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      Lost in the shadows: reflections on the dark side of co-production

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          Abstract

          This article is a response to Oliver et al.’s Commentary ‘The dark side of coproduction: do the costs outweigh the benefits for health research?’ recently published in Health Research Policy and Systems (2019, 17:33). The original commentary raises some important questions about how and when to co-produce health research, including highlighting various professional costs to those involved. However, we identify four related limitations in their inquiry, as follows: (1) the adoption of a problematically expansive definition of co-production that fails to acknowledge key features that distinguish co-production from broader collaboration; (2) a strong focus on technocratic rationales for co-producing research and a relative neglect of democratic rationales; (3) the transposition of legitimate concerns relating to collaboration between researchers and practitioners onto work with patients, service users and marginalised citizens; and (4) the presentation of bad practice as an inherent flaw, or indeed ‘dark side’, of co-production without attending to the corrupting influence of contextual factors within academic research that facilitate and even promote such malpractice. The Commentary’s limitations can be seen to reflect the contemporary use of the term ‘co-production’ more broadly. We describe this phenomenon as ‘cobiquity’ – an apparent appetite for participatory research practice and increased emphasis on partnership working, in combination with the related emergence of a plethora of ‘co’ words, promoting a conflation of meanings and practices from different collaborative traditions. This phenomenon commonly leads to a misappropriation of the term ‘co-production’. Our main motivation is to address this imprecision and the detrimental impact it has on efforts to enable co-production with marginalised and disadvantaged groups. We conclude that Oliver et al. stray too close to ‘the problem’ of ‘co-production’ seeing only the dark side rather than what is casting the shadows. We warn against such a restricted view and argue for greater scrutiny of the structural factors that largely explain academia’s failure to accommodate and promote the egalitarian and utilitarian potential of co-produced research.

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          Epistemic Injustice

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

            Background Coproduction, a collaborative model of research that includes stakeholders in the research process, has been widely advocated as a means of facilitating research use and impact. We summarise the arguments in favour of coproduction, the different approaches to establishing coproductive work and their costs, and offer some advice as to when and how to consider coproduction. Debate Despite the multiplicity of reasons and incentives to coproduce, there is little consensus about what coproduction is, why we do it, what effects we are trying to achieve, or the best coproduction techniques to achieve policy, practice or population health change. Furthermore, coproduction is not free risk or cost. Tensions can arise throughout coproduced research processes between the different interests involved. We identify five types of costs associated with coproduced research affecting the research itself, the research process, professional risks for researchers and stakeholders, personal risks for researchers and stakeholders, and risks to the wider cause of scholarship. Yet, these costs are rarely referred to in the literature, which generally calls for greater inclusion of stakeholders in research processes, focusing exclusively on potential positives. There are few tools to help researchers avoid or alleviate risks to themselves and their stakeholders. Conclusions First, we recommend identifying specific motivations for coproduction and clarifying exactly which outcomes are required for whom for any particular piece of research. Second, we suggest selecting strategies specifically designed to enable these outcomes to be achieved, and properly evaluated. Finally, in the absence of strong evidence about the impact and process of coproduction, we advise a cautious approach to coproduction. This would involve conscious and reflective research practice, evaluation of how coproduced research practices change outcomes, and exploration of the costs and benefits of coproduction. We propose some preliminary advice to help decide when coproduction is likely to be more or less useful.
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              Not always co‐creation: introducing interactional co‐destruction of value in service‐dominant logic

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                Author and article information

                Contributors
                oli.williams@kcl.ac.uk
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                7 May 2020
                7 May 2020
                2020
                : 18
                : 43
                Affiliations
                [1 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, , King’s College London, ; 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA United Kingdom
                [2 ]THIS Institute, Cambridge, United Kingdom
                [3 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Service User Research Enterprise, , King’s College London, ; London, United Kingdom
                [4 ]GRID grid.5685.e, ISNI 0000 0004 1936 9668, University of York, ; York, United Kingdom
                [5 ]GRID grid.8356.8, ISNI 0000 0001 0942 6946, University of Essex, ; Colchester, United Kingdom
                [6 ]GRID grid.6572.6, ISNI 0000 0004 1936 7486, University of Birmingham, ; Birmingham, United Kingdom
                [7 ]GRID grid.451056.3, ISNI 0000 0001 2116 3923, NIHR ARC Northwest London, ; London, United Kingdom
                [8 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, The University of Melbourne, ; Melbourne, Australia
                Article
                558
                10.1186/s12961-020-00558-0
                7204208
                32380998
                344263d0-65a9-4ce7-a2e5-4122aed87639
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 3 September 2019
                : 2 April 2020
                Categories
                Commentary
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                co-production,collaboration,participatory research,collaborative research,applied health research,research impact,dark logic,unintended consequences,user involvement,patient and public involvement

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