Dataset Information

Experiences of participants in the co-design of a community-based health service for people with high healthcare service use.

ABSTRACT:

Background

Incorporating perspectives of health consumers, healthcare workers, policy makers and stakeholders through co-design is essential to design services that are fit for purpose. However, the experiences of co-design participants are poorly understood. The aim of this study is to explore the experiences and perceptions of people involved in the co-design of a new service for people with high healthcare service utilisation.

Methods

A methodology informed by the principles of grounded theory was used in this qualitative study to evaluate the experiences and perceptions of co-design participants. Participants were healthcare professionals, health managers and leaders and health consumers involved in the co-design of the new service in Tasmania, Australia. Semi-structured interviews were conducted, and data were iteratively and concurrently collected and analysed using constant comparative analysis. Audio/audio-visual recordings of interviews were transcribed verbatim. Transcripts, memos, and an audit trail were coded for experiences and perspectives of participants.

Results

There were thirteen participants (5 health professionals, 6 health managers and leaders, and 2 health consumers). Codes were collapsed into six sub-themes and six themes. Themes were bureaucracy hinders co-design, importance of consumers and diversity, importance of a common purpose, relationships are integral, participants expectations inform their co-design experience and learning from co-design.

Conclusion

Most participants reported positive aspects such as having a common purpose, valuing relationships, and having a personal motivation for participating in co-design. However, there were factors which hindered the adaptation of co-design principles and the co-design process. Our research highlights that bureaucracy can hinder co-design, that including people with lived experience is essential and the need to consider various types of diversity when assembling co-design teams. Future co-design projects could use these findings to improve the co-design experience for participants, and ultimately the outcome for communities.

SUBMITTER: McGowan D

PROVIDER: S-EPMC10938828 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Publications

Experiences of participants in the co-design of a community-based health service for people with high healthcare service use.

McGowan Deirdre D Morley Claire C Hansen Emily E Shaw Kelly K Winzenberg Tania T

BMC health services research 20240314 1

<h4>Background</h4>Incorporating perspectives of health consumers, healthcare workers, policy makers and stakeholders through co-design is essential to design services that are fit for purpose. However, the experiences of co-design participants are poorly understood. The aim of this study is to explore the experiences and perceptions of people involved in the co-design of a new service for people with high healthcare service utilisation.<h4>Methods</h4>A methodology informed by the principles of ...[more]

PMID: 38486164

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Project description:BackgroundFor ethnic minority communities in the UK, the COVID-19 pandemic amplified existing health inequalities and created other consequential disadvantages like increased vulnerability to COVID-19, higher rates of hospital admissions, increased mortality and poorer mental health outcomes. While longer-term impacts of COVID-19 are considered, it is crucial for NHS mental health services to understand the specific barriers and needs of ethnic minority communities to provide consistent and equitable access to mental health services. These aspects were the focus of a service evaluation of a Sussex-wide mental health service conducted in co-production with experts-by-experience, public members, health professionals and researchers from ethnic minority communities.MethodsCo-designed creative workshops (n = 13) and semi-structured qualitative interviews (n = 13) were used to explore experiences of accessing specialist mental health services during the COVID-19 pandemic. Participants were: Sussex Partnership NHS Foundation Trust (SPFT) service users recruited between October 2021 and January 2022; aged 16+; from ethnic minority community backgrounds. Data was analysed using Thematic Analysis.ResultsThe analysis yielded five overarching themes contextualising service users' experiences: (1) limited awareness of SPFT mental health services; (2) effects of COVID-19 in gaining access to SPFT; (3) SPFT reaching out to ethnic minorities; (4) being supported, 4a) hiding my mental health status from friends and families, 4b) lack of ethnic diversity in services, and 4c) better provision of information and support services, (5) relationship between childhood experiences and current mental health. These findings led to seven key recommendations for future service developments within SPFT.ConclusionsAlthough this evaluation was set in the context of COVID-19, findings have highlighted specific mental health service needs for ethnic minorities that are applicable beyond the confines of the pandemic. Many benefited from online sessions seen as more inclusive. Mental health advocates, outreach and joint working with communities could help further reduce stigmatising attitudes and improve engagement with mental health services. Improved service awareness of the impact of childhood or historical traumas experienced by ethnic minority communities on current mental health, the role of cultural awareness training and availability of culturally adapted therapies is also needed. Many service improvement recommendations provided could impact all service users.

