Experiences with a co-creation process to adapt a healthy sleep intervention with adolescents: A Health CASCADE process evaluation.

BackgroundAdapting co-creation research processes and/or public health interventions improves the fit between the intervention and population of interest, potentially resulting in more relevant and effective interventions. Mode 2 research approaches (e.g., co-creation, co-production, co-design, community-based participatory research, and participatory action research) can ensure that adaptations fit the socio-cultural and economic contexts. However, an overview of existing practices and how to co-adapt is lacking. This study aimed to provide an overview of the use of co-adaptation in co-creation processes and/or public health interventions.MethodsWe conducted a rapid review search on the Health CASCADE co-creation database. Relevant peer-reviewed studies reporting on co-adaptation of public health interventions were identified. A call for case studies via social media and co-authors’ snowballing was issued to perform interviews with co-creation researchers gaining insights into how co-adaptation was applied from unpublished studies and practice. Interviews were analysed using template analysis.ResultsFourteen studies addressed various public health issues by co-adapting co-creation processes, intervention activities, communication platforms, monitoring strategies, training components, and materials’ language and tone. Most studies lacked detailed reporting on the co-adaptation process, though some provided information on group composition and number, duration, and methods applied. Two out of 14 studies used a framework (i.e., Intervention Mapping Adapt), seven described their adaptation procedure without naming a specific framework, and five did not report any procedures or frameworks. Five of seven case studies used adaptation frameworks (e.g., ADAPT guidance). Interviews provided insights into the co-adaptation process emphasising the importance of contextual fit, integrating prior knowledge, and logging adaptations.ConclusionsThis study is the first introducing the concept of and exploring co-adaptation of co-creation processes and/or public health interventions. It provides details regarding adaptations made, whether and which frameworks were used, and procedures applied to adapt. The findings highlight the need for tailored frameworks for co-adaptation and better reporting of co-adaptation processes.

Despite increasing popularity of co-creation approaches across various types of co-creation (e.g., value co-creation) and research fields, systematic and effective theory-building of co-creation research is generally lacking. We explored co-creation literature underpinned by explicit theory, taking a hybrid approach by combining a narrative literature review of studies in various research fields and a systematic literature review of studies in the field of public health. Subsequently, we identified common dimensions applied to the co-creation process across various types of co-creation and research fields, in performing an inductive thematic analysis. Across the total 27 articles included as part of the narrative and systematic review, we identified 5 dimensions related to the co-creation process applied across 9 research fields: (1) Multi-stakeholder collaborative action; (2) Process of co-learning towards innovation; (3) Contextual knowledge production; (4) Generating meaning; and, (5) Open, trustful and inclusive dialogue. The findings offer renewed insight into the common dimensions of the co-creation process, with underpinning explicit theories across various types of co-creation and research fields. A clear and consistent definition of co-creation was often lacking, especially in the field of public health. We strongly emphasise the need for research to adopt a multi-dimensional approach to the co-creation process—as well as to work towards developing a common language around co-creation, which involves operationalising these identified five dimensions.

Teachers' experiences in co-creating an implementation plan for a public health intervention: a Health CASCADE study.

Background Adolescent sleep deprivation is an important health concern, urging the need to develop effective interventions. Combining a participatory approach (i.e. actively involving the adolescents) and Intervention Mapping (IM) may improve effectiveness. Therefore, the aim of this study was to describe the development of an intervention to improve adolescents' sleep behavior that combined a participatory approach with IM. Secondly, we evaluated the participatory process, based on focus group research in adolescents. Methods In three secondary schools in Flanders (Belgium), an action group with 6-8 pupils and an academic facilitator had weekly sessions with the aim to co-create an intervention, following IM. Three focus groups within each action group were organized throughout the development process. Data were thematically analyzed using NVivo 12. Results During the sessions, each action group went through the different steps of IM: identifying the problem (step 1: needs assessment), deciding on what should be changed (step 2: program objectives) and how it can be changed (step 3: methods and applications), and designing the intervention (step 4: program development). Most adolescents were positive about the content of the sessions, the methods used, the level of participation and the collaboration with the others. Still, they felt more satisfied during the final, more concrete steps. Also, they seemed to lack support from their schools. Conclusions The unique approach of combining participatory research with IM is a promising way to develop an intervention to improve adolescents' sleep. Further research needs to investigate if it leads to more effective and sustainable interventions. Key messages Going through the different steps of Intervention Mapping in cooperation with adolescents is a feasible approach to develop an intervention to promote healthy sleep in adolescents. Adolescents mostly describe participating in the development of a healthy sleep intervention through Intervention Mapping as a positive experience.

