Co-creating active communities: processes and outcomes of linking public rehabilitation programs with civic engagement for active living in a Danish municipality

Res Involv Engagem. 2023 Sep 14;9(1):83. doi: 10.1186/s40900-023-00495-6.

Abstract

Background: Increased levels of physical activity are associated with beneficial health effects for people with type 2 diabetes, cardiovascular disease and/or severe obesity; however, transforming knowledge about these effects into action is challenging. The aim of this paper is to explore lessons learnt from a co-creation process in a partnership project involving local stakeholders, including citizens, and researchers. The purpose of the process was to link a public health care institution with civil society organisations in the local community to make it possible for citizens to continue to be physically active after ending their public rehabilitation. Secondarily, this paper aims to develop a conceptual model of the above process.

Methods: The study constitutes the first part of Project Active Communities and was based on a partnership between three research institutions and a Danish rural municipality, involving municipal and civil society stakeholders and citizens with type 2 diabetes, cardiovascular disease and/or severe obesity in co-creation of concrete interventions for implementation. The co-creation process was divided into two tracks, one involving citizens (two workshops) and one involving municipal and civil society stakeholders (two workshops). The two tracks were concluded with a final workshop involving all stakeholders, including local politicians. Data sources are focus groups and bilateral meetings, workshop observations, and questionnaires.

Results: Lessons learnt include the importance of having a flexible timeframe for the co-creation process; giving room for disagreements and matching of mutual expectations between stakeholders; the value of a coordinator in the municipality to achieve acceptance of the project; and the significance of engaging local politicians in the co-creation process to accommodate internal political agendas. We have developed a conceptual model for a co-creation process, where we outline and explain three distinct phases: stakeholder identification and description, co-creation, and prototyping. The model can be adapted and applied to other sectors and settings.

Conclusions: This study documents lessons learnt in a co-creation process aiming to link a public health care institution with civil society organisations in the local community. Further, this study has specified productive co-creative processes and documented the various phases in a conceptual model.

Keywords: Civil society; Co-creation; Community-based; Partnership; Patient and public involvement; Physical activity; Public rehabilitation.

Plain language summary

It is well known that physical activity has health benefits for people with chronic diseases. In this study, our aim was to explore lessons learnt from a co-creation process and develop a model for others to apply. The study was based on a partnership between three research institutions and a Danish rural municipality, involving municipal and civil society stakeholders and citizens with type 2 diabetes, cardiovascular disease and/or severe obesity. During the study, the above-mentioned stakeholders were invited to five workshops, where interventions for linking a public health care institution and civil society organisations were co-created. The five co-creation workshops led to the identification of four interventions, linking public health care institutions and civil society organisations. Lessons learnt from this project, which can be used by others who wish to design and conduct a co-creative process with diverse stakeholders, include: the importance of having a flexible timeframe for the co-creation process, as delays can easily occur in the unpredictable process of co-creation giving room for disagreements and matching of mutual expectations between stakeholders, as a common understanding of each stakeholder’s motives is important for the success of the project the importance and value of a coordinator in the municipality to achieve acceptance of the project the significance of engaging local politicians in the co-creation process to take internal political agendas into consideration. We conclude by identifying three phases—a stakeholder, a co-creation, and a prototyping phase—in a model for co-creation that may be adapted and used by others.

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