At Health CASCADE, we are part of a wider network of researchers funded to develop robust co-creation methodology and propose co-creation as a promising approach to contemporary societal challenges.

“We are aware of the challenges facing co-creation – from tokenistic engagement to consultation and participation fatigue. Therefore – we believe it is imperative to bring attention to the issues hindering co-creation and work collaboratively towards addressing them systematically”.

“Co-creation” found its first moment in service marketing research during the late 20th century, notably championing the co-creation of value by management theorists like Prahalad and Ramaswamy, advocating for customer involvement in the innovation process – but where does this story take us today?

As informed by Messiha (2023), there was a noticeable surge in the adoption of co-creation, co-design and co-production approaches within public health research since 2012. Agnello and Loisel et al. (2023) visualize this trend, with co-creation becoming a predominate term, outcompeting other related approaches, such as participatory research, in 2018 and onwards. But the question remains, are these co-approaches simply a rebranding of participatory research? To work towards answering this question, Messiha et al. (2023) systematically investigated the theoretical underpinnings of these co-approaches.

The first attempts to consolidate the knowledge about co-creation – from identification and consolidation of theoretical underpinnings of co-approaches, relevant and supportive literature (such as through the curated database) and frameworks as well as recommendations for implementing and evaluating co-creation – comprise great first steps in addressing knowledge fragmentation. Beyond this, the Health CASCADE network is working to further investigate co-creation, including its methodological basis, supportive technologies and the multi-sectorial applications of this basis – to underpin best practices for co-creation. Yet, this is the beginning of a long and much needed process of bridging the gap from a naive praxis to robust co-creation for designing and implementing solutions to complex and wicked public health challenges. Join us in investigating this valuable approach before it becomes too stretched and too fragmented to be trustworthy or effective.

The post Fragmented Knowledge: Bridging the Divide from Naive Praxis to Robust Co-creation appeared first on HEALTH CASCADE.

Exciting developments unfolded in Brussels as Katrina Messiha concluded her secondment at EuroHealthNet on December 15th, 2023. In her role as an Academic and Policy Researcher, Katrina focused on crafting a Policy Précis addressing health equity through inclusive participatory processes. This document provides a comprehensive briefing for members and policymakers, exploring core principles, relevant EU policies and offering actionable recommendations.

Katrina also contributed to EuroHealthNet’s “Flashcard” series on ‘Social Dialogue and Inclusion of Workers’, aligning with the European Pillar of Social Rights. These practical flashcards aim to guide public health professionals and decision-makers in implementing the Pillar’s 20 key principles, each exploring the relevance of a different principle to the public health sector.

During her secondment, Katrina actively participated in conferences, including EuroHealthNet’s event on ‘Unlocking the Potential of the European Semester’ in collaboration with the European Economic and Social Committee.

Stay tuned for an upcoming informative report, policy précis and flashcard release. Keep your eyes peeled for more details!

The post Katrina’s Secondment in Brussels at EuroHealthNet appeared first on HEALTH CASCADE.

Katrina Messiha, in her capacity as a Visiting Researcher at the University of Cambridge through the NIHR-funded ComPHAD project, has been involved in integrating her PhD work to contribute to the advancement of brain health research, with a focus on prioritising historically marginalised groups. Since May 2023 (and ongoing), she has actively collaborated to achieve key objectives in implementing co-creation approaches tailored to research on brain health.

In addition to providing key insights from her existing PhD work to the ComPHAD project, Katrina’s research involved extracting nuanced insights from secondary literature sources to comprehend primary care, public health and social care needs concerning dementia. She synthesized subtleties of cognitive decline from academic and grey literature, informing the development of an Assets-based Approach Framework.

Additionally, Katrina engaged in focus group discussions and co-development activities, including Public and Patient Involvement and Engagement (PPIE), with community organizations and stakeholders. This collaborative effort led to the creation of a detailed report. She also organized and facilitated participatory workshops, conducting subsequent data analysis based on these sessions. Also, Katrina presented some of her PhD findings within the ComPHAD group and received an invitation to present her work to the broader Cambridge Public Health network in the new year. Moreover, she recently completed a blog for the Cambridge Public Health website (here), drawing on her co-creation research and offering insights from her work in critical realism.

Beyond this six-month secondment, Katrina is co-leading two studies with the University of Cambridge. One entails a grey literature scoping review on brain health, while the other centres on a narrative synthesis conducted through participatory workshops grounded in critical realism.

The post Katrina’s Secondment in Cambridge, the ComPHAD project appeared first on HEALTH CASCADE.

In Brussels, Katrina Messiha immersed herself in co-creation, participatory processes, collaboration among EU member states and public health initiatives. Notably, she made a recent contribution to the MOSAIC Project Final Event, through a poster presentation (see poster here) underlining the significance of critical realism in enriching the evidence base for co-creation research in public health. For more details, refer to her blog for the University of Cambridge – here.

