Abstract

Design-based research (DBR) is an innovative methodology for co-creation, but potentials, challenges, and differences between methodological ideals and the real-life intervention context are under-researched. This study analyzes the DBR process in which researchers, professionals, and families co-design a family-based intervention to prevent childhood overweight and obesity in a rural municipality. It involves interviews with six key stakeholders in the co-design process. Data were coded and analyzed using systematic text condensation, while the theory of the “social effectiveness of interventions” developed by Rod et al. (2014) was used as an analytical tool for unpacking the co-creation process and exploring methodological barriers and potentials. The DBR approach contributed with a feeling that everyone’s perspective was important, and the professionals got a new perspective on the families’ experiences with healthy living they did not previously consider. We also found that the iterative design process did not fully align with the organizational structures in the municipality or with the needs of stakeholders, leading to friction in the partnership. This study emphasizes the complexity of using an anti-hierarchical approach within a hierarchical context, and the importance of being aware of how the DBR approach shapes the partnership, as well as of how the social dynamics within the partnership shape the design process.

Highlights

  • Over the past decades, childhood overweight and obesity became an increasing problem for public health worldwide [1]

  • We found that the Design-based research (DBR) approach contributed a feeling of creating an equal partnership between the three municipal units and the research center

  • The iterative design process did not fully align with the organizational structures in the municipality or with the needs of stakeholders, which led to friction in the partnership—friction that was overlooked as a pivotal contextual feature

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Summary

Introduction

Childhood overweight and obesity became an increasing problem for public health worldwide [1]. It is known that involvement of parents in preventive interventions is often challenged by recruitment and retention [7]. To improve interventions and better integrate programs into the parents’ sociocultural context, it is vital to engage parents in the development, implementation, and evaluation of obesity prevention interventions [8]. Involvement of local professionals is essential to obtaining contextual knowledge to inform intervention development and implementation [9]. Collaborative work by professionals in a variety of disciplines, local families, and researchers is key to targeting health disparities in families [10].

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