Engaging refugee women and girls as safeguarding experts, using creative and participatory methods

Alina Potts

This blog post is based on the Evidence & Policy article, Engaging refugee women and girls as experts: co-creating evidence on sexual exploitation and abuse in humanitarian crises using creative, participatory methods, part of the Special Issue on Creativity and Co-production.

Efforts to build evidence on how best to deliver humanitarian assistance have grown over the past decade, at a time when the number of forcibly displaced people in the world has risen to over 84 million. Yet crisis-affected people are often left out of shaping the questions asked, and participating in answering them. Creative, participatory research methods can break down these silos and enable the co-production of evidence with displaced populations, and its uptake for practice and policy. The ‘Empowered Aid‘ study engages in participatory action research with refugee women and girls in Uganda and Lebanon to examine how to better prevent sexual exploitation and abuse (SEA) in aid delivery. Co-producing knowledge about violence with those most affected by it creates actionable evidence to reduce risks.

In humanitarian settings, pre-existing power imbalances due to gender, age, and other factors can be exacerbated. While women and children account for a large share of the displaced, they are often left out of decision making, despite the impact aid delivery has on their lives and their heightened risk of gender-based violence, including sexual exploitation and abuse (SEA). While a system of reporting and response has been put in place over the last two decades, many survivors are discouraged from using it due to a lack of access, information, and trust in the process or the organisations leading it. Accountability mechanisms have also focused on responding to abuses already perpetrated, rather than working to prevent them.

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I’m not in the ‘too hard basket’ – I wove my kete to create my success

Katey Thom, Stella Black, David Burnside and Jessica Hastings

This blog post is based on the Evidence & Policy article, ‘He Ture Kia Tika/Let the Law Be Right: informing evidence-based policy through kaupapa Māori and co-production of lived experience‘, part of the Special Issue on Creativity and Co-production.

A kaupapa Māori co-production project that honours the voices of those with lived experience of incarceration

Research often tells us most prisoners have experienced mental distress or addiction within their lifetime but often end up in the ‘too hard basket’. The criminal justice system of Aotearoa, with its strong Westminster roots, significantly contributes to intergenerational traumatic experiences and struggles to get help that is needed. Our project aimed to reject this basket, replacing it with a diverse array of kete (baskets) filled with localised mātauranga (ancient knowledge derived from a te ao Māori worldview), strategies and solutions to improve wellbeing and reduce reoffending.

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Harnessing creativity in participatory research – the tension between process and product

Louise Phillips, Maria Bee Christensen-Strynø and Lisbeth Frølunde

This blog post is based on the Evidence & Policy article, ‘Arts-based co-production in participatory research: harnessing creativity in the tension between process and product‘, part of the Special Issue on Creativity and Co-production.

In participatory research, researchers share the ideal of democratising knowledge production, on the basis of an expanded understanding of what counts as knowledge and whose knowledge counts. People with knowledge based on their own lived experience take part as co-researchers in processes of co-producing knowledge together with academic researchers. This process of harnessing the knowledge of people with lived experience can make a valuable contribution to the transformation of health and social care practice, as well as to the research field.

Arts-based research methods are often used to draw out the personal knowledge of co-researchers, including the emotional and aesthetic dimensions. But the use of arts-based co-production in participatory research does not easily get rid of the difficulties of putting the principles into practice – due to the tensions that arise between cultivating the collaborative, creative process and generating specific research results.

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A new way for system design: building a relational infrastructure

Mandy D. Owens, Sally Ngo, Sue Grinnell, Dana Pearlman, Betty Bekemeier and Sarah Cusworth

This blog post is based on the Evidence & Policy article, ‘Co-producing evidence-informed criminal legal re-entry policy with the community: an application of policy codesign‘, part of the Special Issue on Creativity and Co-production.

Health service researchers are plagued by the fear that policy and system-level improvement efforts will ignore or under-utilize research. Consequently, efforts at system improvement that come out of research centers tend to use “research-first” approaches that include protocols, trainings, and coaching sessions around evidence-based programs. But oftentimes the issue is not that a system is unaware of the research, it is uncertainty about how to get something going that fits the local context. This has as much or more to do with local values, personalities, and working relationships as it does with the specifics of a protocol.

Our study finds that engaging a community in a policy codesign process that prioritizes mutual learning, rather than a protocol, not only yielded a high-quality plan but built the relational infrastructure for local collaboration long after the external design facilitators left.

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Designing futures together: co-designing health and social services with structurally vulnerable populations

Samantha K. Micsinszki, Alexis Buettgen, Gillian Mulvale, Sandra Moll, Michelle Wyndham-West, Emma Bruce, Karlie Rogerson, Louise Murray-Leung, Robert Fleisig, Sean Park and Michelle Phoenix

This blog post is based on the Evidence & Policy article, ‘Creative processes in co-designing a co-design hub: towards system change in health and social services in collaboration with structurally vulnerable populations‘, part of the Special Issue on Creativity and Co-production.

