Can co-creation achieve better outcomes for people and communities?

By Deborah Ghate

The language of ‘co-processes’ is much in vogue in policy, practice and academic communities worldwide. In commerce, product design and politics, the power of the crowd has long been recognised, but can co-processes be harnessed for the public good? The answer, right now, appears to be ‘maybe’.

What are co-processes and what are they for?

The briefest survey of the literature on co-processes confirms there is substantial variation in how they are defined and what methods or techniques they include. A confusing multiplicity of related terms exists—co-construction, co-production, co-design, co-innovation, co-creation—all are in regular use, sometimes interchangeably, and often defined at an unhelpful level of abstraction (for more on this topic see the blog post by Allison Metz on Co-creation, co-design, co-production, co-construction: same or different?). Nevertheless, however we define co-processes, participatory methods, boundary-spanning and inclusivity to varying degrees are foundational principles that can be detected in most accounts. Beyond that, the stated purposes and proposed outcomes vary considerably.

As a better taxonomy of co-processes develops, perhaps we will arrive at something like the concept of a spectrum, with different members of a family of co-processes ranged along it according to the narrowness or specificity of their ultimate goal or the complexity of their methods. If so, as a specialist in implementation and improvement of practice and policy in human services, my personal interest lies closest to the idea of co-creation: as a co-process for the public good “deeply involving stakeholders in identifying all dimensions of the problem and designing and implementing solutions” (Pfitzer, Bocksette and Stamp 2013) and utilised particularly in the whole effort to improve outcomes for groups of individuals or communities, from start to finish.

Co-creation might therefore become the term we use to describe a ‘total process’, positioned somewhere near the upper end of this notional spectrum, encompassing knowledge production, problem specification, needs analysis, service design and planning, service implementation and delivery, and monitoring and impact evaluation, all undertaken as a joint enterprise between end-users and professionals and others with a stake in the outcomes.

What are the active ingredients of co-processes?

Implementation science often refers to the idea of ‘active ingredients’: the core elements of an intervention that produce the beneficial changes for which we hope. What are the supposed active ingredients of co-processes? How are they different from (for example) the more familiar ideas of ‘collaboration’ or ‘joint working’?

Implicit in the most compelling and thoughtful accounts are the concepts of depth (as opposed to superficiality) and diversity and inclusivity (as contrasted with tokenism or elitism) around common purpose often connected with tackling intractable social or community problems (so-called ‘wicked problems’).

The activities involved are described in terms of exchanging narratives, active and empathic listening, collaborative analysis and synthesis, and joint engagement in a range of participatory undertakings including the generation of new data.

The ideal attributes of participants in a successful co-process are often characterised by what a philosopher would call intellectual virtues – open-mindedness, curiosity, self-awareness, tolerance of ambiguity, willingness to suspend bias or prejudice, ability to build effective interpersonal relationships.

The outcomes, various and many though they are, are thought to be synergistic – exceeding, by virtue of the group process, what could have been achieved by any individual member working alone.

How might co-processes work?

Much of the rhetoric on co-processes suggests that they are automatically in the public interest, and even that simply participating in a co-process can be beneficial in its own right. Yet while we have some ideas about how a causal relationship between co-processes and outcomes could work, it is clear from the literature that we don’t in fact have much evidence that it does work – yet.

If we were building testable hypotheses about how co-processes could work to produce beneficial change, what might these be? Given the possible active ingredients outlined above, and taking co-creation as the variant co-process for our example, as a first step we could propose a number of distinct mechanisms of change that produce the outcomes we desire.

Mechanisms of change are not the end outcomes in themselves: they are the necessary intermediate shifts – the responses of participants – that must occur in order to produce end outcomes (Weiss 1997). The mechanisms will vary to some degree depending on the target outcomes, but still, we might be able to envision three generic mechanisms that connect co-process endeavours to co-process outcomes:

1. Mind-set shifts, at the individual and group level.
   These might include changes in the (e)quality of personal and power relationships, deepening of knowledge and understanding of others’ perspectives and circumstances, and revisions in pre-conceived ideas about the nature of problems and their solutions.
2. Changes in facilitative behaviours.
   People might work differently or treat each other differently. These might manifest for participants at the individual level (for example, treating one another with greater respect or consideration), or at the group or organisational level (for example, changes in professional practices, such as listening or explaining more carefully to other stakeholders, or asking different sorts of questions).
3. Capacity shifts.
   At the individual and group levels, these might include acquisition of specific technical skills, or competencies and resources built through the process: for example, in problem definition and framing, needs analysis, influencing and advocating, communication, service design, systems thinking and systems analysis, and monitoring and evaluation. At the group, community, organisational or whole-system level, capacity shifts might manifest as increased willingness and skills to work across boundaries, to accommodate different priorities, to think beyond usual social and systemic divisions, or to develop formulae for sharing rather than competing (for example in the use of resources, or in the defining of social or professional territories). A more authorising environment or co-created infrastructure might develop, more conducive to innovative shared approaches than was previously the case.

The challenge now is to flesh out the ideal theory of change, so that we can begin to test elements of it against results in the messy real world in which co-processes actually take place. Given that top-down, single agency, ‘expert-driven’ solutions continue to shift the dial of so many urgent social and environmental problems at a frustratingly slow pace, it is not surprising that many think the effort spent clarifying the potential of co-processes is effort well spent.

References:
Pfitzer, M., Bocksette, V. and Stamp, M. (2013). Innovating for shared value. Harvard Business Review, September.
Online: http://hbr.org/2013/09/innovating-for-shared-value/ar/pr

Weiss, C. (1997). Theory-based evaluation: Past, present and future. New Directions for Evaluation, 76, Winter: 41-55.

Biography: Deborah Ghate is Chief Executive of the independent non-profit Colebrooke Centre for Evidence and Implementation (www.cevi.org.uk). A researcher, analyst and organisational leader specialising in implementation science and practice in child and family services, she serves on the Board of the Global Implementation Initiative (GII), is Chair of the UK Implementation Network (UK-IN; [Moderator note; in October 2021, the following link was found to be non-functional and was removed: (uk-in[dot]org[dot]uk)], and a visiting fellow at the Centre for Child and Family Research, University of Loughborough. She is currently working on various themes in implementation and improvement science and practice including systems leadership, co-creation and using theories of change for quality improvement. She is co-Principal Investigator of the Co-Creative Capacity Pursuit funded by the National Socio-Environmental Synthesis Center (SESYNC).

This blog post is the first of a series resulting from the initial meeting in April 2016 of the Co-Creative Capacity Pursuit. This pursuit is part of the theme Building Resources for Complex Action-Oriented Team Science funded by the National Socio-Environmental Synthesis Center (SESYNC).