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Ethics in Research01:56

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Are you really doing 'codesign'? Critical reflections when working with vulnerable populations.

Sandra Moll1, Michelle Wyndham-West2, Gillian Mulvale3

  • 1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada molls@mcmaster.ca.

BMJ Open
|November 5, 2020
PubMed
Summary

This study explores codesign in health research, emphasizing meaningful engagement with vulnerable populations. It identifies risks and offers a tool for reflexive codesign processes to ensure equitable outcomes.

Keywords:
organisation of health servicesqualitative researchquality in health carestatistics & research methods

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Area of Science:

  • Health Services Research
  • Community-Based Participatory Research
  • Patient and Public Involvement

Background:

  • Codesign, coproduction, and patient engagement are increasingly vital in health research for meaningful service development.
  • Lack of clarity exists regarding codesign principles and practices, particularly for engaging vulnerable populations with intersecting disparities.
  • Vulnerable populations, facing disparities due to poverty, language barriers, age, disability, minority status, or stigmatized conditions, require specific considerations in research.

Purpose of the Study:

  • To critically examine codesign research methodologies specifically with vulnerable populations.
  • To identify key considerations during the planning, implementation, and output phases of codesign research.
  • To address risks and tensions inherent in codesign with marginalized groups.

Main Methods:

  • Critical reflection on existing codesign literature and practices.
  • Identification of risks and tensions across different phases of codesign research.
  • Development of a reflexivity tool for codesign processes.

Main Results:

  • The paper outlines critical issues in planning, implementing, and reporting codesign research with vulnerable groups.
  • Specific risks and tensions associated with engaging diverse and vulnerable populations are identified.
  • A practical tool is proposed to enhance reflexivity and mitigate challenges in codesign.

Conclusions:

  • Effective codesign with vulnerable populations requires careful planning, mindful implementation, and reflexive practice.
  • Addressing health and healthcare disparities necessitates tailored codesign approaches.
  • The proposed reflexivity tool can support researchers in conducting more equitable and impactful codesign studies.