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      CO-Creation and Evaluation of Food Environments to Advance Community Health (COACH)

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          HIGHLIGHTS

          • •

            Existing food systems contribute to chronic disease.

          • •

            Co-creation theory can inform the creation of health-enabling food retail environments.

          • •

            Multiple stakeholders should be engaged at relevant stages of co-creation.

          • •

            A best practice co-creation framework is developed from research and practice.

          • •

            The framework (COACH) is supported by a checklist for each stage of change.

          Abstract

          Introduction

          Food environments are a key determinant of food intake and diet-related health. This paper describes the development of an iterative, adaptive, context-specific framework for health-enabling food environments embedded in cocreation theory.

          Methods

          A 3-stage multimethod framework for the coproduction and prototyping of public health interventions was followed in an iterative manner during the development of the framework. These 3 stages were (1) evidence review, including systematic review, consultation with experts, and observation of current work; (2) codesign of the framework prototype with multiple stakeholders; and (3) coproduction through refinement of the prototype through stakeholder workshops and expert reviews with incorporation of researcher notes and workshop evaluation. We use the term prototype during the development phase and the term framework to report on the final product.

          Results

          COACH (CO-creation and evaluation of food environments to Advance Community Health) is a process framework that describes what best practice application of cocreation in health-enabling food retail environments should involve. COACH consists of 10 interdependent factors within a 4-phase continuous quality improvement cycle. The 4 phases of the cycle are engagement and governance establishment, communication and policy alignment, codesign and implementation, and monitoring and evaluation.

          Conclusions

          Utilizing cocreation theory represents an innovative step in research and practice to improve the healthiness of food retail environments. COACH provides a specific, unique, and comprehensive guide to the utilization of cocreation to improve the healthiness of food environments in practice.

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          Most cited references51

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          The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

          Boyd Swinburn, Vivica I Kraak, Steven Allender … (2019)
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            Achieving Research Impact Through Co‐creation in Community‐Based Health Services: Literature Review and Case Study

            TRISHA GREENHALGH, Claire Jackson, Sara Shaw … (2016)
            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.
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              Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

              Calum F. Leask, Marlene Sandlund, Dawn Skelton … (2019)
              Plain English summary Background: Society has to cope with a large burden of health issues. There is need to find solutions to prevent diseases and help individuals live healthier lifestyles. Individual needs and circumstances vary greatly and one size fit all solutions do not tend to work well. More tailored solutions centred on individuals’ needs and circumstances can be developed in collaboration with these individuals. This process, known as co-creation, has shown promise but it requires guiding principles to improve its effectiveness. The aim of this study was to identify a key set of principles and recommendations for co-creating public health interventions. Methods: These principles were collaboratively developed through analysing a set of case studies targeting different health behaviours (such as reducing sitting and improving strength and balance) in different groups of people (such as adolescent schoolgirls and older adults living in the community). Results: The key principles of co-creation are presented in four stages: Planning (what is the purpose of the co-creation; and who should be involved?); Conducting (what activities can be used during co-creation; and how to ensure buy-in and commitment?); Evaluating (how do we know the process and the outcome are valid and effective?) and Reporting (how to report the findings?). Three models are proposed to show how co-created solutions can be scaled up to a population level. Conclusions: These recommendations aim to help the co-creation of public health interventions by providing a framework and governance to guide the process. Abstract Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible.
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                Author and article information

                Contributors
                Jillian Whelan
                Journal
                Journal ID (nlm-ta): AJPM Focus
                Journal ID (iso-abbrev): AJPM Focus
                Title: AJPM Focus
                Publisher: Elsevier
                ISSN (Electronic): 2773-0654
                Publication date PMC-release: 27 May 2023
                Publication date Collection: September 2023
                Publication date (Electronic): 27 May 2023
                Volume: 2
                Issue: 3
                Electronic Location Identifier: 100111
                Affiliations
                [1 ]Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Medicine, Deakin University, Geelong, Australia
                [2 ]Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Science, School of Clinical Sciences, Monash University, Melbourne, Australia
                [3 ]Global Centre for Preventive Health and Nutrition (GLOBE), Institute of Health Transformation, School of Health and Social Development, Deakin University, Geelong, Australia
                [4 ]School of Public Health, The University of Queensland, Brisbane, Australia
                [5 ]Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Darwin, Australia
                [6 ]Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Australia
                Author notes
                [* ]Address correspondence to: Jill Whelan, PhD, School of Medicine, Deakin University – Geelong Waterfront Campus, 1 Geringhap Street, Geelong, VIC 3220, Australia. jill.whelan@ 123456deakin.edu.au
                Article
                Publisher Item ID: S2773-0654(23)00048-2 Publisher ID: 100111
                DOI: 10.1016/j.focus.2023.100111
                PMC ID: 10546519
                PubMed ID: 37790671
                SO-VID: 15333f3f-0a93-466a-9b05-bb5a4292f281
                Copyright © © 2023 The Author(s)
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Categories
                Subject: Translational Science

                Keywords: food environments,cocreation,health promotion,frameworks,practical guidance,continuous quality improvement
                Data availability:
                Keywords: food environments, cocreation, health promotion, frameworks, practical guidance, continuous quality improvement

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