“Co-creation” in transdisciplinary research is marked by ambiguity, revealing tensions between collaboration, conflict, and creativity. We argue that co-creative processes must embrace dissent, emotion, and context-specific dialogue to avoid reproducing power imbalances. True co-creation requires competence, transparency, and the capacity and commitment to shared learning in order to transform conflicts constructively.

Purpose of the paper:The purpose of the paper is to analyze how co-creation is managed within the innovative business models of sharing economy platforms.Methodology: Case studies analysis has been performed on three sharing economy platforms.Platforms have been selected according to the extent to which innovation driven by co-creative processes was evincible in the value proposition, in the profit formula or in the key processes and resources.The cases have been analyzed through the D.A.R.T. model that defines the four places of co-creation (dialogue, access, risk, transparency).Findings: The analysis shows that there is a link between the type of innovation and the dimension of co-creation.In particular: Dialogue is relevant when cocreation refers to the innovation of the value proposition; Access is more stressed when co-creation drives the innovation in the key resources and processes; Risk comes to be underlined in the platform where co-creation involves the definition of the profit formula.Transparency is a common element across all of the analyzed cases.Research limits: Shortcomings concern the selection of the theoretical framework, the exclusion of platforms other than C2C and the focus on secondary data.Practical implications: The analysis allows to understand the dimensions of co-creation that emerge as being particularly relevant in sharing economy platforms where the innovation of the business model is based on the involvement of customers.Originality of the paper: This work provides a joint analysis of BMI and co-creation as emerging in sharing economy platforms, proposing an integrated interpretation of these phenomena.

The ICT sector is one of the fastest growing sectors in the global economy. It provides a wide range of services for different actors according to their type of actions. Meantime, there is a limited understanding how different ICT tools can support co-creation process among different groups of stakeholders in terms of the Responsible Research and Innovation (RRI) processes. As we see the core principle of the RRI is a common work, or in other words—a co-creation process. So who and how can facilitate and ensure the quality of such co-creation process and its outcomes in multidisciplinary society? This article puts focus specifically on the use of ICT tools for communication and knowledge exchange (creation of common projects) among different groups of stakeholders, emphasising the importance of such online co-creation in nowadays transdisciplinary society and explaining the importance of the facilitation of co-creation process. It also highlights the architecture of Co-RRI platform, an example of a web platform which supports stakeholders’ cooperation in the frames of the Horizon 2020 FoTRRIS project. It was created to support project Co-RRI activities in five partner countries (Belgium, Spain, Italy, Hungary, and Austria). The need for such cooperation practices in local communities is demonstrated and experiences of local communities are summarised.

BackgroundThe problem of mental ill-health in doctors is complex, accentuated by the COVID-19 pandemic, and impacts on healthcare provision and broader organisational performance. There are many interventions to address the problem but currently no systematic way to categorise them, which makes it hard to describe and compare interventions. As a result, implementation tends to be unfocussed and fall short of the standards developed for implementing complex healthcare interventions. This study aims to develop: 1) a conceptual typology of workplace mental health and wellbeing interventions and 2) a mapping tool to apply the typology within research and practice.MethodsTypology development was based on iterative cycles of analysis of published and in-practice interventions, incorporation of relevant theories and frameworks, and team and stakeholder group discussions.ResultsThe newly developed typology and mapping tool enable interventions to be conceptualised and/or mapped into different categories, for example whether they are designed to be largely preventative (by either improving the workplace or increasing personal resources) or to resolve problems after they have arisen. Interventions may be mapped across more than one category to reflect the nuance and complexity in many mental health and wellbeing interventions. Mapping of interventions indicated that most publications have not clarified their underlying assumptions about what causes outcomes or the theoretical basis for the intervention.ConclusionThe conceptual typology and mapping tool aims to raise the quality of future research and promote clear thinking about the nature and purpose of interventions, In doing so it aims to support future research and practice in planning interventions to improve the mental health and wellbeing of doctors.

