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Article
Publication date: 20 March 2017

Janet R. McColl-Kennedy, Hannah Snyder, Mattias Elg, Lars Witell, Anu Helkkula, Suellen J. Hogan and Laurel Anderson

The purpose of this paper is to synthesize findings from health care research with those in service research to identify key conceptualizations of the changing role of the…

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Abstract

Purpose

The purpose of this paper is to synthesize findings from health care research with those in service research to identify key conceptualizations of the changing role of the health care customer, to identify gaps in theory, and to propose a compelling research agenda.

Design/methodology/approach

This study combines a meta-narrative review of health care research, and a systematic review of service research, using thematic analysis to identify key practice approaches and the changing role of the health care customer.

Findings

The review reveals different conceptualizations of the customer role within the ten key practice approaches, and identifies an increased activation of the role of the health care customer over time. This change implies a re-orientation, that is, moving away from the health care professional setting the agenda, prescribing and delivering treatment where the customer merely complies with orders, to the customer actively contributing and co-creating value with service providers and other actors in the ecosystem to the extent the health care customer desires.

Originality/value

This study not only identifies key practice approaches by synthesizing findings from health care research with those in service research, it also identifies how the role of the health care customer is changing and highlights effects of the changing role across the practice approaches. A research agenda to guide future health care service research is also provided.

Details

Journal of Service Management, vol. 28 no. 1
Type: Research Article
ISSN: 1757-5818

Keywords

Article
Publication date: 30 September 2013

Sarah-Anne Munoz

Current policy context in the UK promotes the “co-production” of health and care services – with service users and providers working in partnership. However, the…

526

Abstract

Purpose

Current policy context in the UK promotes the “co-production” of health and care services – with service users and providers working in partnership. However, the assumption that all individuals and communities have the personal resources, skills and willingness to get involved in co-produced services may have implications for social and geographical equity of access to health and care services. The paper presents the results of a nine-month action research project with a remote and rural community in Scotland to discuss the implications of co-produced health and care services for remote and rural community members – particularly those with ageing populations.

Design/methodology/approach

The research project worked with community members, health care providers and commissioners to develop a community social enterprise model for home care delivery. Textual resources collected during this action research process were subject to thematic analysis in order to explore community perceptions and experiences of service co-production development in the remote and rural context.

Findings

The qualitative analysis showed that community members identified some positive aspects of being involved in service co-production relating to sense of community, empowerment and personal satisfaction. However, negative impacts included increased feelings of pressure, strain and frustration among those who took part in the co-production process. Overall, the community was reluctant to engage with “transformative” co-production and traditional provider-user dynamics were maintained.

Originality/value

The example is used to demonstrate the types of resources that rural individuals and communities draw on in order to create social enterprises and how the potentially negative impacts of co-produced services for different types of social and geographical community may be overlooked in contemporary policy and practice.

Article
Publication date: 14 December 2015

Vanessa Pinfold, Paulina Szymczynska, Sarah Hamilton, Richard Peacocke, Shirley Dean, Naomi Clewett, Jill Manthorpe and John Larsen

The purpose of this paper is to reflect on the process of co-producing mental health research where work was shared between university academics, charity-based researchers…

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Abstract

Purpose

The purpose of this paper is to reflect on the process of co-producing mental health research where work was shared between university academics, charity-based researchers and a Lived Experience Advisory Panel.

Design/methodology/approach

The authors express the opinions of a research team made up of people with experience of using mental health services, being carers and being academically trained researchers from a range of health and social science disciplines. Some had experience in several areas. The paper is co-produced to provide collective reflection and recommendations.

Findings

Co-production of research is not well documented in published literature. The authors believe there is scope to develop co-production approaches, but further conceptual and theoretical work is needed alongside empirical studies. A socially situated complex research project, possibly involving multi-stakeholder groups, demands flexibility in approach. Similarly to user-controlled and other emancipatory methodologies, co-production makes the democratisation of research a primary objective in order to produce better quality and more relevant studies. Co-production also addresses inequalities in power and control within research projects; this way of working does provide a healthy challenge to traditional research hierarchies.

