Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Box 356560, Seattle, USA.
School of Public Health, University of Washington, 3980 15th Ave, Box 351621, Seattle, NE, USA.
Implement Sci. 2023 Sep 21;18(1):44. doi: 10.1186/s13012-023-01295-y.
Strategies for supporting evidence-informed health policy are a recognized but understudied area of policy dissemination and implementation science. Codesign describes a set of strategies potentially well suited to address the complexity presented by policy formation and implementation. We examine the health policy literature describing the use of codesign in initiatives intended to combine diverse sources of knowledge and evidence in policymaking.
The search included PubMed, MEDLINE, PsychInfo, CINAHL, Web of Science, and Google Scholar in November 2022 and included papers published between 1996 and 2022. Terms included codesign, health, policy, and system terminology. Title and abstracts were reviewed in duplicate and included if efforts informed policy or system-level decision-making. Extracted data followed scoping review guidelines for location, evaluation method, health focus, codesign definition, description, level of health system user input, sectors involved, and reported benefits and challenges.
From 550 titles, 23 citations describing 32 policy codesign studies were included from multiple continents (Australia/New Zealand, 32%; UK/Europe, 32%; South America, 14%; Africa, 9%; USA/Canada 23%). Document type was primarily case study (77%). The area of health focus was widely distributed. Policy type was more commonly little p policy (47%), followed by big p policy (25%), and service innovations that included policy-enabled funding (25%). Models and frameworks originated from formal design (e.g., human-centered or participatory design (44%), political science (38%), or health service research (16%). Reported outcomes included community mobilization (50%), policy feasibility (41%), improved multisector alignment (31%), and introduction of novel ideas and critical thinking (47%). Studies engaging policy users in full decision-making roles self-reported higher levels of community mobilization and community needs than other types of engagement.
Policy codesign is theoretically promising and is gaining interest among diverse health sectors for addressing the complexity of policy formation and implementation. The maturity of the science is just emerging. We observed trends in the association of codesign strategies and outcomes that suggests a research agenda in this area could provide practical insights for tailoring policy codesign to respond to local contextual factors including values, needs, and resources.
支持循证卫生政策的策略是政策传播和实施科学中一个公认但研究不足的领域。共同设计描述了一系列策略，这些策略可能非常适合解决政策制定和实施过程中出现的复杂性。我们研究了描述在旨在将不同来源的知识和证据结合到决策中的政策制定倡议中使用共同设计的卫生政策文献。
搜索包括 2022 年 11 月在 PubMed、MEDLINE、PsychInfo、CINAHL、Web of Science 和 Google Scholar 中进行的研究，包括 1996 年至 2022 年期间发表的论文。术语包括共同设计、卫生、政策和系统术语。标题和摘要进行了重复审查，如果努力为政策或系统层面的决策提供信息，则包括在内。提取的数据遵循范围审查指南，用于记录位置、评估方法、卫生重点、共同设计定义、描述、卫生系统用户投入水平、参与的部门以及报告的利益和挑战。
从 550 个标题中，有 23 篇引文描述了来自多个大陆的 32 项政策共同设计研究（澳大利亚/新西兰，32%；英国/欧洲，32%；南美洲，14%；非洲，9%；美国/加拿大，23%）。文件类型主要是案例研究（77%）。卫生重点领域分布广泛。政策类型更常见的是小 p 政策（47%），其次是大 p 政策（25%），以及包括政策支持资金的服务创新（25%）。模型和框架源自正式设计（例如，以人为中心或参与式设计（44%）、政治学（38%）或卫生服务研究（16%））。报告的结果包括社区动员（50%）、政策可行性（41%）、改善多部门一致性（31%）以及引入新想法和批判性思维（47%）。让政策用户充分参与决策角色的研究报告称，社区动员和社区需求水平高于其他类型的参与。
共同设计在理论上具有前景，并且正在引起不同卫生部门的兴趣，以解决政策制定和实施的复杂性。该科学的成熟度刚刚出现。我们观察到共同设计策略和结果之间的关联趋势，这表明该领域的研究议程可以为定制政策共同设计以应对包括价值观、需求和资源在内的当地背景因素提供实用见解。
