggests that introducing uncertainty can foster knowledge emergence in co‐creation practices (Hartner‐Tiefenthaler, Roetzer, Bottaro, & Peschl, ; Wiltschnig, Christensen, & Ball, ).…”