{"title":"初级卫生保健的共同生产、共同创造和共同设计：设计、实施、影响和可持续性的范围审查","authors":"Cate Dingelstad, Nicolette Hodyl, Rebecca Wyse, Suzanne Lewis, Alison Koschel, Nicholas Goodwin","doi":"10.1111/hex.70447","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>The terms coproduction, co-creation and codesign (called the ‘Three-Cs’ in this article) are applied to activities that include stakeholders in the design and implementation of health services. This scoping review sought to understand how Three-Cs approaches have been designed and implemented sustainably in the primary health care context.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Three databases (Medline, Embase and CINAHL) were searched for articles published between 2013 and 2024 using key words related to the Three-Cs and primary health care (Appendix A) and limited to articles available in English. Dual blind review against specific inclusion and exclusion criteria was carried out at both title/abstract and full text screening stages. The SPICE Framework was used to consider design, implementation, impact and sustainability. An assessment of quality and risk of bias was completed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [1]. The Framework to Assess the Impact of Translational (FAIT) health research [2] was used to review and assess the impact of the design and implementation of Three-Cs approaches in each study.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirty articles were included in this review with 33% (<i>n</i> = 10) providing a clear definition of their Three-Cs approach: 10% (<i>n </i>= 3) identified their approach as Coproduction, 20% (<i>n</i> = 6) as co-creation, and 70% (<i>n</i> = 21) as Codesign. Implementation contexts included clinical settings (10%, <i>n</i> = 3), for example prediabetes programs; community settings (50%, <i>n</i> = 15) such as care navigation support; and health systems settings (40%, <i>n</i> = 12) including health service development. Approaches were implemented across metropolitan (37%, <i>n</i> = 11), regional (43%, <i>n</i> = 13), and rural (17%, <i>n</i> = 5) settings.</p>\n \n <p>Three-Cs approaches in primary health care settings were most typically used for health promotion, and to support improved health equity and health access. Key outcomes included novel solutions to problems, improvements to health and health systems, and solutions that met consumer needs. While nine of the 30 studies undertook some form of evaluation, limited evidence on impact and sustainability was found (7%, <i>n</i> = 2), where only two studies assessed whether the change that was implemented using a Three-Cs approach was maintained in the longer term.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Three-Cs approaches have been adopted across a variety of primary health care settings, yet evidence for impact and sustainability is currently limited. More research is needed to evaluate how the Three-Cs may best be implemented to support the long-term sustainability of programs designed by such approaches. Future work should focus on developing a primary health care specific framework or guidance for implementing and evaluating Three-Cs models, particularly in low-resource settings and in typically underrepresented populations. This study will extend to consider how the FAIT assessment process can help to support the development of much needed implementation guidance.</p>\n </section>\n </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70447","citationCount":"0","resultStr":"{\"title\":\"Co-Production, Co-Creation and Co-Design in Primary Health Care: A Scoping Review of Design, Implementation, Impact and Sustainability\",\"authors\":\"Cate Dingelstad, Nicolette Hodyl, Rebecca Wyse, Suzanne Lewis, Alison Koschel, Nicholas Goodwin\",\"doi\":\"10.1111/hex.70447\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>The terms coproduction, co-creation and codesign (called the ‘Three-Cs’ in this article) are applied to activities that include stakeholders in the design and implementation of health services. This scoping review sought to understand how Three-Cs approaches have been designed and implemented sustainably in the primary health care context.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Three databases (Medline, Embase and CINAHL) were searched for articles published between 2013 and 2024 using key words related to the Three-Cs and primary health care (Appendix A) and limited to articles available in English. Dual blind review against specific inclusion and exclusion criteria was carried out at both title/abstract and full text screening stages. The SPICE Framework was used to consider design, implementation, impact and sustainability. An assessment of quality and risk of bias was completed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [1]. The Framework to Assess the Impact of Translational (FAIT) health research [2] was used to review and assess the impact of the design and implementation of Three-Cs approaches in each study.