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共同制定新的公平包容共创宪章:来自学术和生活经验专家国际论坛的见解。

Co-creating a new Charter for equitable and inclusive co-creation: insights from an international forum of academic and lived experience experts.

机构信息

DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada

School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

出版信息

BMJ Open. 2024 Mar 19;14(3):e078950. doi: 10.1136/bmjopen-2023-078950.


DOI:10.1136/bmjopen-2023-078950
PMID:38508634
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10953044/
Abstract

BACKGROUND: Co-creation approaches, such as co-design and co-production, aspire to power-sharing and collaboration between service providers and service users, recognising the specific insights each group can provide to improve health and other public services. However, an intentional focus on equity-based approaches grounded in lived experience and epistemic justice is required considering entrenched structural inequities between service-users and service-providers in public and institutional spaces where co-creation happens. OBJECTIVES: This paper presents a Charter of tenets and principles to foster a new era of 'Equity-based Co-Creation' (EqCC). METHODS: The Charter is based on themes heard during an International Forum held in August 2022 in Ontario, Canada, where 48 lived experience experts and researchers were purposively invited to deliberate challenges and opportunities in advancing equity in the co-creation field. RESULTS: The Charter's seven tenets-honouring worldviews, acknowledging ongoing and historical harms, operationalising inclusivity, establishing safer and brave spaces, valuing lived experiences, 'being with' and fostering trust, and cultivating an EqCC heartset/mindset-aim to promote intentional inclusion of participants with intersecting social positions and differing historic oppressions. This means honouring and foregrounding lived experiences of service users and communities experiencing ongoing structural oppression and socio-political alienation-Black, Indigenous and people of colour; disabled, Mad and Deaf communities, women, 2S/LGBTQIA+ communities, people perceived to be mentally ill and other minoritised groups-to address epistemic injustice in co-creation methodologies and practice, thereby providing opportunities to begin to dismantle intersecting systems of oppression and structural violence. CONCLUSIONS: Each Charter tenet speaks to a multilayered, multidimensional process that is foundational to shifting paradigms about redesigning our health and social systems and changing our relational practices. Readers are encouraged to share their reactions to the Charter, their experiences implementing it in their own work, and to participate in a growing international EqCC community of practice.

摘要

背景:共创方法,如共同设计和共同制作,旨在实现服务提供者和服务使用者之间的权力共享和协作,认识到每个群体都可以提供特定的见解,以改善健康和其他公共服务。然而,鉴于在共创发生的公共和机构空间中,服务使用者和服务提供者之间存在根深蒂固的结构性不平等,需要将重点有意地放在基于权益的方法上,并以生活经验和认识论正义为基础。

目的:本文提出了一项原则宪章,以促进“基于权益的共创”(EqCC)的新时代。

方法:该宪章基于 2022 年 8 月在加拿大安大略省举行的国际论坛上听到的主题,该论坛专门邀请了 48 名生活经验专家和研究人员,商讨在共创领域推进公平方面面临的挑战和机遇。

结果:宪章的七个原则——尊重世界观、承认持续和历史上的伤害、实施包容性、建立更安全和勇敢的空间、重视生活经验、“与”并建立信任、培养 EqCC 的心态/思维模式——旨在促进有交集的社会地位和不同历史压迫的参与者的有意包容。这意味着尊重和突出处于持续结构性压迫和社会政治异化中的服务使用者和社区的生活经验——黑人和土著人、残疾人和聋哑社区、妇女、2S/LGBTQIA+ 社区、被认为患有精神疾病的人和其他少数群体——以解决共创方法和实践中的认识论不公正问题,从而提供机会开始拆除交叉的压迫系统和结构性暴力。

结论:宪章的每一项原则都涉及到一个多层次、多维度的过程,这是重新设计我们的健康和社会系统以及改变我们的关系实践的基础。鼓励读者分享他们对宪章的反应、他们在自己工作中实施宪章的经验,并参与不断发展的国际 EqCC 实践社区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ac/10953044/d7475ef3be05/bmjopen-2023-078950f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ac/10953044/d7475ef3be05/bmjopen-2023-078950f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ac/10953044/d7475ef3be05/bmjopen-2023-078950f01.jpg

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引用本文的文献

[1]
Towards Coproduction in Mental Health Academia: A Cooperative Inquiry.

Int J Ment Health Nurs. 2025-7

[2]
Co-creation methods for public health research - characteristics, benefits, and challenges: a Health CASCADE scoping review.

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本文引用的文献

[1]
Brave spaces: Indigenous children in Canada plan for a different tomorrow.

Appl Physiol Nutr Metab. 2022-6-1

[2]
Are you really doing 'codesign'? Critical reflections when working with vulnerable populations.

BMJ Open. 2020-11-3

[3]
Finding harmony within dissonance: Engaging patients, family/caregivers and service providers in research to fundamentally restructure relationships through integrative dynamics.

Health Expect. 2021-5

[4]
Lost in the shadows: reflections on the dark side of co-production.

Health Res Policy Syst. 2020-5-7

[5]
What Is the Co-Creation of New Knowledge? A Content Analysis and Proposed Definition for Health Interventions.

Int J Environ Res Public Health. 2020-3-26

[6]
The dark side of coproduction: do the costs outweigh the benefits for health research?

Health Res Policy Syst. 2019-3-28

[7]
Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration.

Health Expect. 2019-1-2

[8]
The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement.

Med Humanit. 2019-9

[9]
Racism as a Determinant of Health: A Systematic Review and Meta-Analysis.

PLoS One. 2015-9-23

[10]
Patients and staff as codesigners of healthcare services.

BMJ. 2015-2-10

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