Kneale Dylan, O'Mara-Eves Alison, Candy Bridget, Cain Lizzie, Catchpole Jessica, Chesworth Angela, Oliver Sandy, Sutcliffe Katy, Pascal Niccola Hutchinson, Thomas James
EPPI Centre, Social Research Institute, University College London, London, UK.
Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, University College London, London, UK.
Health Expect. 2025 Aug;28(4):e70346. doi: 10.1111/hex.70346.
There is increasing work towards drawing on theory, implementing co-production and accounting for complexity within the production of systematic reviews for public health. In this paper, we report on the process of co-producing a theory; in this case, a graphical articulation of theory in the form of a logic model, which describes how contextual factors influence children's health.
We undertook a series of three online co-production workshops, involving 18-20 participants in each, and worked with an advisory group of experts with professional and lived expertise. An online virtual whiteboard was used to support the identification of factors that contributed to poorer childhood health, explanations for these factors, and connections between different factors.
Driven by government strategy, we initially focussed our work on childhood obesity. However, co-production was transformational in switching the focus of the logic model away from a narrow focus on Body Mass Index as a measure of obesity, to a more holistic theory of factors that shape children's health, recognised as the intersection between healthy eating, physical activity and mental well-being. Theorising with a diverse range of co-producers helped us to recognise the stigmatising impacts that an exclusive focus on clinical measures of children's health can have, and the way that a narrow clinical focus inhibits theorising the complexity and drivers of poorer health.
Co-production led to a switch in theorising away from narratives of children's health that focus closely on personal responsibility, towards narratives that explore structural and contextual drivers of health.
The logic model was entirely driven by the contributions of researchers, those with lived experience (e.g., as parents and/or who have experienced poor health), and those with professional experience (e.g., as teachers) who worked together to co-produce the model. An advisory group composed of people with a similar range of expertise helped to shape the conduct of co-production and dissemination (including in the preparation of this manuscript).
在为公共卫生进行系统评价的过程中，借鉴理论、实施共同生产以及考虑复杂性的工作越来越多。在本文中，我们报告了共同构建一种理论的过程；在这个案例中，是以逻辑模型的形式对理论进行图形化阐述，该模型描述了背景因素如何影响儿童健康。
我们举办了一系列三场在线共同生产研讨会，每场有18 - 20名参与者，并与一个由具有专业和实际经验的专家组成的咨询小组合作。使用在线虚拟白板来帮助确定导致儿童健康状况较差的因素、这些因素的解释以及不同因素之间的联系。
在政府战略的推动下，我们最初将工作重点放在儿童肥胖问题上。然而，共同生产具有变革性，它将逻辑模型的重点从仅将体重指数作为肥胖衡量标准的狭隘关注点，转变为一种更全面的关于影响儿童健康因素的理论，即认识到健康饮食、体育活动和心理健康之间的交叉点。与众多不同的共同生产者进行理论构建，帮助我们认识到仅关注儿童健康临床指标可能产生的污名化影响，以及狭隘的临床关注点抑制对较差健康状况的复杂性和驱动因素进行理论化的方式。
共同生产导致理论构建从紧密关注个人责任的儿童健康叙述，转向探索健康的结构和背景驱动因素的叙述。
逻辑模型完全由研究人员、有实际经验的人（如作为父母和/或经历过健康不佳的人）以及有专业经验的人（如教师）共同贡献驱动，他们共同合作构建了该模型。一个由具有类似专业知识范围的人组成的咨询小组帮助塑造了共同生产和传播的过程（包括在撰写本手稿过程中）。
