This journal special issue builds on a growing body of co-design activity and expertise. Guest edited by an international, multidisciplinary editorial team, the special issue explores the role of co-design in sharing, synthesising and mobilising knowledge.
In 2019, Policy Press journal ‘Evidence & Policy‘ called for special issue proposals. Evidence & Policy is an interdisciplinary journal exploring the relationship between researchers and the evidence they produce and the concerns of policy makers and practitioners in areas that include health and social care. A team led by Research Fellow Joe Langley responded to this with a Special Issue titled Creativity & Coproduction.
The creative design practices used in co-design, and the role these play in sharing, synthesising and mobilising knowledge, have been a significant strand of Lab4Living activity, led by Joe Langley, over the past decade. Co-design has been employed within health research to support and enable better translation of research evidence into practice and policy.
Through this co-design work, Joe had established a critical mass of colleagues from around the world with this shared interest, equally driven to continue to challenge, extend and grow the field. Joe convened a small group of interested researchers and describes below how they approached guest editing a special issue.
We were aware of a previous special issue in this journal (Metz et al., 2019) that explored the topic of “Co-creative approaches to knowledge production”. The guest editors of this earlier issue suggested “a greater focus on the topic of creativity” and how it might be of value in addressing the research-practice gap. It therefore felt a natural progression for our small team of interested researchers to put together a proposal to explore the theme of Creativity in Co-production. We wanted to ask (and try to answer) the following questions:
- How is creativity applied within co-production?
- How does such creativity influence the incorporation of evidence into policy or practice?
- What impact(s) or effect(s) does creativity have in these applications?
- What are the implications of this, and for whom?
But first, who is “we”?
The Guest Editorial Team
Given the time frame for responding to the call for special issue proposals, Joe went to established relationships with people he knew had an interest in these topics while also seeking a balance between people from Arts and Science disciplines. Below is a ‘rogues gallery’ of what became our editorial group and a bit more detail about each.
Joe Langley is a Design Engineer and Academic Researcher. He explores various forms of participatory research and innovation using design practices and co-design approaches, with a focus on Knowledge Mobilisation and the use of evidence in shaping and informing innovations. It is Joe that has led this strand of activity and focus within Lab4Living.
Working alongside Joe and adding different perspectives to this activity have been Claire Craig and Smizz.
Claire Craig is a Historian, Occupational Therapist and Design Researcher in Lab4Living. She focuses on end-of-life care and on Dementia but has been hugely interested in how these creative practices enable people living with Dementia, to contribute their experiences to participatory research and intervention development.
Sarah Smith (aka Smizz) is a local Councillor for the people of Ardwick and Carcroft ward of Doncaster. She is also an international renowned Artist, a Radiographer and a researcher with Lab4Living. She has won innovation awards for her patient centred and co-designed resources to better support patients in her Radiography clinic. She using drawing as method in her research work, as ways of engaging with people and of observing or seeing interactions, spaces and situations.
Joe has worked extensively with Ian Gwilt, Professor of Design at the University of South Australia’s UniSA:Creative. During his previous time working at Lab4Living, Ian worked with Joe and others on projects exploring how people communicate and express pain, and how patient experience data can be used immediately to improve care in acute setting. His current research in visual communication design in the context of healthcare and wellbeing looks at how we can incorporate visual communication design practices into interdisciplinary research teams. A component of this relates to ways in which data is made tangible and interactive.
Joe met Erna Snelgrove-Clarke through the Knowledge Utilisation Colloquium, which he became involved with through his NIHR Knowledge Mobilisation Research Fellowship. Erna is a Nurse specialising in maternal and new-born health with career in both clinical work and research. She is based in Queen’s University, Faculty of Health Sciences, Canada. Her research and clinical work focuses on implementing evidence for compassionate, person-centred care. Erna has been a willing accomplice in trying out novel ways of enabling interdisciplinary working, of supporting non-academic people to engage in research and of challenging academics to be more open and engaging with the research.
Nicola Kayes is an ‘old friend’ of Lab4Living (old in terms of friendship and not related to age in any way!) through the Design4Health network. Nicola has a background in health psychology and is based in the Centre for Person Centred Research at Auckland University of Technology in New Zealand. Her work aims to challenge conventional rehabilitation practice through rethinking ways of working to improve outcomes that matter to people. This has led to collaborative work with design colleagues exploring the potential of creative and participatory practices in rethinking rehabilitation.
Proposing the Special Issue
We collectively drafted the original proposal to Evidence & Policy when the call for proposals was released, using our network of familiar peers to meet the deadline. We successfully argued for a larger editorial group, due to the bread of disciplinary expertise required, and the proposal was subsequently accepted.
