Co-Designing Local Collaboration Between Social Services, Primary Healthcare, and the Third Sector-A Realist Process...

Area of Science:

• Community-based participatory research
• Health services research
• Social science research

Background:

• Co-design is increasingly utilized for developing research interventions and community services.
• Understanding the mechanisms driving change in co-design processes is essential.
• This study evaluates factors influencing co-design for local collaboration between social services, primary care, and the third sector.

Purpose of the Study:

• To evaluate contextual factors and mechanisms shaping a co-design process.
• To foster local collaboration among social services, primary care, and the third sector.
• To understand how co-design drives change in community-based initiatives.

Main Methods:

• A realist process evaluation using an initial program theory (IPT) based on Intervention-Context-Actor-Mechanism-Outcome (ICAMO) configurations.
• IPT was tested and refined through deductive analysis of six group interviews using realist interviewing.
• Documentation from the planning and implementation phases informed the IPT.

Main Results:

• Three interconnected ICAMO configurations were identified, detailing stakeholder engagement, trust development, and ideation for collaboration.
• Key mechanisms identified include sensing opportunities for change, building trust, and experiencing group agency.
• Stakeholder assessment of value, emerging trust, and facilitated ideation were crucial for engagement and collaboration.

Conclusions:

• Effective co-design requires impartial facilitation to build trust and perceived neutrality.
• Constructive participation relies on representatives with practical knowledge, a sense of opportunity, and the mandate to act.
• Sustained participation is vital for competence, relationship building, and developing shared goals in collaborative structures.