11.D. Scientific session: Participatory approaches and co-creation in complex interventions to reduce inequity in health
Authors:   Organised by: Holbaek Hospital (Denmark), University of Copenhagen (Denmark),   Chair persons: Vivian Rueskov Poulsen (Denmark), Maria Marti Castaner (Denmark)
Published: October 2024

Abstract

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.