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Table 3 Beneficial outcomes and challenges of policy codesign

From: Strategies for enacting health policy codesign: a scoping review and direction for research

 

Positive reported outcomes

Reported challenges

Article/case study

Knowledge of community needs

Community mobilization (equity)

Feasible policy options

Multi-sector alignment

Novel ideas, critical thinking

 

Banana (2015) [41]

x

x

x

x

 

Finding community and system individuals willing to commit social capital to being a codesigner and champion, dynamic relationships among community and government

Evans (2016) Case study 1 [19]

x

x

x

 

x

Emotionally taxing for citizen participants

Hagen (2018) [63] Case study 1

x

x

x

x

x

Finding community members willing to commit social capital and participate in codesign framework, need for flexibility, resource intensive, skepticism and discomfort with ambiguity

Hagen (2018) [63] Case study 2

x

   

x

Slowness, skepticism from those used to traditional approaches to policy consultation

Hagen (2018) [63] Case study 3

  

x

x

x

Discomfort with ambiguity, cost and time needed for codesign, skepticism among those used to more traditional policy consultation

Hagen (2018) [63] Case study 4

x

x

   

Energy and resource intensive, skepticism among those used to traditional policy consultation,

Hagen (2018) [63] Case study 5

  

x

x

 

Energy and resource intensive, slowness and flexibility, prototyping complex situations is difficult

Hagen (2018) [63] Case study 6

  

x

 

x

Energy (not necessarily resource) intensive, need for flexibility, consistent need for engagement

Hagen (2018) [63] Case study 7

x

x

  

x

Energy and resource intensive, periods of slowness, consistent need for engagement, skepticism among those used to traditional policy consultation

Holmes (2011) [43] Case study 1

x

x

x

 

x

Energy and resource intensive, requires strong project management

Holmes (2012) Case study 5

x

x

   

Energy and resource intensive, consistent need for engagement

Llano-Arias (2015) [45] Case study 1

 

x

   

Discomfort among politicians with increased community mobilization, policy implementation difficult

Llano-Arias (2015) [45] Case study 2

 

x

 

x

 

_

Mullins (2021) [46]

x

x

   

Difficulty recruiting sufficient citizens, need for continuous engagement, consistently negotiating power differences

Munoz-Erickson (2014) [47]

     

_

van der Bijl-Brouwer (2016) [40]

   

x

x

Managing multiple stakeholder groups

Bovaird (2012) Case study 2 [48]

x

x

   

_

Bovaird (2012) Case study 3 [48]

x

   

x

_

Bovaird (2007) [49] Case study 2

x

x

  

x

Negotiating between professional and citizen roles

Ostrom (1996) [50]

 

x

x

 

x

Supporting citizens to commit social capital to the project, good teamwork within public agencies, regular communication, time and resource intensive

Marchal (2021) [51]

x

   

x

Those lower in political hierarchies may not feel empowered to speak up without the process intentionally facilitating a sense of safety

Springs (2019) [52]

  

x

 

x

-

Spaa (2022) [53]

   

x

x

-

Richardson (2021) [54]

x

x

   

The time needed to meaningfully engage residents

Young (2018) [55]

x

    

-

Bittle (2022) [56]

x

x

   

Time needed to build and maintain strong relationships. Ensuring participatory approaches engages residents outside of “the usual suspects” who tend to be highly engaged

Lloyd-Williams (2021) [57]

x

 

x

  

This effort did not involve consumers/intended beneficiaries and the authors note that equitable solutions would benenfit from more consumer involvement

Goodyear (2022) [58]

x

  

x

x

Even with codesign, implementation of new approaches will be challenging

Owens (2022) [59]

x

x

x

  

The array of ideas considered by a codesign process may be limited by the self-selection of participants, i.e., those who are willing to join may already have biases

FreeBairn (2017) [14]

  

x

x

  

Lazo-Porras (2020) [60]

  

x

x

 

The time and effort needed goes beyond traditionally accepted timeframes for policy development. Methods must balance scientific knowledge and community needs