Integrating Co-Created and Theory-Driven Insights: A Worked Example Using an Equitable and Power Sharing Approach

Co-creation with citizens has emerged as an integral component in tackling a plethora of healthcare inequities. At the stage of scientific conceptualization, processes of integrating co-created insights as legitimate forms of knowledge lack transparent methods, risking disempowerment for citizens who have been positioned as influencing research processes and outcomes. We detail an approach to integrating co-created insights into a scientific model using an equitable and power-sharing approach (EPSA) method, exampled during the study design phase of the AFFIRM Relationships project. The EPSA method consists of three phases: a preparatory phase (researcher reflexivity, topic formulation and sensitization); a co-creation phase (knowledge production, analytic phases, summarizing and ethics work) and an insight integration phase. Applying the EPSA method highlighted the important role of researcher reflexivity in preparing to foster a safe environment for open dialogue during co-creation. Transforming scientific research stages into activities that can engage co-researchers (including conducting analysis, critical thinking, and producing overarching themes) underscored an equitable partnership. While the final phase enabled identification of how resulting knowledge was derived (i.e., via co-creation or existing theory), further consideration of how refinement processes can be grounded in lived experience is necessary, particularly during final stages as decision-making becomes increasingly led by academic team members.