© 2016 Milbank Memorial Fund. Policy Points: Co-creation - collaborative knowledge generation by academics working alongside other stakeholders - is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Context Co-creation - collaborative knowledge generation by academics working alongside other stakeholders - reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. Methods We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Findings Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of relationships, and governance and facilitation arrangements, especially the style of leadership and how conflict is managed). In both the literature review and the case study, co-creation "failures" could often be tracked back to abandoning (or never adopting) these principles. All co-creation models made strong claims for significant and sustainable societal impacts as a result of the adaptive and developmental research process; these were illustrated in the case study. Conclusions Co-creation models have high potential for societal impact but depend critically on key success principles. To capture the nonlinear chains of causation in the co-creation pathway, impact metrics must reflect the dynamic nature and complex interdependencies of health research systems and address processes as well as outcomes.

Achieving research impact through co-creation in community-based health services: Literature review and case study

What is it that makes a profession a profession and assures its members special status? What do professionals need to be able to claim their turf and establish priority over others who interact wit...

The gold standard: the challenge of evidence-based medicine and standardization in health care

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The McDonaldization of Society: An Investigation into the Changing Character of Contemporary Social Life

Inclusion: The Politics of Difference in Medical Research

A dental instrument for cutting and vibrating the stone loose from dentures, the device comprising an electrical implement in which electrical current moves a vibrating magnet iron at a very high speed so as to cause a forward extending piston that cuts and vibrates the stone loose.

The Third Wave of Science Studies

Beyond two communities - from research utilization and knowledge translation to co-production?

In recent years, the healthcare field welcomed an emerging field of practices captured under the umbrella term ‘Big Data’. This term is surrounded with positive rhetoric and promises about the abil...

/pdf/conceptualizations-of-big-data-and-their-epistemological-4i4qukx0ny.pdf

Conceptualizations of Big Data and their epistemological claims in healthcare: A discourse analysis

The call for ‘evidence-based health policy’ in the Netherlands has to date been accommodated by the consensual policy tradition in this country and by the institutionalised arrangements for research funding, researcher career development and research accountability systems.
The aim of this paper is to describe and explain from a sociological perspective how these arrangements for two-way research–policy interactions enable the co-production of ‘useable
knowledge’ for ‘doable problems’ in health policy making. We conclude that many arrangements function as boundary objects that allow for mediation between research and policy. This
mediation occurs via both frontstage and backstage processes. The backstage processes are an essential precondition for the co-production of acceptable evidence, policy advice and
policy in the frontstage. However, as a result of the increasing emphasis on evidence-based policy, and an accompanying instrumentalisation of research use in the policy process, some
of the characteristic, and until now productive, elements of the Dutch system are threatened.

Linking research and policy in Dutch healthcare: infrastructure, innovations and impacts

Researchers are increasingly expected to deliver “socially robust knowledge” that is not only scientifically reliable but also takes into account demands from societal actors. This article focuses on an empirical example where these additional criteria are explicitly organized into research settings. We investigate how the multiple “accountabilities” are managed in such “responsive research settings.” This article provides an empirical account of such an organizational format: the Dutch Academic Collaborative Centres for Public Health. We present a cross-case analysis of four collaborative research projects conducted within this context. We build on (and extend) Miller’s notion of “hybrid management.” The article shows that the extended concept of hybrid management is useful to study the different accountabilities encountered in such settings. We analyze how the collaboration developed and which conflicts or dilemmas arose. We then focus on the different hybrid management strategies used in the collaborat...

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Hybrid Management Configurations in Joint Research

textPublic health policies and services are increasingly scrutinized for their quality and accountability and 'evidence-based' ways of working are becoming more important in most public sector activities. In the Netherlands this led to the development of academic collaborative centers (ACCs) for public health: formal, long-term collaborations between municipal health services, university departments and other stakeholders. In this paper we argue that discussing issues of research uptake or research utilization in terms of 'gaps' that need to be 'bridged' is unproductive when analyzing structural collaborations or partnerships between researchers, policy-makers and practitioners. Within collaborative settings such as the ACCs, the clear distinction between what counts as 'science' and what counts as 'policy' is only one side of the story. We use the notions of 'boundary organization' and 'front stage and back stage settings' to analyze a case study of a collaborative project conducted within one of the ACCs.

Rik Wehrens

Papers

Beyond two communities - from research utilization and knowledge translation to co-production?

Conceptualizations of Big Data and their epistemological claims in healthcare: A discourse analysis

Linking research and policy in Dutch healthcare: infrastructure, innovations and impacts

Hybrid Management Configurations in Joint Research

Coordination of research, policy and practice: A case study of collaboration in the field of public health