Enhancing Rigor, Quality, and Patient Engagement in Qualitative Research: A Step-By-Step Guide to Applying Reflexive Thematic Analysis to the Experience-Based Co-Design Methodology.

Experience-based co-design (EBCD) is a qualitative form of participatory action research supported by a toolkit providing guidance and recommendations. The toolkit is intentionally non-prescriptive, allowing EBCD practitioners the freedom to flex the approach to cater to the needs of their specific populations and contexts. For less experienced researchers, the lack of specificity can be a challenge when navigating activities such as data analysis, particularly as wider literature provides limited insights to methods, processes, methodological critique, and lessons learned. Despite increasing use of EBCD, few practitioners publish details of their methods, processes, or decision-making for how they adapt EBCD for their studies, focusing more often on findings and outcomes. This can impact understanding and development of rigor in EBCD literature. In this methodology paper, we respond to this gap by providing a case example and step-by-step guide for application of reflexive thematic analysis to EBCD, with consideration of reflexivity, a conceptual framing for interpreting experiences, opportunities for greater participant involvement, and strengths and challenges of using reflexive thematic analysis within EBCD.