The objective of this scoping review was to map how intervention mapping has been used to develop health promotion interventions for adults with chronic conditions. Chronic conditions present a growing burden of disease across the world, with many countries looking for novel ways of managing these conditions. Intervention mapping is a 6-step behavioral change intervention development approach that can be used to create programs or innovations for health promotion in different settings and locations. This review considered all studies that used intervention mapping to develop a health promotion intervention for adults (≥18 years) with a chronic condition in any setting or location. To be included, the study had to use at least 1 of the 6 steps of intervention mapping. This scoping review followed the JBI methodology for scoping reviews. In May 2023, the databases MEDLINE (EBSCOhost), CINAHL (EBSCOhost), Allied and Complementary Medicine Database (EBSCOhost), APA PsycINFO (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews (Cochrane Library), Scopus, and Web of Science Core Collection; the trial registries Cochrane Central Register of Controlled Trials (Cochrane Library), ClinicalTrials.gov, ISRCTN Registry, Research Registry, European Union Clinical Trials Register, Australian New Zealand Clinical Trials Registry, and the Trials Register of Promoting Health Interventions; and the gray literature databases EThOS, EBSCO Open Dissertations (EBSCOhost), and Sherpa Services (OpenDOAR) were systematically searched. Title and abstract screening was conducted by 3 reviewers independently, with conflicts resolved through discussion. Full-text screening of selected studies was conducted similarly by 2 reviewers. Data were extracted by 1 reviewer using a predefined yet flexible tool developed by the reviewers. A second reviewer independently extracted the first 10% of the included studies, with any discrepancies between reviewers resolved through discussion and random checks on 10% of the remaining studies providing extra fidelity. The data are presented in tables, graphs, and diagrams, with a descriptive summary and discussion of the results. After screening, 56 studies were included in this review. Interventions were developed for 26 named chronic conditions. Steps 1, 2, and 3 were included in 55 studies (98%), step 4 was included in 48 studies (86%), step 5 was included in 30 studies (54%), and step 6 was included in 25 studies (45%). Stakeholder involvement included people with lived experience, health care professionals, experts, and community members, and was reported most often in the work group involved in conducting the research. The most common theory utilized by the included studies was the Social Cognitive Theory. Although intervention mapping was adapted by all the included studies to fit their needs, this flexibility is embraced by the authors of intervention mapping. Stakeholders were involved throughout, although less so in later steps. Theory, although regularly employed, was not always fully integrated into the developed interventions. The findings of this scoping review suggest that a dedicated intervention mapping reporting tool should be developed to improve the reporting in the literature and enable easier understanding and synthesis of future research. Future intervention developers must recognize the benefits while understanding the challenges of fully engaging with theory when developing their interventions. OSF https://osf.io/z9kdc.

