Recovery and Renewal of Co-design Approaches in Health through a Pandemic: a realist synthesis.

Background: The COVID-19 pandemic has significantly transformed the landscape of work and collaboration, impacting design and research methodologies and techniques. Co-design approaches have been both negatively and positively affected by the pandemic, prompting a need to investigate and understand the extent of these impacts, changes, and adaptations, specifically in the health sector. Despite the challenges that the pandemic has imposed on conducting co-design and related projects, it has also encouraged a re-evaluation of co-design practices, leading to innovative solutions and techniques. Designers and researchers have explored alternative ways to engage stakeholders and end-users, leveraging virtual workshops and participatory platforms. These adaptations have the potential to enhance inclusivity, allowing a wider range of individuals to contribute their perspectives and insights through co-design and thus to contribute to healthcare change. Objective: This study aims to explore the impacts of the pandemic on co-design and related practices, focusing on practices in healthcare that have been gained, adapted, or enhanced, with a specific focus on issues of equity, diversity, and inclusion. Methods: The study uses a realist synthesis methodology to identify and analyze the effects of the pandemic on co-design approaches in health, drawing on a range of sources including first-person experiences, grey and academic literature. A community of practice in co-design in health will be engaged to support this process. Results: By examining the experiences and insights of professionals, practitioners, and communities who were actively involved in co-design, and have navigated the challenges and opportunities of the pandemic, we can gain a deeper understanding of the strategies, tools, and techniques that have facilitated effective co-design during the pandemic, to contribute to building resilience and capacity in co-design in health beyond the pandemic. Conclusions: By involving community partners, community of practice (research), and design practitioners we expect closer proximity to practice with capacity building occurring through the realist process, thus enabling rapid adoption and refinement of new techniques or insights that emerge. Ultimately, this research will contribute to the advancement of co-design methodologies and inform the future of co-design in health.