Contributing to The University of Cambridge’s ComPHAD Project
Katrina Messiha is a Marie Curie doctoral fellow within the Health CASCADE project. Her research focuses on developing theoretical principles for co-creation in public health.
In this blog, Katrina Messiha discusses her recently published systematic review (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.) in the Journal of Public Health [Oxford University Press] and its potential applications. Specifically, she articulates the key take away messages and the implications of the review and explores how this work will inform and contribute to ongoing research initiatives, such as the ComPHAD Project at the University of Cambridge.
There is much promise in adopting co-approaches, namely – co-creation, co-design, and co-production, considering their capacity to actively involve diverse and affected stakeholders in public health initiatives. We defined these co-approaches using the work of Vargas et al. In order to develop public health interventions in an effective and trustworthy way, it is crucial to use an evidence-based approach grounded in theory, given the General Medical Council’s guidance which is the most extensively cited. My systematic review’s findings shed insight into how explicit theories and theoretical frameworks were applied across any or all phases of co-creation initiatives in the public health field, notably in the contemporary period (since 2012 as marked by a heightened interest and activity in co-creation across research fields).
Compatible with the PRISMA guidelines, we searched four databases (PubMed, Ebsco/ CINAHL, Ebsco/ APA PsycINFO and Elsevier/ Scopus) with the most use across biomedical, health, psychology and multidisciplinary academic and research settings. We included articles according to our criteria: original studies (and protocols), with explicit reference to theory/ theoretical framework which was used for co-creation, co-design and co-production in public health research relating to any/ all parts of its approach or particular elements. The methodological quality of the included studies was assessed using a validated quality assessment tool coupled with a modified theory analysis approach to analyse the data extracted from the included articles. In terms of results, six distinct theories and three theoretical frameworks were identified and categorised according to the explicit co-approach(es) used.
For co-creation, Empowerment Theory was used by two articles, Social Learning Theory and Narrative Learning Theory as well as Symbolic Interactionism Theoretical Framework was used. For co-creation and co-design, Social Effectiveness of Interventions Theory was used as well as Realist Evaluation Theoretical Framework. For co-production and co-design, Normalisation Process Theory and Interactional Ritual Change theory was used. Finally, for co-design, Social Innovation Theory and Theoretical Framework of Social Justice was used. The review clearly delineated how and why these theories/ theoretical frameworks were used, and most of the included papers used such for informing the (analytical) methods. Also, some of the identified theories, like Empowerment Theory, fits with the alternative fields to public health research.
Overall, the findings of this review contribute to the effective and systematic theory-building of co-creation, co-design, and co-production – which can inform future public health research using these co-approaches. The review’s significance lies in its comprehensiveness, making it a valuable resource for researchers and practitioners in public health and related fields, to pragmatically draw upon. Further, we underscore the potential applications of the review, extending to ongoing research initiatives such as the ComPHAD Project led by the University of Cambridge. For instance, its findings will enable knowledge sharing and application in the ComPHAD project and beyond. Part of my work with the University of Cambridge also extends to work on the meta-theoretical level, specifically, the use of critical realism as a congruent lens for enriching evidence-based co-creation for public health research.
To elaborate further on the ComPHAD project, it builds on two decades of work in longitudinal studies of aging, including the Cognitive Function and Ageing Studies (CFAS) and CFAS II. However, traditional approaches to longitudinal studies have tended to exclude certain communities or population groups, leading to gaps in health data and an incomplete understanding of the aging process. ComPHAD aims to address these gaps by using a co-creation approach to develop a more sustainable and inclusive way of conducting longitudinal studies in diverse communities. Therefore, I get the privilege of collaborating with the various and talented team members of the ComPHAD project, in progressing their important co-development work with an intersectional lens on vulnerable populations, such as those facing homelessness and dementia/ cognitive decline.
As an element of my collaboration, I will support the translation of the theories and theoretical frameworks identified for co-creation initiatives as part of my systematic review, in order to inform the development of ComPHAD’s research methodology in addition to that of the Health CASCADE projects’. In this way, both projects can build on existing research, tailor its approach to meet the needs of the communities it serves and input towards best practices. For illustration, Empowerment Theory in co-creation initiatives was identified as prominent in the systematic review since it was used by more than one article, unlike the other theories/ theoretical frameworks used by one article each. Therefore, Empowerment Theory may be a pertinent theory to use in line with the ComPHAD project’s aim of empowering communities to take an active role throughout the research process.
In closing, I look forward to observing the potential of this systematic review materialise in context of various innovative and powerful projects dedicated to conceptualising and enacting evidence-based co-creation research in public health. If you would like to inquire about how I can support you to incorporate or implement the systematic review findings/ collaborate with me on work that you render relevant in scope, then please do not hesitate to get in contact with me on my email address: k.m.messiha@amsterdamumc.nl – and I thank you in advance for your interest on this front!