Process of developing the special issue
The process we followed (Figure 1) to engage and work with contributing authors is outlined below in the schematic. It is an imperfect co-production process (driven by goodwill and ‘spare’ time). Yet it illustrates that co-production can take a variety of forms, depending on context, purpose, the people involved and resources available. While more dedicated time would have made this significantly better, we hope the spirit and intention of our process along with honesty, vulnerability, transparency and empathy for our authors served to give them a greater sense of engagement. Our hope was that by creating space for our authors to come together (synchronously and asynchronously), they were able to feel part of something bigger, rather than just contributing their paper to a special issue in isolation and without a sense of the whole, as is often the case with special issues.
At the abstract submission stage, three different people from the editorial group reviewed each abstract in a first pass review, using a set of criteria to specify whether it was in scope for the journal, in scope for the special issue theme, and of sufficient quality. They also indicated what type of paper (research, debate, practice) they believed each to be. Borderline abstracts were then reviewed again by one further person (from the editorial group) with additional criteria added to consider whether the abstract offered any distinctive value/contribution compared to others that had been positively reviewed. Abstracts passing these criteria were invited for full paper submissions.
Full paper stage
As full papers were submitted, they were initially reviewed by the Journal Editor-in-Chief. Those that met the basic requirements of the journal and were marked as being for the special issue were forwarded to the Guest Editors to manage the blind review process. In our blind review process, we sought out reviewers for each article from a science discipline and from a creative/design discipline. For some papers, we were also able to secure a patient/public reviewer.
The two workshops were crucial in our attempts to ensure the issue presented as a cohesive narrative rather than a collection of disparate articles. Workshop 1 enabled authors and editors to meet each other, share abstracts and begin to get a sense of the collective themes.
Before Workshop 2 we shared draft manuscripts between all editors and authors (with prior agreement), providing an opportunity to scan the manuscripts and undertake a rapid synthesis to identify distinctive contributions and common themes. Workshop 2 enabled us to begin sharing identified themes and prioritise key messages for the collection as a whole – this process was formative to what ultimately made it to the page in our editorial.
We carried out a rapid synthesis across the 11 articles and drew out ten cross cutting themes, and four additional factors of note, which we have termed Golden Threads. The ten themes were grouped into three categories. These are discussed in more detail in our covering editorial and are summarised here in table 2.
|Enabling people to contribute||Making sense of a topic||Transforming evidence into action|
|Fulfilling: creative practices in shared settings, enhance a person’s sense of wellbeing, fulfilment, and accomplishment||5. Complexity: creative practices enable a person or group of people to map out or ‘see’ complexity with nuance||8. Embodied and Affective Cognition: creative practices enable people to think with embodied and affective cognition|
|Accessibility: creative practices are perceived as something anyone can have a go at||6. Different Perspectives: creative practices enable sharing and appreciation of different perspectives||9. Customisation: creative practices support the exploration and development of customisation|
|Creating Conditions: creative practices create and sustain informal, relaxed, and messy conditions, ideal for building relationships||7. Sense-making: creative practices support individual and collective sense-making||10. Activism: creative practices are proactive and encourage activation and action|
|Self-expression: creative practices support a variety of forms of self-expression enabling people to communicate complex ideas or experiences, tacit knowledge and other intangible information|
Additional ‘golden threads’
|Notable author||Prof Trish Greenhalgh. Check out “Towards an institute for patient-led research”|
|Story telling||A central feature in all the articles in a variety of forms as data, data analysis and data sharing.|
|Imagination||An implied connection across several articles, creative practices allow people to ‘see’ things differently; different perspectives of experience (multiple ‘truths’) or different possibilities for the future. Creative practices broke personal ‘norms’, to see beyond the constraints of their personal social and physical experiences.|
|Power||An explicit theme across most articles, and implied across others. Creative practices were seen as a way of dismantling and levelling hierarchal structures.|
The Special Issue
The special issue comprises 11 articles; 9 Research papers and 2 Practice papers. A summary description of them can be found below in Table 1. [is this the final selection that have been published? or the long list?]