Furthermore, at EuroHealthNet’s Conference on ‘Unlocking the Potential of the European Semester: Achieving a Wellbeing Economy through Participatory Societies’, Katrina discussed the importance of rejecting linear co-creation models, aligning with the sentiments expressed by the keynote speaker Krzysztof Balon. Both reinforced the need to adapt to dynamic interactions inherent in the co-creation process.

Her active involvement extended to Eurocities’s Living-in.EU Stakeholder Forum, the European Commission’s European Partnership Stakeholder Forum 2023 and European Parliament to participate in the event ‘A Stitch in Time: Early Intervention to Tackle Europe’s NCD Crisis – Expert Recommendations for Sustainable and Resilient Health Systems’.  These efforts underscore her dedication to addressing Europe’s Non-Communicable Diseases crisis and advocating for sustainable, participatory approaches in public health.

The post Katrina Messiha Showcases Co-Creation in Public Health at Key European Events appeared first on HEALTH CASCADE.

In the first systematic review of its kind, published in the Journal of Public Health (Oxford University Press), a diverse team of co-creation researchers, led by Katrina Messiha, identified and summarized contemporary (explicit) theories used in co-creation, co-design and co-production within public health research. A comprehensive exploration of four databases—PubMed, CINAHL, Scopus and APA PsycINFO, entailed executing meticulous quality assessments and extracting theory content as integral components of the review process.

This systematic review highlights collaborative methodologies grounded in theories, involving diverse stakeholders across contexts, populations and public health issues. It provides a nuanced understanding of the applications and influences of these co-approaches. The team’s findings contribute saliently to academic discourse, offering valuable insights for practitioners and policymakers navigating the public health landscape.

Despite the limited number of articles included, the included theories for co-creation, co-design and co-production in public health establish a valuable foundation for developing effective strategies in future initiatives. Further, the review’s emphasis on synthesizing current theories, and exploring how and why these theories underpin co-approaches, underscores a commitment to advancing interdisciplinary approaches and enhancing public health interventions.

REFERENCE: Messiha, K., Chinapaw, M.J., Ket, H.C., An, Q., Anand-Kumar, V., Longworth, G.R., Chastin, S. and Altenburg, T.M., 2023. Systematic Review of Contemporary Theories Used for Co-creation, Co-design and Co-production in Public Health. Journal of Public Health, p.fdad046.

The post Systematic Review of Contemporary Theories Used for Co-creation, Co-design and Co-production in Public Health appeared first on HEALTH CASCADE.

Katrina Messiha led co-working sessions at our October 2023 Barcelona meeting, on part of her PhD research on “Enriching the Evidence Base of Co-creation in Public Health with Methodological Principles of Critical Realism”. These sessions aimed to connect critical realism (a meta-theory) with practical application, deepening the understanding of critical realism’s role. The sessions included a knowledge transfer phase where Katrina presented one of her PhD studies and a collaborative segment with several participating researchers, focused on applying the acquired knowledge. 

Participating researchers engaged with and provided feedback on Katrina’s research findings within real-world contexts, specifically in multisectoral work package projects 3-6. Discussions explored the intersection of critical realism methodological principles and co-creation in public health. In this vein, participating researchers drew parallels between said principles and their co-creation projects in various public health contexts. The sessions served as a favourable and insightful platform for both knowledge exchange and collective brainstorming.  

The post Enriching the Evidence Base of Co-creation in Public Health with Methodological Principles of Critical Realism appeared first on HEALTH CASCADE.

The post Cascading Collaborative Approaches in Public Health appeared first on HEALTH CASCADE.

On 4^th December 2022, Katrina Messiha (ESR1) received abstract acceptance of her systematic review, following the conference’s double-blind peer review process, which she’ll present at the 6^th ICPR 2023 on “Participation, Co-creation and Service Users’ Positions”; contributing to its agenda of transforming knowledge and critically furthering practice, theories and methods, on 7^th – 9^th June 2023, at Aalborg University (Denmark). 

Katrina’s work entitled “Systematic Review of Contemporary Theories Used for Co-creation, Co-design and Co-production in Public Health” (co-authors: Chinapaw, MJM; Ket, JCF; An, Q; Anand-Kumar, V; Longworth, GR; Chastin, S; Altenburg, TM) systematically reviewed and quality assessed the scientific evidence about co-creation, co-design and co-production in four databases (PubMed, CINAHL, Scopus and APA PsycINFO), specifically by categorising the contemporary theories (including theoretical frameworks) used in each, in the context of public health research. In addition, this study is being considered for publication as a peer-reviewed article by a reputable journal.  

