Optimising co-design with ethnic minority consumers

Abstract

Co-design as a participatory method aims to improve health service design and implementation. It is being used more frequently by researchers and practitioners in various health and social care settings. Co-design has the potential for achieving positive outcomes for the end users involved in the process; however, involvement of diverse ethnic minority population in the process remains limited. While the need to engage with diverse voices is identified, there is less information available on how to achieve meaningful engagement with these groups. Ethnic minorities are super-diverse population and the diversity between and within these groups need consideration for optimising their participation in co-design. Based on our experience of working with diverse ethnic minority groups towards the co-design of consumer engagement strategies to improve patient safety in cancer services as part of the two nationally-funded research projects in Australia, we outline reflections and practical techniques to optimise co-design with people from diverse ethnic backgrounds. We identify three key aspects of the co-design process pertinent to the involvement of this population; 1) starting at the pre-commencement stage to ensure diverse, seldom heard consumers are invited to and included in co-design work, 2) considering logistics and adequate resources to provide appropriate support to address needs before, during and beyond the co-design process, and 3) supporting and enabling a diversity of contributions via the co-design process.

Co-designing a cancer care intervention: reflections of participants and a doctoral researcher on roles and contributions

“…Factors that influence the success of codesign projects in healthcare organisations include having an adaptive, relaxed and inclusive environment [ 17 , 21 ], skilled facilitation [ 13 , 17 ], shared understanding of aim and purpose of the process [ 17 ], trust and empathy [ 23 ] and cultural appropriateness [ 7 ]. But there are also reported challenges in the implementation of codesign.…”

Co-design for indigenous and other children and young people from priority social groups: A systematic review

“… Talamaivao et al (2021) highlight that enduring change in health and disability systems “can only occur when power imbalances are examined and addressed – for example, by reorienting funding structures, services, access and representation for and partnerships with Indigenous peoples” (pp.54–55). Co-design has been touted as a means by which power imbalances can be addressed ( Chauhan et al, 2021 ; Mark & Hagen, 2020 ; Moll et al, 2020 ), however Mark and Hagen (2020) caution that the term ‘co-design’ has been used on occasion to “infer a degree of power sharing, participation and partnership that never really existed” (p.5). We observed that a critique of power base, power relations and power dynamics in the study settings and co-design processes and practices was lacking by the authors of the studies included in this systematic review.…”

“… Moll et al (2020) have since developed a tool supporting reflexivity in co-design with “vulnerable populations” to address issues of power (the authors specify their description of the term “vulnerability” does not reflect “an individual characteristic, but as the result of social and systemic barriers” (p.1). Based upon their co-design with diverse ethnic social groups, Chauhan et al (2021) outline important mechanisms around addressing power imbalances. These include, amongst others, the building of strong relationships with communities and specifically, addressing the socio-cultural needs of participants involved in the co-design to support their equitable participation.…”

“…However, crucially, they note that success is “contingent upon health system environment, culture and organisational commitment that prioritises and sufficiently resources high-quality co-design” (p.5). This necessitates commitment from those in positions of power in ensuring that high-quality co-design is prioritised and that appropriate resources are allocated from the outset ( Chauhan et al, 2021 ).…”

The Need for Inclusive Genomic Research

“…Use of codesign among underrepresented populations to increase engagement and participation could be of great value in certain contexts, though given the cultural diversity that may exist between ancestry groups, this will require deep engagement with individual communities to be most useful. 20 Developing a greater appreciation among researchers, clinicians, funding bodies, policymakers and other key stakeholders of the social, ethical, and scientific imperative for inclusive research is needed. Further, intentional effort to create diverse research teams is essential for building an internal comprehension of the effects of systemic and institutionalized racism.…”