The dark side of coproduction: do the costs outweigh the benefits for health research?

Abstract

Background Coproduction, a collaborative model of research that includes stakeholders in the research process, has been widely advocated as a means of facilitating research use and impact. We summarise the arguments in favour of coproduction, the different approaches to establishing coproductive work and their costs, and offer some advice as to when and how to consider coproduction. Debate Despite the multiplicity of reasons and incentives to coproduce, there is little consensus about what coproduction is, why we do it, what effects we are trying to achieve, or the best coproduction techniques to achieve policy, practice or population health change. Furthermore, coproduction is not free risk or cost. Tensions can arise throughout coproduced research processes between the different interests involved. We identify five types of costs associated with coproduced research affecting the research itself, the research process, professional risks for researchers and stakeholders, personal risks for researchers and stakeholders, and risks to the wider cause of scholarship. Yet, these costs are rarely referred to in the literature, which generally calls for greater inclusion of stakeholders in research processes, focusing exclusively on potential positives. There are few tools to help researchers avoid or alleviate risks to themselves and their stakeholders. Conclusions First, we recommend identifying specific motivations for coproduction and clarifying exactly which outcomes are required for whom for any particular piece of research. Second, we suggest selecting strategies specifically designed to enable these outcomes to be achieved, and properly evaluated. Finally, in the absence of strong evidence about the impact and process of coproduction, we advise a cautious approach to coproduction. This would involve conscious and reflective research practice, evaluation of how coproduced research practices change outcomes, and exploration of the costs and benefits of coproduction. We propose some preliminary advice to help decide when coproduction is likely to be more or less useful.

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

“…Through initial meetings, a research agreement document was written which formalized the contract between the newly established partnership. At this early stage, the team negotiated the research question, which has been highlighted as a potential challenge where priorities and values differ . At this stage, Nura and Fiona both reflected on their sense of being outsiders;…”

“…The time and effort taken to invest in and manage relationships have been highlighted as a cost of co‐production . Negotiating and renegotiating their identities as insiders and outsiders also had some personal costs for the co‐researchers.…”

“…In this study, equal power meant valuing experiential knowledge 26 The time and effort taken to invest in and manage relationships have been highlighted as a cost of co-production. 1 Negotiating and renegotiating their identities as insiders and outsiders also had some personal costs for the co-researchers. Throughout project, Nura and Fiona had to challenge themselves regularly to step outside the comfort of their own identities and roles.…”

“…Collaborative models of research are rooted in long‐standing political, social and artistic traditions, and the multitude of collaborative research practices and co‐production models reflects different motivations, activities and discourses . For this reason, coproduction is a contested concept and has been described as a ‘poorly formulated’ term .…”

“…Collaborative models of research are rooted in long-standing political, social and artistic traditions, and the multitude of collaborative research practices and co-production models reflects different motivations, activities and discourses. 1,2 For this reason, coproduction is a contested concept 3 and has been described as a 'poorly formulated' term. 4,5 Facer and Enwright argue that no single research method can be labelled 'co-production' but 'Instead, there are myriad different forms, practices and methods that project teams are using to address the question of how to create new knowledge and practice about "communities"'.…”