The post 6th International Conference on Practice Research: “Participation, Co-creation and Service Users’ Positions” appeared first on HEALTH CASCADE.

One year ago, Katrina Messiha’s (ESR1) earliest secondment hosted by GCU mainly entailed experience and collaboration with Obesity Action Scotland’s (OAS) co-creation work. Funded by the Scottish Government and hosted by the RCPSG, OAS offers clinical guidance and advocacy on addressing obesity in Scotland. OAS hosts the National Co-ordinator for a Whole Systems Approach (WSA) to Diet and Healthy Weight Programme. Other partners in the programme include The Scottish Government, Public Health Scotland, and Food Standards Scotland, who collectively work to govern the WSA programme.  

Katrina attended OAS meetings led by Niamh Smith, to observe how local leads from the early adopter areas discuss their progress and learn from each other. This fed into an understanding of interactional knowledge production/ translation, a key dimension of co-creation. Overall, this enriching secondment gave direct exposure to a real-life co-creation campaign at scale, elevating an understanding of its operationalisation on the ground and reinforcing the need for proper staffing, prioritisation and momentum. The secondment lasted a month – including some Scottish culture; namely, Burns supper and a hike in the national parks!  

The post <strong>Katrina’s First MSCA Secondment with Obesity Action Scotland: A Whole Systems Approach to Co-creation for Addressing the Obesity Crisis</strong>  appeared first on HEALTH CASCADE.

Rabab Chrifou is a Marie Curie doctoral fellow within the Health CASCADE project. Her research focuses on the ethical aspects of co-creation within public health. 

Katrina and Rabab carried out interviews with researchers and facilitators that had published work on and had previous experience with co-creation, respectively, in order to direct their research in evidence-based co-creation principles and ethics. A topic that they both picked up on in their conversations was the notion of a ‘true’ and ‘false’ form of co-creation.

A key consideration in exploring theory and ethics relating to co-creation is its ‘true’ versus ‘false’ form – in other words, whether there is a ‘deep’ co-creation that is distinguished against the notion of tokenistic co-creation. Interviews with researchers and facilitators with expertise regarding co-creation revealed their thinking around this.  

When participants were asked to define co-creation, examples of insights given included: ‘collaboration between different groups of stakeholders to develop a mutually-beneficial outcome’, ‘a process where, we have people representing organisations, they come together and they try to create something’, ‘co-creation is about participants being involved in the whole process, from initiation to commenting on the final policy’, and ‘co-creation is an umbrella and includes different ways of participation, including participatory health research’.  

The underlying definitions, extracted from our interviews, suggests that co-creation (directed at health improvement) consists of ‘participants’ who engage in the process of creating something with a goal (for instance, of obtaining a beneficial health outcome). Furthermore, our interviewees mentioned that ‘true’ co-creation can be characterized by intense time investment, collective value creation, combining different types of knowledge, more obligations with regards to inclusiveness, focus on reciprocity and the presence of a preliminary process to arrive at a shared question.  

In terms of what does not include co-creation, the participants identified that it is ‘something that doesn’t benefit all groups of stakeholders’, ‘tokenism: having your own ideas but you involve others to strengthen your own ideas’, and ‘doing it on your own’. But there were some different views on this topic. For instance, one participant felt that consultation is very useful for co-creation, whereas another participant said that it is not ‘true’ co-creation, thus perhaps more tokenistic. That said, some participants argued that the distinctive features of ‘true’ co-creation should be preserved, and that one has to be careful not to overstate it to avoid devaluing the concept of it over time.  

Besides these two extremes of ‘true’ and ‘false’ co-creation, some participants referred to the nature of co-creation. As one of the participants stated: ‘So there’s deep co-creation and then there’s surface co-creation and that deep co-creation, it means we are on equal terms with those that we co-create with.’ Also, co-creation, as is understood by the participants, may not be the ultimate solution for the concerned public health issue. Other, less intense forms of participation, may be equally valuable for the envisioned purpose: ‘Within participatory work, co-creation is at the top of the tree, co-creation describes a process of a certain type which is right in certain circumstances, and other approaches are equally right in that circumstance.’  

Overall, the interviews showed that co-creation cannot be categorised as easily as Arnstein’s Ladder (1969) portrays participation to be, since participation itself is nuanced and not straightforward. Whilst the interviews served to stimulate thinking around what potentially counts as true co-creation, our first impression is that the fluidity around the concept and approach of co-creation leaves room for us to further scrutinise both the theoretical and ethical implications of it within public health. This will be achieved through thorough systematic work and a novel angle, additionally applying it to several real-life co-creation-based projects, which can enrich the process and strengthen evidence-based research.   

The post ‘True’ Co-creation Versus ‘False’ Co-creation   appeared first on HEALTH CASCADE.