Project description:In Western countries, the concepts of healthy ageing and active ageing, that is, concepts that favour health, participation, and security to increase the quality of life of older people, have become key issues. Hence, the effective design of public green spaces in urban areas is crucial, as visiting these areas encourages social relations and interactions in natural, healthy contexts. Consistent with these perspectives, existing landscape design criteria emphasise the importance of considering not only the functional and aesthetic elements, but also the ecosystemic and biophilic relationships between people and the environment, producing positive effects for both. To maximise the impact of such design criteria, proper engagement strategies are desirable, both to assign an active role to older people themselves and to inform the fine-tuning of the design process according to the specific needs of the local population. This study presents an interdisciplinary co-design method that encourages and informs a biophilic approach by describing the experiences of people in natural environments, actual and designed, through the application of attention restoration theory (ART). The case study was developed through six focus group meetings with older people for the co-design of a restorative area in a community garden in the Ortica district in Milan (Italy). Results show how the main needs expressed by participants can be classified into the ART factors of "compatibility" (a multifunctional garden), "fascination" (sense of contact with nature), and "being away" (metaphorical escape from nursing homes). The garden designed includes biophilic principles that respond to such needs, and specific links with designed elements were identified. For example, "being away" (e.g., isolation from daily routine and visual occlusion of the surroundings) and "compatibility" (e.g., pergola and aesthetic value) are the factors that include the elements that more satisfactorily answer previous needs. "Fascination" also includes many positive aspects, allowing space for improvements (e.g., more water elements, interaction with animals). Implications of the method are discussed, including the importance of subjective experience in informing design, the use of different psychological constructs to describe it, and the methodological alternatives for psychological assessment.

Project description:Community-based health insurance (CBHI) as a demand-side intervention is presumed to drive improvements in health services quality, and the quality of health services is an important supple-side factor in motivating CBHI enrollment and retention. There is, however, limited evidence on this interaction. This study examined the interaction between quality of health services and CBHI enrollment and renewal. A mixed-method comparative study was conducted in four agrarian regions of Ethiopia. The study followed the Donabedian model to compare quality of health services in health centers located in woredas/districts that implemented CBHI with those that did not. Data was collected through facility assessments, client-exit interviews, and key informant interviews. In addition to manual thematic analysis of qualitative data, quantitative descriptive and inferential analyses were done using SPSS vs 25. The process related (composite index including provider-client interpersonal communication) and outcome related (client satisfaction) measures of service quality in CBHI woreda/districts differed significantly from non-CBHI woredas/districts, but there were no significant differences in overall measures of structural quality between the two. The study found better diagnostic test capacity, availability of tracer drugs, provider interpersonal communication, and service quality standards in CBHI woredas. A higher proportion of clients at CBHI health centers gave high ratings of overall satisfaction with services. Individual and household factors including family size, age, household health care-related expenditures, and educational status, played a more significant role in CBHI enrollment and renewal decisions than health service quality. Key-informants reported in interviews that participation in the scheme increased accountability of health facilities in CBHI woredas/districts, because they promised to provide quality services using the CBHI premium collected at the beginning of the year from all enrolled households. This study indicates a need for follow-up research to understand the nuanced linkages between quality of care and CBHI enrollment.

Dataset Information

Experiences of participants in the co-design of a community-based health service for people with high healthcare service use.

Background

Methods

Results

Conclusion

Publications

Experiences of participants in the co-design of a community-based health service for people with high healthcare service use.

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