|Lead author||Article type, country of origin||Summary||Creative practices used:||Applied to:|
|MacGregor et al.||Research paper, Canada||Reports a cross case evaluation using realist methods. The article proposes that arts-informed approaches: (1) address context specificity and sensitivity, (2) promote engagement, (3) enhance and intertwine skills and (4) broaden thinking about Impact.||Variety of art, play, design, game approaches||Predominately intended to engage people and to catalyse action|
|Beckett et al.||Research paper, UK||Explores the use (and value) of drama and Storytelling as method to share, explore and synthesis diverse knowledge. The article highlights the importance of approaches that promote social interaction in these processes and the importance of supporting people to actively alter outcomes.||Forum Theatre (performance, theatre & storytelling)||Dissemination, reflection, intervention development|
|Grindell et al.||Research paper, UK||Reports a cross case evaluation (14 cases) that used creative co-design to support evidence-into-practice improvement projects. The authors outline three key themes of (1) creative and visual, (2) design-led and (3) creating the right conditions.||Creative Co-design (and diversity of forms of making in 14 projects)||Service improvement, guideline implementation, knowledge mobilisation|
|The Co-design Hub Team (Micsinszki et al.)||Research paper, Canada||Reports the use of creative co-design methods with vulnerable people to create a Theory of Change (ToC). This ToC is intended to steer the development of infrastructure that will include vulnerable people in future healthcare research and design work.||Creative co-design (Experience-Based-Co-design based)||Developing a theory of change for a Co-design Hub|
|Potts et al.||Research paper, Uganda & Lebanon||A case study employing co-creative participatory methods and engaging refugee women and girls, to explore experiences of sexual exploitation and abuse in humanitarian crises to develop policy changes. This paper picks up on issues relating to power and (methodological) accessibility within co-production.||Drawing, drama, storytelling, community mapping, body mapping||Drawing, drama, storytelling, community mapping, body mapping, policy recommendations|
|Adelle et al.||Research paper, South Africa||A case study using Digital Story Telling to explore and share experiential knowledge of food insecurity directly into policy forums. This article picks up on issues relating to ethical risks and welfare of storytellers.||Digital storytelling||Used to ‘counter balance’ scientific evidence in a policy making forum|
|Owens et al.||Research paper, USA||A case study reporting the co-production of evidence-informed criminal legal re-entry policy with the community. It raises interests points about the absorption of evidence and shared decision making in co-production, along with creative control and shared ownership as impacting the implementation, adoption and uptake of the policies.||Visualisations, personas, brainstorming, prototyping,||Policy and intervention design and implementation|
|Spaa et al.||Research paper, UK||Reporting work within a policy Co-Design context, this article suggests that the creative practices of design support reflective thinking, that in turn support deliberation and decision making and in group settings can also be applied to highlight assumptions.||Creative, reflective practices of design||Policy co-design, specifically deliberation, decision making, assumption visibility|
|Phillips et al.||Research paper, Denmark||Analyses a Parkinson’s co-production case study that used arts-based methods, to develop and theoretical framework, highlighting tensions between arts and science, research and practice, evidence and judgement.||Creative writing, story-telling, dance, music||Eliciting and synthesising experiential, embodied, affective and aesthetic knowledge|
|Thom et al.||Practice paper, Aotearoa (New Zealand)||Reports a specific case study situated in Aotearoa, using Kaupapa Māori led co-production. He Ture Kia Tika/Let the Law be Right focused on informing evidence-based policy relating to prisoners, specifically in relation to their mental health and substance use. However, the report focuses on the method rooted in Māori epistemology and culture highlighting the appropriateness of this in developing appropriate policy addressing deep cultural injustices.||Māori storytelling methods||Sharing and understanding lived experiences, policy development|
|Webber et al.||Practice paper, UK||Reports a specific case study purposively using Creative Co-design for service improvements within a low back pain physiotherapy service.||Drawing, collages, mood boards, visual metaphors, personas, ideation prompts and provocations, role play||Exploring current experience, existing evidence, intervention development|
The special issue will be published early in May 2022. The themes we have drawn out are framed as a starting point for debate so we encourage people to get in touch or to join the conversation via social media.
Gold Open Access
One important point on the process; our host institution (Sheffield Hallam University) agreed to pay for the Gold Open Access for all the articles in this special issue, meaning that they are free to access. On behalf of all the authors, editors and readers, thanks: we are truly grateful. We sought Open Access because there is so much about co-production within the academic sector that pays lip-service to ensuring non-academics and co-production partners have some parity yet publication paywalls are often one barrier that goes unaddressed. We felt it vitally important that we practised what we were preaching in all aspects of this work and felt everyone (within and outside academic institutions) should have access to this work.
Final points on the process: several hot debate topics arose between authors, reviewers and editors throughout the process. These are expanded upon in an accompanying blog post hosted by the publishers. And Joe also goes into more detail reflecting on the experiences of pulling the special issue together in two research blog posts, linked below.
- Researcher blog: Guest editing a Special Issue for Evidence & Policy during COVID
- Researcher blog: Sources of inspiration for creative practices in co-production