Background: Contemporary public health challenges is connected to societal development. Defined as a “complex” or a “wicked” problem, public health and health inequities needs to be addressed by multiple stakeholders across all sectors, at all levels of government, in a whole-of-society approach. This paper address the question: “Can theories of co-creation accelerate progress in addressing wicked problems in public health?”
Purpose: The purpose of this paper is two-fold: (1) to contextualize the theoretical framework of “Co-creation” within a health promotion agenda; and (2) explore the potential of co-creation as a theoretical framework for health promotion, suggesting that theories of co-creation can push theoretical development that challenges and complement traditional biomedical approaches to public health.
Methodology/approach: For this purpose, the paper will conduct a systematic review of existing theoretical literature discussing “co-creation” in the context of health promotion. This could lead the identification of possibilities for theoretical development combining co-creation with existing theories developed in the field of health promotion, and allow to discuss its effects and implications for further research and practice. The paper will contextualize the discussion of theoretical development through Kuhn’s conceptualization of paradigms as a structure for scientific revolutions.
Tentative findings: Public health has traditionally been dominated by the biomedical paradigm, focusing on preventive medicine. However, a narrow biomedical perspective is insufficient in addressing the complexity in factors determining populations health and well-being. Since the 1980s, ecological and asset based models of health promotion have generated a great deal of enthusiasm in research and practice. Health promotion can be coined as processes that empower people and societies to gain greater control and influence over factors determining their health and well-being. However, scholars have argued that health promotion is in danger of stagnation due to a lack of metatheoretical conceptualization. Although the concept of “co-creation” has different origins than health promotion, there are clear parallels and conceptual similarities. Co-creation is described as a resource integration process involving actors and stakeholders that are linked in an eco-system through a shared problem, challenge, or task. This process occurs when value propositions attract actors to share their knowledge, resources, competences and ideas during collaborative activities and interactions. Similarities between health promotion and co-creation includes a focus on solving complex real-world problems, and with a particular focus on processes, assets, empowerment, social capital, participatory approaches, stakeholder engagement and citizens’ civic engagement and trust.
Conclusion and practical implications: It can be argued that theoretical frameworks of “Co-creation” and health promotion, in Kuhns sense of scientific paradigms, has clear pre-paradigmatic features. This paper suggests that theories of co-creation can boost development and support theoretical framing of health promotion as an emerging paradigm in public health. Theoretical development could improve adequate responses to complex public health challenges, e.g. to guide innovations and development of practices, as well as shed new light over and closing research gaps.
Key words: Co-creation, health promotion, paradigms, theory development
