MapStakes-PH: A Methodological Framework for Co-Creation in Preventive Public Health

Co-creation is increasingly used in public health to strengthen the relevance, feasibility, and sustainability of interventions, yet many approaches remain either too generic to guide implementation or too rigid for multi-country adaptation. This paper presents the application of the MapStakes-PH framework as a practical, step-by-step roadmap for organizing co-creation processes in preventive public health, using Project Sunrise, a Horizon Europe–funded initiative on adolescent cancer prevention implemented across eight European countries, as an illustrative use case. Grounded in stakeholder theory, co-creation is a participatory approach requiring meaningful collaboration among diverse actors (e.g., young people, families, educators, practitioners, researchers, community representatives, and policymakers) throughout design and implementation to design, develop, and improve systems, policies, or experiences, with attention to local context and equity. The MapStakes-PH Framework, originally developed for environmental and urban planning, offers a five-step process to (1) identify, (2) analyze, (3) engage, (4) coordinate, and (5) evaluate stakeholder contributions, the centerpiece of co-creation. We describe how the project team transferred this framework into a health promotion setting to structure stakeholder mapping, convene local co-creation councils, support co-design of context-specific actions, and maintain iterative learning through light-touch feedback cycles. The framework’s strengths for qualitative, practice-based co-creation include its usability, explicit decision points, adaptability across settings, and capacity to make stakeholder dynamics actionable, without oversimplifying complexity. We detail the five steps, the assumptions required for use, and practical considerations for adoption (e.g., participation/selection effects, facilitation intensity, and scalability). Consistent with the manuscript’s scope, we focus on the process architecture and implementation roadmap rather than reporting empirical outcomes.