The use of co-production, co-design and co-creation to mobilise knowledge in the management of health conditions: a systematic review

Abstract

Background Knowledge mobilisation is a term used in healthcare research to describe the process of generating, sharing and using evidence. ‘Co’approaches, such as co-production, co-design and co-creation, have been proposed as a way of overcoming the knowledge to practice gap. There is a need to understand why researchers choose to adopt these approaches, how they achieve knowledge mobilisation in the management of health conditions, and the extent to which knowledge mobilisation is accomplished. Methods Studies that explicitly used the terms co-production, co-design or co-creation to mobilise knowledge in the management of health conditions were included. Web of Science, EMBASE via OvidSP, MEDLINE via OvidSP and CINHAL via EBSCO databases were searched up to April 2021. Quality assessment was carried out using the Joanna Briggs Institute qualitative quality assessment checklist. Pluye and Hong’s seven steps for mixed studies reviews were followed. Data were synthesised using thematic synthesis. Results Twenty four international studies were included. These were qualitative studies, case studies and study protocols. Key aspects of ‘co’approaches were bringing people together as active and equal partners, valuing all types of knowledge, using creative approaches to understand and solve problems, and using iterative prototyping techniques. Authors articulated mechanisms of action that included developing a shared understanding, identifying and meeting needs, giving everyone a voice and sense of ownership, and creating trust and confidence. They believed these mechanisms could produce interventions that were relevant and acceptable to stakeholders, more useable and more likely to be implemented in healthcare. Varied activities were used to promote these mechanisms such as interviews and creative workshops. There appeared to be a lack of robust evaluation of the interventions produced so little evidence in this review that ‘co’approaches improved the management of health conditions. Conclusion Those using ‘co’approaches believed that they could achieve knowledge mobilisation through a number of mechanisms, but there was no evidence that these led to improved health. The framework of key aspects and mechanisms of ‘co’approaches developed here may help researchers to meet the principles of these approaches. There is a need for robust evaluation to identify whether ‘co’approaches produce improved health outcomes. Trial Registration PROSPERO CRD42020187463.

Tensions and Paradoxes of Scaling Up: A Critical Reflection on Physical Activity Promotion

“… Co-creation for planning and design: Whilst scaling up does not have a single recommended design or evaluation approach, approaches that actively engage stakeholders from various system levels, early and throughout the research and process is essential. Future considerations: This can be achieved, for example, via co-creation, co-design and co-production [ 99 ] of evidence and interventions for scale-up. Research designs, partnerships and funding sources that can accommodate the length of time required to thoroughly evaluate impacts of scaling up (5+ years), may contribute to the generation of evidence that is more useful for evaluating scale-up outcomes.…”

“…Future considerations: This can be achieved, for example, via co-creation, co-design and co-production [ 99 ] of evidence and interventions for scale-up. Research designs, partnerships and funding sources that can accommodate the length of time required to thoroughly evaluate impacts of scaling up (5+ years), may contribute to the generation of evidence that is more useful for evaluating scale-up outcomes.…”

Co-design of a behaviour change intervention to equip geriatricians and pharmacists to proactively deprescribe medicines that are no longer needed or are risky to continue in hospital

“…We embedded a trigger film 26 introducing the barriers and enabler to deprescribing 25 and the six BCTs 6 into an online survey. Ahead of Round 1 workshops, we asked panel members to view the video and to record their initial ideas about how the BCTs could be operationalised at their hospital.…”

“…To help guide the ideation process, we introduced geriatrician and pharmacist personas to present experiences expressed in a previous focus group study relating to the barriers and enabler 25 to deprescribing that the CHARMER intervention seeks to address (Supplementary file 1). 26 We then asked panel members to discuss how the barriers and enabler influence deprescribing practice through a journey mapping exercise, followed by brainstorming ideas for how the relevant BCT(s) to address them could be operationalised, emphasising free flow of ideas regardless of acceptability and feasibility at this stage. We then presented a summary of the pre-workshop activity ideas to generate further discussion.…”

Evaluating the role and effectiveness of co‐produced community‐based mental health interventions that aim to reduce suicide among adults: A systematic review

“…13,17,18 This 'one size fits all' approach is attributed to different interpretations in how co-production is operationalized within policy, knowledge creation and subsequently implemented in practice within service delivery. 2,19,20 There is a paucity of evaluation considering the extent to which co-productive approaches cultivate meaningful outcomes [20][21][22] and whether positive outcomes associated with co-production are sustained over time. 23 Further, reluctance to relinquish professional roles and responsibilities, such as those held by researchers or practitioners, may lead to a power imbalance that could threaten the integrity of the mutually equitable relationship.…”