Co-production of a research and advocacy agenda for Inclusion Health

Abstract

BackgroundInclusion Health aims to address and prevent the health harms of extreme inequity faced by excluded groups, including those affected by homelessness, drug addiction, imprisonment, and sex work. Engagement workshops with these groups have shown discordance between published research and what research they think is important. We aimed to involve these excluded groups and the wider service, policy, charity, and academic community who work with them to co-develop research and advocacy priorities. MethodsUsing a co-production approach, we held a 1-day event in London, UK, that involved inclusive, participatory, and consensus-building activities. We facilitated workshops on preventing exclusion, improving services for excluded groups, and escaping exclusion. We recorded participants’ views as observations, field notes, and ranked-lists of problems and suggested solutions. Professional artists captured frustrations and hopes for the future by drawing a visual representation. We conducted rapid thematic analysis of discussions on the day and triangulated these sources of information to develop research and advocacy priorities. FindingsApproximately 100 people attended, with at least 20 people with experience of exclusion. The other participants represented the National Health Service, various charity organisations, national, regional, and local government representatives, and several academic institutions. Emerging priorities included the following: tackling the upstream causes of exclusion (political determinants, poverty, and traumatic childhoods); addressing public and professional ignorance, indifference, and stigma by creating inclusion-focused public messages; making services more accessible and integrated through infrastructure (eg, national registries of services); putting excluded groups at the heart of health research, service development, and decision making, through the development of training for recruitment and co-design; and creating better routes out of exclusion. InterpretationDespite challenges in finding a common language, co-production effectively developed an Inclusion Health agenda aligned with the perceived needs of excluded groups and those who work with them. Funding agencies and the public health community should deliver this research agenda to improve the health and lives of people affected by exclusion. FundingUniversity College London Grand Challenges.