By Katrina Messiha.
How can we avoid co-creation being used as a general term for any form of stakeholder engagement? Are there key dimensions that co-creation processes should aim to consider?
Based on analysis across 9 research fields, several types of co-creation and explicit theories, colleagues and I (Messiha et al., 2025) argue that co-creation is a multidimensional process, with five dimensions:
- Multi-stakeholder collaborative action;
- Process of co-learning towards innovation;
- Contextual knowledge production;
- Generating meaning; and
- Open, trustful and inclusive dialogue.
These dimensions offer a conceptual tool for planning, examining and strengthening co-creation research. They can be used by research teams and various stakeholders to reflect on what is happening in a co-creation process, what may be missing and where further attention is needed.
1. Multi-stakeholder collaborative action
This dimension concerns who is engaged, how they are engaged and what they do together.
Co-creation requires collaborative action among different and relevant stakeholders who bring different forms of knowledge, responsibility and influence. Stakeholders may comprise researchers, professionals, policy actors, community organisations, service users and citizens.
The key question is “How did stakeholders act together?”. This includes examining shared decision-making, division of roles, joint problem-solving and the extent to which stakeholders contribute across different stages of research.
2. Co-learning towards innovation
Co-creation is also a learning process. Stakeholders not only provide information; they learn with and from one another with a view of enabling something new.
In that regard, this co-learning may entail developing new understandings of the problem, acquiring practical skills, questioning assumptions or refining possible solutions. Innovation should be understood broadly. It may refer to a new intervention, a revised service, a changed relationship, an improved process or a more context-sensitive way of framing the issue.
This dimension directs attention to feedback loops to varied extents. Are stakeholders able to reflect on what is emerging? Are their insights used to reshape the process?
3. Contextual knowledge production
Co-creation depends on the production and integration of contextual knowledge.
Contextual knowledge includes lived experience, professional judgement, organisational routines, local histories, cultural meanings, practice-based expertise and theory-informed insight. It is knowledge that helps explain what matters in a particular setting and why.
This dimension is especially important because interventions and policies may potentially fail when they are transferred into settings without sufficient attention to context. Co-creation can help generate knowledge about what is feasible, acceptable, relevant and sustainable in a specific environment.
The task is not to collect contextual knowledge as an accessory to the co-creation research process. Rather, it is to recognise the production of contextual knowledge as central to the research process.
4. Generating meaning
Co-creation further entails generating meaning, recognising that stakeholders engage in research for reasons that are not only technical.
Stakeholder engagement may connect to identity, values, recognition, relevance, ownership, hope, frustration or a desire for change. A co-created output is more likely to matter when the process allows stakeholders to see why their engagement is important.
This dimension asks: What makes the process meaningful to those engaged? How do stakeholders interpret their own contribution? Do the outcomes connect to their needs, interests and lived realities?
Generating meaning helps explain why stakeholders remain engaged and why outputs may be perceived as legitimate, useful or worth sustaining.
5. Open, trustful and inclusive dialogue
The fifth dimension concerns the relational conditions that enable co-creation.
Open, trustful and inclusive dialogue allows stakeholders to speak honestly, challenge assumptions and negotiate different perspectives. It entails transparency, mutual respect, freedom to express disagreement and acknowledgement of different kinds of expertise.
This dimension is not merely about communication style. It may be regarded as a condition for optimal use of the other dimensions. Without openness, collaboration may become tokenistic. Without trust, stakeholders may withhold concerns or local knowledge. Without inclusion, some voices may dominate while others are marginalised.
How the dimensions overlap
The five dimensions should not be treated as separate categories. They convincingly overlap and reinforce one another.
For illustration: Multi-stakeholder collaborative action creates the setting in which co-learning and eventually, the capacity to address solutions can occur. Co-learning helps stakeholders generate and reinterpret contextual knowledge. The production of contextual knowledge can make outputs more meaningful. Generating meaning can strengthen commitment to collaborative action. Open, trustful and inclusive dialogue supports all the other dimensions by shaping the quality of interaction.
The dimensions also help identify weaknesses. A co-creation research project may have strong dialogue but limited shared decision making. It may generate rich contextual knowledge but fail to translate that knowledge into innovation. It may engage many stakeholders but offer few opportunities for learning or meaning-making.
Used in this way, the dimensions become a reflective tool. They can support co-creation research projects through: planning, conducting/ facilitation, evaluation and reporting of co-creation processes.
Using the five dimensions as a reflective tool
Research teams can use the dimensions by asking:
- Which dimensions are already strong in our co-creation process?
- Which dimensions are underdeveloped?
- Who is engaged in collaborative action and who is absent?
- What forms of co-learning are taking place?
- What contextual knowledge is being produced and how is it being used?
- What makes participation or engagement meaningful for different stakeholders?
- Are dialogue, trust and inclusion actively supported?
The five dimensions do not necessarily replace tools that examine power, participation levels or equity. They also do not prescribe a fixed sequence. Instead, they provide a common language for understanding co-creation as a dynamic, relational and context-sensitive process.
What are your experiences of using co-creation in research, policy or practice? Which of these dimensions have you found hardest to achieve? Are there additional dimensions that should be considered when co-creation takes place in your context?
To find out more:
Messiha, K., Altenburg, T. M., Giné-Garriga, M., Chastin, S. and Chinapaw, M. J. (2025). Enriching the existing knowledge about co-creation: Identifying dimensions of co-creation using explicit theory in various research fields. Minerva, 64: 455-478. (Online): https://link.springer.com/article/10.1007/s11024-024-09559-7
Use of Artificial Intelligence (AI) Statement: Artificial intelligence was not used in the development of the paper on which this i2Insights contribution is based. OpenAI’s ChatGPT (GPT-5.5) was used as an editorial support tool during preparation of this i2Insights contribution. AI assistance was introduced only after the intellectual content of the article had been developed and drafted by the author. The tool was used to assist with improving clarity and conciseness. Typical prompts requested the refinement of wording formulations that preserved the original meaning. All AI-generated suggestions were reviewed critically by the author, who retained full responsibility for deciding whether to incorporate, modify or reject them. (For i2Insights policy on artificial intelligence please see https://i2insights.org/contributing-to-i2insights/guidelines-for-authors/#artificial-intelligence.)
Biography: Katrina Messiha MSc is a Marie Skłodowska-Curie PhD Fellow at Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, the Netherlands. Her research focuses on co-creation, public health, theory-informed research, stakeholder engagement and the development of conceptual approaches to support research implementation.