BackgroundImplementing public health interventions in schools requires active involvement of multiple stakeholders and adaptation of interventions to fit local contexts, to account for successful design, implementation, and consequently effectiveness of these interventions. Active collaboration, preferably in a co-creation process, with school staff is needed to enhance the implementation of school-based public health interventions. However, involving them in research through a co-creation process is challenging due to competing demands on their time. Hence, there is a need for insights into the factors facilitating or impeding co-creation processes involving school staff.MethodsTo gain in-depth knowledge of school staff’s experiences a scoping review and thematic synthesis have been conducted. Peer reviewed articles written in English and published between January 2012 and November 2023 were retrieved from ERIC, Education Database, Medline (PubMed interface), Embase, Web of Science, Scopus, and Health CASCADE Co-creation Database. Considering the high amount of search results the title and abstract screening was performed using ASReview. A thematic synthesis was conducted on the included articles.ResultsTen scientific peer reviewed articles were included and thematically synthesised. Six descriptive themes described factors influencing the co-creation process, including competing work roles and responsibilities of school staff, multistakeholder collaboration, benefits of participation in the co-creation process, power imbalances between different stakeholders, and school staff’s lived experiences. Additionally, four analytical themes emerged indicating that demands of the co-creation process outweigh its benefits. To tackle excessive demands school staff preferred a guided process in which high-level participation was less important. School staff joined the co-creation process to serve students and emphasised the importance of being heard and taken seriously.ConclusionsSchool staff indicated that excessive demands outweigh the benefits experienced during the co-creation process. Therefore, school staff preferred less time-intensive processes. Improving students outcomes was school staff’s motivation to be involved, which asks for processes with student-related goals and observable student benefits. Moreover, school staff needs to be acknowledged as an expert and valued for their involvement. These results should be considered to make co-creation processes involving school staff more feasible and satisfactory.

Adolescents' sleep deteriorated over the last decades, urging the need to develop effective interventions. Using participatory action research (PAR) is a promising and unique approach to target adolescents' sleep. This study aims to describe the process and results of combining PAR and intervention mapping (IM) to guide future researchers on developing and planning of the implementation and evaluation of interventions promoting healthy sleep in adolescents. In each of three intervention schools (two with general and technical education and one with technical and vocational education), an action team including adolescents (age 13- 15 years, n=max. 12) and a researcher was composed to develop and plan the intervention. During weekly sessions (n=ranging from 23 to 34 per school), the action team went through the six steps of IM. A short PAR was performed with parents (n=7) to develop parental intervention components. Combining PAR and IM resulted in interventions focusing on the importance of healthy sleep, regular sleep patterns and associated behaviors: screen behaviors, physical activity, dietary behavior and relaxation. Several differences in the participatory process (i.e. more guidance needed during brainstorms in the vocational/technical school) and developed intervention (i.e. less intrusive intervention components in the vocational/technical school) were observed between schools. Combining PAR with IM resulted in more extensive interventions than other existing school-based sleep interventions. Future studies should investigate whether a participatory developed sleep intervention could be transferred to another setting using a shorter participatory process.

Background Companies increasingly allocate resources to promote health and sustainable employability (SE) of employees. In practice, the effectiveness of these interventions is reduced by factors on meso and micro levels, leading to failed implementation (https://doi.org/10.3233/WOR-23050). This study aimed to develop and test a tool for screening and optimizing organizational readiness for innovative health interventions. The Consolidated Framework for Implementation (CFIR) was used as a framework. Methods A scoping review was used to find evidence about factors that influence the implementation process of interventions. The taxonomy was enriched by conducting 12 semi-structured interviews with 3 groups of stakeholders: (HR) managers, employees and experts. A face validity test was carried out using the think-aloud method to evaluate the relevance and user-friendliness of the developed tool. Results Barriers and facilitators found in the review and interviews were classified into the CFIR domains and appeared to interact dynamically. Factors such as relative advantage, tailor-made design, low complexity, anticipated cost reductions and alignment with legislation occurred as facilitators. Support from high- and mid-level leaders, available resources, and alignment with organization's mission emerged as critical conditions for sustainable implementation. Organizational structure and culture can be both facilitator and barrier. Prevailing power dimensions and the capabilities of innovation recipients appear to play a role as well. The screening tool was developed and evaluated positively and as being low threshold by end-users. Conclusions A tool for screening and increasing organizational readiness for implementing health interventions was developed systematically and evaluated positively. This instrument could be used by organizations who aim to implement innovative and possibly disruptive interventions to increase their employees’ health and SE. Key messages • In practice, health and SE interventions are not effective due to failed implementation and the fact that they are too innovative or disruptive. • A tool for screening and increasing organizational readiness for implementation of health and SE interventions was developed systematically and tested positively.