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Thirty articles were included in this review with 33% (<i>n</i> = 10) providing a clear definition of their Three-Cs approach: 10% (<i>n </i>= 3) identified their approach as Coproduction, 20% (<i>n</i> = 6) as co-creation, and 70% (<i>n</i> = 21) as Codesign. Implementation contexts included clinical settings (10%, <i>n</i> = 3), for example prediabetes programs; community settings (50%, <i>n</i> = 15) such as care navigation support; and health systems settings (40%, <i>n</i> = 12) including health service development. Approaches were implemented across metropolitan (37%, <i>n</i> = 11), regional (43%, <i>n</i> = 13), and rural (17%, <i>n</i> = 5) settings.</p>\\n \\n <p>Three-Cs approaches in primary health care settings were most typically used for health promotion, and to support improved health equity and health access. Key outcomes included novel solutions to problems, improvements to health and health systems, and solutions that met consumer needs. While nine of the 30 studies undertook some form of evaluation, limited evidence on impact and sustainability was found (7%, <i>n</i> = 2), where only two studies assessed whether the change that was implemented using a Three-Cs approach was maintained in the longer term.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Three-Cs approaches have been adopted across a variety of primary health care settings, yet evidence for impact and sustainability is currently limited. More research is needed to evaluate how the Three-Cs may best be implemented to support the long-term sustainability of programs designed by such approaches. Future work should focus on developing a primary health care specific framework or guidance for implementing and evaluating Three-Cs models, particularly in low-resource settings and in typically underrepresented populations. 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Co-Production, Co-Creation and Co-Design in Primary Health Care: A Scoping Review of Design, Implementation, Impact and Sustainability
Introduction
The terms coproduction, co-creation and codesign (called the ‘Three-Cs’ in this article) are applied to activities that include stakeholders in the design and implementation of health services. This scoping review sought to understand how Three-Cs approaches have been designed and implemented sustainably in the primary health care context.
Methods
Three databases (Medline, Embase and CINAHL) were searched for articles published between 2013 and 2024 using key words related to the Three-Cs and primary health care (Appendix A) and limited to articles available in English. Dual blind review against specific inclusion and exclusion criteria was carried out at both title/abstract and full text screening stages. The SPICE Framework was used to consider design, implementation, impact and sustainability. An assessment of quality and risk of bias was completed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [1]. The Framework to Assess the Impact of Translational (FAIT) health research [2] was used to review and assess the impact of the design and implementation of Three-Cs approaches in each study.
Results
Thirty articles were included in this review with 33% (n = 10) providing a clear definition of their Three-Cs approach: 10% (n = 3) identified their approach as Coproduction, 20% (n = 6) as co-creation, and 70% (n = 21) as Codesign. Implementation contexts included clinical settings (10%, n = 3), for example prediabetes programs; community settings (50%, n = 15) such as care navigation support; and health systems settings (40%, n = 12) including health service development. Approaches were implemented across metropolitan (37%, n = 11), regional (43%, n = 13), and rural (17%, n = 5) settings.
Three-Cs approaches in primary health care settings were most typically used for health promotion, and to support improved health equity and health access. Key outcomes included novel solutions to problems, improvements to health and health systems, and solutions that met consumer needs. While nine of the 30 studies undertook some form of evaluation, limited evidence on impact and sustainability was found (7%, n = 2), where only two studies assessed whether the change that was implemented using a Three-Cs approach was maintained in the longer term.
Conclusion
Three-Cs approaches have been adopted across a variety of primary health care settings, yet evidence for impact and sustainability is currently limited. More research is needed to evaluate how the Three-Cs may best be implemented to support the long-term sustainability of programs designed by such approaches. Future work should focus on developing a primary health care specific framework or guidance for implementing and evaluating Three-Cs models, particularly in low-resource settings and in typically underrepresented populations. This study will extend to consider how the FAIT assessment process can help to support the development of much needed implementation guidance.
期刊介绍：
Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including:
• Person-centred care and quality improvement
• Patients'' participation in decisions about disease prevention and management
• Public perceptions of health services
• Citizen involvement in health care policy making and priority-setting
• Methods for monitoring and evaluating participation
• Empowerment and consumerism
• Patients'' role in safety and quality
• Patient and public role in health services research
• Co-production (researchers working with patients and the public) of research, health care and policy
Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.
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