Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration

Gillian Mulvale; Sandra Moll; Ashleigh Miatello; Glenn Robert; Michael Larkin; Victoria J. Palmer; Alicia Powell; Chelsea Gable; Melissa Girling

doi:10.1111/hex.12864

journal article Open Access Jan 02, 2019

Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration

Gillian Mulvale

Sandra Moll

Ashleigh Miatello Glenn Robert

Michael Larkin

Victoria J. Palmer Alicia Powell Chelsea Gable Melissa Girling

Health Expectations Vol. 22 No. 3 pp. 284-297 · Wiley

View at Publisher Save 10.1111/hex.12864

Abstract

AbstractBackgroundCodesign has the potential to transform health and other public services. To avoid unintentionally reinforcing existing inequities, better understanding is needed of how to facilitate involvement of vulnerable populations in acceptable, ethical and effective codesign.ObjectiveTo explore citizens’ involvement in codesigning public services for vulnerable groups, identify challenges and suggest improvements.DesignA modified case study approach. Pattern matching was used to compare reported challenges with a priori theoretical propositions.Setting and participantsA two‐day international symposium involved 28 practitioners, academics and service users from seven countries to reflect on challenges and to codesign improved processes for involving vulnerable populations.Intervention studiedEight case studies working with vulnerable and disadvantaged populations in three countries.ResultsWe identified five shared challenges to meaningful, sustained participation of vulnerable populations: engagement; power differentials; health concerns; funding; and other economic/social circumstances. In response, a focus on relationships and flexibility is essential. We encourage codesign projects to enact a set of principles or heuristics rather than following pre‐specified steps. We identify a set of principles and tactics, relating to challenges outlined in our case studies, which may help in codesigning public services with vulnerable populations.Discussion and conclusionsCodesign facilitators must consider how meaningful engagement will be achieved and how power differentials will be managed when working with services for vulnerable populations. The need for flexibility and responsiveness to service user needs may challenge expectations about timelines and outcomes. User‐centred evaluations of codesigned public services are needed.

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References

Details

Published: Jan 02, 2019
Vol/Issue: 22(3)
Pages: 284-297
License: View

Authors

G

Gillian Mulvale

McMaster University Burlington Ontario Canada

S

Sandra Moll

McMaster University Burlington Ontario Canada

A

Ashleigh Miatello

McMaster University Burlington Ontario Canada

G

Glenn Robert

King's College London London UK

M

Michael Larkin

Aston University Birmingham UK

V

Victoria J. Palmer

The University of Melbourne Parkville Victoria Australia

A

Alicia Powell

McMaster University Burlington Ontario Canada

C

Chelsea Gable

McMaster University Burlington Ontario Canada

M

Melissa Girling

Newcastle University Newcastle upon Tyne UK

Funding

Social Sciences and Humanities Research Council of Canada Award: 611‐2017‐0221

Aston University

Cite This Article

Gillian Mulvale, Sandra Moll, Ashleigh Miatello, et al. (2019). Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration. Health Expectations, 22(3), 284-297. https://doi.org/10.1111/hex.12864

Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration

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