Health disparities are linked to social inequalities, necessitating health researchers to address the health gaps that exist between different social groups, particularly in the realm of health interventions. This workshop delves into the significance of co-creation processes and participatory approaches in complex health interventions to reduce social inequities in health outcomes. Through empirical cases illustrating co-creation processes in intervention research, the workshop aims to enlighten the audience on the continuum of participatory approaches. The MRC/NIH framework of complex interventions highlights the importance of engagement with relevant stakeholders throughout the research phases to enhance the likelihood of developing or identifying interventions that can positively impact health outcomes. However, the extent and nature of stakeholder involvement may vary depending on the specific context and stage of the research. While stakeholder involvement has been a longstanding focus, the concept of co-creation, where stakeholders actively participate in the entire process of intervention development, implementation, and evaluation, has emerged more recently. This shift from creating interventions for the target population to collaborating with them in the intervention’s creation has led to the emergence of more inclusive health interventions that are contextually relevant and tailored to the local settings where they are intended to create change. Yet, introducing participatory approaches in intervention research may raise new questions about decision-making and power dynamics. While interventions led solely by experts and researchers may overlook the empowerment and capacity-building potential among stakeholders and intervention sites, co-creation processes have the capacity to empower stakeholders and address health inequities effectively. However, challenges persist in ensuring equal collaboration between researchers and participants, especially in disadvantaged groups. This workshop aims to prompt reflection on ethical issues arising from traditional health intervention approaches and approaches to ensure participants’ ownership of interventions when they are adapted in new contexts. Moreover, this workshop will discuss the design of participatory interventions: What methods can we use to co-create? What stakeholders to involve? At what stages of the intervention should co-creation occur? The workshop program begins with an introductory presentation of participatory approaches and co-creation in health intervention research, with examples from a school-based intervention. Next, three empirical cases of co-creation processes introduced in interventions in different contexts are presented. Finally, the audience is invited to a take part in a discussion focusing on how participatory approaches among disadvantaged populations can potentially contribute to reduced social inequity in health. Key messages • The involvement of stakeholders in the development, implementation and evaluation of health interventions can take many forms, and what is meaningful for the specific context needs to be considered. • Co-creation approaches in health interventions empower participants and address unequal power dynamics between those who deliver and those who receive health interventions.

BackgroundDesert recreational sport injuries in the UAE, a tourism-driven nation, are a growing public health concern. To address the lack of research on quad bike/ATV injuries, we conducted multiple studies...

Patient and Public Involvement (PPI) is considered good practice in all health research including literature reviews. Reporting of involvement practice in realist reviews has been inconsistent leaving gaps in understanding of best practice. Realist reviews are theory driven and explain how interventions work, for whom and in which circumstances. PPI in realist reviews provides a link between programme theory and real-world experiences and can be achieved through a ‘stakeholder group’ bringing lived and professional experience together. This paper discusses experiences of a stakeholder group with seven members with lived experience and eight members with professional experience in a realist review focused on how community mental health crisis services work. A mental health crisis is a time of distress when people need urgent support. Many different agencies can respond to mental health crises, but despite this, people often find it hard to navigate to the right help at the right time. Reflections on involvement in four stakeholder meetings alongside practical examples of involvement activities used during the realist review are discussed. Having two researchers co-lead the stakeholder group from both lived and professional experience perspectives provided a bridge between the different expertise within the stakeholder group. Engagement with a voluntary organisation provided support to lived experience stakeholders, which sustained their involvement over time. Social connectedness was needed to establish trust between stakeholders. This required informal social contact between stakeholders that needed to be planned, especially for online meetings. To maintain the emotional wellbeing of the stakeholders during their involvement, safe spaces for discussion are needed and these are best planned in partnership with the stakeholders. We concluded that consideration of ways to provide opportunity for informal contact in online meetings may improve the experience of the stakeholders. Careful consideration of ways to sustain stakeholders’ contribution over time are needed. The emotional impact of involvement should be considered when planning realist reviews. This may include built in flexibility in the involvement to include small expertise specific breakout groups, individual meetings, and should be planned in partnership with the stakeholders.