Processes and outcomes of co-design to improve physical health care with mental health consumers in primary care

Co-design is increasingly used to improve and innovate in health care, but research into improving co-design processes has been limited. Co-design combines service user, service provider and other stakeholder expertise to develop novel solutions informed by lived experience. This study examined the co-design processes that contributed to the experience and outcomes of a co-design project involving mental health consumers, families/carers/kin, primary care providers, and peer support workers. The co-design project, which aimed to improve mental health consumers’ physical health care in primary care settings, created and tested a Physical Health Conversation Guide (PHCG). This study comprised two interrelated stages. Stage 1 co-designed the PHCG and determined a method for testing it. The research analysed the co-designers’ experience and the processes by which outcomes were achieved. Stage 2 explored experiences of using the PHCG, its impact on physical healthcare interactions, ways to improve the PHCG and how these findings reflected on the co-design process. Lived experience researchers and a Lived Experience Advisory Group ensured research processes were informed by lived expertise. This research clarified three key co-design processes - generating knowledge, creating space, and influencing change - and described the interdependent tensions that underlie them. The findings highlighted mechanisms that support collaborative decision-making in healthcare co-design and the role of time in the achievement of tasks - constructing meaning, building relationships, and negotiating action - that are core to each of these processes. Testing confirmed that the PHCG aligned with consumers’ preferences for personal control and a holistic approach to health and primary care providers’ preferences for patient-centredness and efficient information sharing. Foregrounding lived expertise to improve interactions about mental health consumers’ physical health was a strength of this study. The research clarified key processes that contributed to equitable participation and collaborative decision-making in co-design. This study also corroborated the effectiveness of co-design for developing a mutually acceptable solution that had the potential to improve mental health consumers’ health care and outcomes.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2024

Author dc:creator

• Thorburn, Kathryn ; https://orcid.org/0000-0002-7383-874X

• co-design
• mental health
• physical health
• primary care
• healthcare
• collaborative decisions
• anzsrc-for: 42 HEALTH SCIENCES

Statement dc:rights

• open access
• CC BY 4.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by/4.0/

Language dc:language

en

Identifier

https://doi.org/10.26190/unsworks/30608

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/103342