Practical implications

Lessons learned should be honestly shared to develop co-production research methods. Projects need to have a strategy for how to value different contributions and facilitate constructive relationships if discord emerges. Establishing clear project roles, expectations and process for payment are essential in developing genuine collaborative partnerships.

Originality/value

It is a viewpoint paper.

Details

Mental Health Review Journal, vol. 20 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 14 December 2015

Andy Turner, Alba X. Realpe, Louise M. Wallace and Joanna Kosmala-Anderson

There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a…

Abstract

Purpose

There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP.

Design/methodology/approach

The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up.

Findings

Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills.

Originality/value

The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.

Details

Mental Health Review Journal, vol. 20 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 16 September 2011

Cormac Russell

This paper seeks to outline the ways in which the desire to age well is inextricably linked to the domains of community and associational life; relies for its strength on…

Abstract

Purpose

This paper seeks to outline the ways in which the desire to age well is inextricably linked to the domains of community and associational life; relies for its strength on intimate, soft, human contact in addition to more distant, cold, professional services; can call on an abundance of untapped, local‐based care and, with greater intentionality by policy makers and practitioners, can lead to better physical and mental health outcomes for senior citizens.

Design/methodology/approach

The paper is a reflection piece based on the proven qualities of asset‐based community development as a process for convening conversations in communities – from which the latent, caring capacities of individuals and associations are unleashed – allowing communities to build from the inside out. Communities define an ageing well agenda for their locale and implement that agenda according to their capacities.

Findings

The paper finds that citizens and communities co‐producing health outcomes will out‐perform individuals reliant on professional medical services only.

Practical implications

Communities have immense resources for health creation; tapping those resources leverages more health benefits than professional medical interventions alone.

Originality/value

The paper challenges the omnipotent, medicalised, “sickness” model of healthcare and encourages the adoption of a model of healthcare in which citizens, older or otherwise, co‐produce healthy lifestyles and health outcomes in their communities with the assistance of professionals.

Details

Working with Older People, vol. 15 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 11 January 2016

Rocco Palumbo

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional…

4221

Abstract

Purpose

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional bio-medical model which focusses on illness treatment and neglects the role played by patients in the provision of care.

Design/methodology/approach

For this purpose, the author conducted a systematic review, which paved the way for the identification of the concept of “health care co-production” and allowed to discuss its effects and implications. Starting from a database of 254 records, 65 papers have been included in systematic review and informed the development of this paper.

Findings

Co-production of health care services implies the establishment of co-creating partnerships between health care professionals and patients, which are aimed at mobilizing the dormant resources of the latter. However, several barriers prevent the full implementation of health care co-production, nurturing the application of the traditional bio-medical model.

Practical implications

Co-production of health care is difficult to realize, due to both health care professionals’ hostility and patients unwillingness to be involved in the provision of care. Nonetheless, the scientific literature is consistent in claiming that co-production of care paves the way for increased health outcomes, enhanced patient satisfaction, better service innovation, and cost savings. The establishment of multi-disciplinary health care teams, the improvement of patient-provider communication, and the enhancement of the use of ICTs for the purpose of value co-creation are crucial ingredients in the recipe for increased patient engagement.

Originality/value

To the knowledge of the author, this is the first paper aimed at systematizing the scientific literature in the field of health care co-production. The originality of this paper stems from its twofold relevance: on the one hand, it emphasizes the pros and the cons of health care co-production and, on the other hand, it provides with insightful directions to deal with the engagement of patients in value co-creation.

