Adopting, implementing and assimilating coproduced health and social care innovations involving structurally vulnerable populations: findings from a longitudinal, multiple case study design in Canada, Scotland and Sweden.

Autor: Mulvale G; DeGroote School of Business, McMaster University, 4350 South Service Road, Suite 421, Burlington, ON, L7L 5R8, Canada. mulvale@mcmaster.ca., Green J; DeGroote School of Business, McMaster University, 4350 South Service Road, Suite 421, Burlington, ON, L7L 5R8, Canada., Robert G; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.; The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden., Larkin M; Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom., Vackerberg N; Region Jönköping County, Jönköping, Sweden.; The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden., Kjellström S; The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden., Hossain P; Department of Health Research Methods, Evidence, and Impact (HEI), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada., Moll S; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada., Lim E; School of Health and Welfare, Jönköping University, Jönköping, Sweden.; SingHealth Office of Regional Health, Singapore Health Services, Singapore, Singapore., Craythorne SL; Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom.
Jazyk: angličtina
Zdroj: Health research policy and systems [Health Res Policy Syst] 2024 Apr 02; Vol. 22 (1), pp. 42. Date of Electronic Publication: 2024 Apr 02.
DOI: 10.1186/s12961-024-01130-w
Abstrakt: Background: Innovations in coproduction are shaping public service reform in diverse contexts around the world. Although many innovations are local, others have expanded and evolved over time. We know very little, however, about the process of implementation and evolution of coproduction. The purpose of this study was to explore the adoption, implementation and assimilation of three approaches to the coproduction of public services with structurally vulnerable groups.
Methods: We conducted a 4 year longitudinal multiple case study (2019-2023) of three coproduced public service innovations involving vulnerable populations: ESTHER in Jönköping Region, Sweden involving people with multiple complex needs (Case 1); Making Recovery Real in Dundee, Scotland with people who have serious mental illness (Case 2); and Learning Centres in Manitoba, Canada (Case 3), also involving people with serious mental illness. Data sources included 14 interviews with strategic decision-makers and a document analysis to understand the history and contextual factors relating to each case. Three frameworks informed the case study protocol, semi-structured interview guides, data extraction, deductive coding and analysis: the Consolidated Framework for Implementation Research, the Diffusion of Innovation model and Lozeau's Compatibility Gaps to understand assimilation.
Results: The adoption of coproduction involving structurally vulnerable populations was a notable evolution of existing improvement efforts in Cases 1 and 3, while impetus by an external change agency, existing collaborative efforts among community organizations, and the opportunity to inform a new municipal mental health policy sparked adoption in Case 2. In all cases, coproduced innovation centred around a central philosophy that valued lived experience on an equal basis with professional knowledge in coproduction processes. This philosophical orientation offered flexibility and adaptability to local contexts, thereby facilitating implementation when compared with more defined programming. According to the informants, efforts to avoid co-optation risks were successful, resulting in the assimilation of new mindsets and coproduction processes, with examples of how this had led to transformative change.
Conclusions: In exploring innovations in coproduction with structurally vulnerable groups, our findings suggest several additional considerations when applying existing theoretical frameworks. These include the philosophical nature of the innovation, the need to study the evolution of the innovation itself as it emerges over time, greater attention to partnered processes as disruptors to existing power structures and an emphasis on driving transformational change in organizational cultures.
(© 2024. The Author(s).)
Databáze: MEDLINE
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