What creative tools can we use to disrupt the status quo and create truly inclusive health and social services? Co-designing evidence and policy change in collaboration with health and social service users and their families is part of an exciting and growing international movement. In our Evidence & Policy article, ‘Creative processes in co-designing a co-design hub: towards system change in health and social services in collaboration with structurally vulnerable populations’, we highlight how our interdisciplinary team of researchers, trainees and lived experience experts engaged in a three-year collaborative process to promote engagement, education, and innovation in equity-based co-design. This article is part of a special issue on creativity and co-production that highlights how collaborative practices, such as co-design and co-production, can be elevated using creative devices and tools (e.g., imagination, storytelling, art etc.) to create a shared language, build relationships, and make meaning.

Co-design approaches take a person-centered perspective, utilizing a design lens to develop solutions to problems in collaboration with lived experience experts. This approach can redistribute power when we meaningfully and effectively engage individuals and communities who experience structural vulnerabilities that affect their health and well-being (e.g., racism, sexism, ableism, colonialism). In other words, how do we ensure that diverse experiences are included and that co-design processes lead to lasting system change?

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Can creative co-design improve healthcare intervention development?

Richard Webber

This blog post is based on the Evidence & Policy article, ‘The creative co-design of low back pain education resources‘, part of the Special Issue on Creativity and Co-production.

In our recent Evidence and Policy article we provide a detailed description of how a specific creative co-design approach was used to blend academic knowledge with stakeholder knowledge in the development of a complex intervention that addressed a NICE guideline recommendation about information and advice for people with back pain.

In the UK, the National Institute of Clinical Excellence (NICE) produce clinical guidelines based on the best research available in order ensure people receive consistent evidence-based care. However, despite almost universal agreement amongst health professionals that clinical practice should be based on best available evidence, guidelines are routinely not used as specified in decisions relating to individual care.

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Enacting change: using Forum Theatre to improve post-injury psychological care

Kate Beckett and Toity Deave

This blog post is based on the Evidence & Policy article, ‘Using Forum Theatre to mobilise knowledge and improve NHS care: The Enhancing Post-injury psychological Intervention and Care (EPPIC) study‘, part of the Special Issue on Creativity and Co-production.

We know that physical trauma causes psychological problems. The evidence suggests that around 30% of injured adults will develop a psychological problem such as Post Traumatic Stress Disorder within twelve months of injury and these have a significant impact on their recovery. Despite this, NHS management of trauma patients’ psychological needs is generally poor, which leads to under-recognition, delayed treatment, and increased individual, societal and healthcare costs.

The inability of this evidence to directly influence practice is symptomatic of a broader concern about the generation and uptake of research. It goes to the heart of how we perceive human health and healthcare (and the interplay between physical, social, and psychological factors), how we produce knowledge to shape and change it, and how we understand the way knowledge is effectively transmitted in practice. Our study, as published in a recent Special Issue of Evidence & Policy, used innovative methods to address these wider challenges and improve post-injury psychological care.

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Improving knowledge mobilisation in healthcare: a qualitative exploration of creative co-design methods

Dan Wolstenholme

This blog post is based on the Evidence & Policy article, ‘Improving knowledge mobilisation in healthcare: a qualitative exploration of creative co-design methods‘, part of the Special Issue on Creativity and Co-production.

Creative methods help get evidence and policy into practice

Evaluating 14 healthcare improvement and research projects that used creative methods, we identified three interconnected themes that result in the optimal conditions for getting evidence into practice.

Co-production, co-creation and co-design are increasingly used in healthcare research knowledge mobilisation. These methods have grown in popularity, and the broad range of approaches are often used uncritically. Our recently published Evidence & Policy paper focuses on the creativity component of these approaches, specifically when working with design professionals.

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Four questions relating to creativity and co-production

Joe Langley, Nicola Kayes, Ian Gwilt, Erna Snelgrove-Clarke, Sarah Smith and Claire Craig

Reflections arising from an Evidence & Policy Special Issue exploring the role and value of Creative Practices in Co-production. This blog post is based on the Editorial to the Special Issue, ‘Exploring the value and role of creative practices in research co-production‘.

Our Evidence & Policy Special Issue, exploring the value and role of creativity and co-production in research, highlights four key questions:

  1. What constitutes research? And who decides?
  2. What constitutes legitimate knowledge?
  3. What constitutes creativity and co-production in research?
  4. To what extent are we constrained in the opportunities to undertake ‘creative’ research?
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PODCAST: The many faces of disability

This podcast is based on the special issue of Evidence & Policy ‘‘The many faces of disability in evidence for policy and practice: embracing complexity.

Carol Rivas and Ikuko Tomomatsu

In this episode of the Transforming Society Podcast, Jess Miles speaks with Carol Rivas and Ikuko Tomomatsu, two of the guest editors of a special issue of Evidence & PolicyThe many faces of disability in evidence for policy and practice: embracing complexity’.

They discuss the problems with current representations of disability, recent examples of policy that has failed disabled people and the changes that could be made so people with disabilities can be better supported and allowed to participate in policy making.

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