Details

International Journal of Public Sector Management, vol. 29 no. 1
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 31 December 2010

Martha Chinouya and Peter Aspinall

‘Black Africans’ in England are disproportionately and highly affected by the heterosexually contracted HIV epidemic. Policy and practice frameworks have advocated ethnic…

Abstract

‘Black Africans’ in England are disproportionately and highly affected by the heterosexually contracted HIV epidemic. Policy and practice frameworks have advocated ethnic matching in HIV prevention. We explore how self‐identifying ‘black African’ workers in London were co‐producers of ‘black African’ identities to target in preventative HIV interventions. Drawing on a focused literature review and 12 in‐depth interviews with workers, the paper identifies themes associated with co‐production of an African identify by workers. The historical inclusion of the category ‘black African’ in the 1991 census coincided with the emergence of Africans as at higher HIV ‘risk’. In co‐producing an African public, the workers projected their heterosexual and Christian affiliations on to the targeted population, perceiving themselves as ‘insiders’ knowledgeable about rumours that had historically co‐produced African identities. Fear of those in authority galvanised the formation of African‐led agencies, offering entry points for HIV prevention to Africans. By projecting aspects of their complex ‘selves’ on to the ‘other’, encounters in public spaces were deemed ‘opportunities’ for outreach interventions. The ethics of ‘cold calling’, confidentiality and informed consent were taken as ‘given’ in these socially produced ‘private’ spaces located in ‘public’ venues. In following HIV prevention frameworks as advocated by Pulle et al (2004), the workers endorsed yet problematised the notion of ethnic matching.

Details

International Journal of Migration, Health and Social Care, vol. 6 no. 4
Type: Research Article
ISSN: 1747-9894

Keywords

Open Access
Article
Publication date: 27 September 2021

Rocco Palumbo, Capolupo Nicola and Paola Adinolfi

Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The…

2456

Abstract

Purpose

Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The digitization of health-care calls for a reframing of health literacy in the cyber-physical environment. The article systematizes current scientific knowledge about digital health literacy and investigates the role of health-care organizations in delivering health literate health-care services in a digital environment.

Design/methodology/approach

A literature review was accomplished. A targeted query to collect relevant scientific contributions was run on PubMed, Scopus and Web of Science. A narrative approach was undertaken to summarize the study findings and to envision avenues for further development in the field of digital health literacy.

Findings

Digital health literacy has peculiar attributes as compared with health literacy. Patients may suffer from a lack of human touch when they access health services in the digital environment. This may impair their ability to collect health information and to appropriately use it to co-create value and to co-produce health promotion and risk prevention services. Health-care organizations should strive for increasing the patients’ ability to navigate the digital health-care environment and boosting the latter’s value co-creation capability.

Practical implications

Tailored solutions should be designed to promote digital health literacy at the individual and organizational level. On the one hand, attention should be paid to the patients’ special digital information needs and to avoid flaws in their ability to contribute to health services’ co-production. On the other hand, health-care organizations should be involved in the design of user-friendly e-health solutions, which aim at engaging patients in value co-creation.

Originality/value

This contribution is a first attempt to systematize extant scientific knowledge in the field of digital health literacy specifically focused on the strategies and initiatives that health-care organizations may take to address the limited digital health literacy pandemic.

Details

Kybernetes, vol. 51 no. 13
Type: Research Article
ISSN: 0368-492X

Keywords

Book part
Publication date: 19 December 2013

Ruth A. Anderson

In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend…

Abstract

In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend these ideas specifically to how we might think about reducing seemingly intractable problems in health care such as patient safety, patient falls, hospital acquired infection, and the rise of chronic illness and obesity. I suggest that such changes will require managers and providers to view health care organizations and patients as complex adaptive systems and include patients as full participants in co-producing their health care.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

Keywords

Article
Publication date: 2 December 2009

Sam Bennett, Helen Sanderson and Gill Bailey

The active and passive flow of information that this issue of WwOP has so far explored is all about the betterment of older people's lives. But how far can we drill down…

Abstract

The active and passive flow of information that this issue of WwOP has so far explored is all about the betterment of older people's lives. But how far can we drill down into the minutiae of an individual's life in order to make it better without being intrusive? Through the story of Dennis, Sam Bennett, Helen Sanderson and Gill Bailey now describe a method that is being refined to do just that.

Details

Working with Older People, vol. 13 no. 4
Type: Research Article
ISSN: 1366-3666

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