Project Case Study Questionnaire/ Report for:
Community solutions for health equity (CSfHE)-
A project of the Fylde Coast Research Collaboration
Embedded Files
1.Name of your organisation
University of Liverpool
2.Your name and role in the project
Dr Barbara Mezes- Principal Investigator; email: b.mezes@liverpool.ac.uk. I am happy for my email address to be made public.
3.What is the title of the project?
Community solutions for health equity (CSfHE)- a project of the Fylde Coast Research Collaboration (original title at the time of the application was ‘Fylde Coast Research Consortium’)
4.Overview
The project brought together members of the public, Voluntary, Community, Faith, and Social Enterprise (VCFSE) and public sector stakeholders to build partnerships across the sectors and address health disparities on the Fylde Coast. The goal was to better understand drivers of ill-health, map local services, and establish co-production groups to actively engage key stakeholders in planning their integrated place-based care model and for future research in the area. We also built partnership with other coastal communities in East Sussex and laid foundations for future collaborations to improve the wellbeing of people living in coastal areas.
5.Setting
The project took place on the Fylde Coast home to Blackpool.
The Fylde Coast is situated along the northwest coast of England, and Blackpool is one of the major towns on the Fylde Coast with a population of approximately 140K. The area has an older population than the national average but with similar proportion of people under the age of 18. Blackpool is the most deprived local authority in England and experiences the lowest life expectancy for both males and females. The Fylde Coast faces specific public health challenges. These challenges include issues such as obesity, substance abuse, and higher than national average rates of physical and mental health problems. Addressing these challenges involves community-wide initiatives, health promotion campaigns, and preventive healthcare measures. The success of health and social care initiatives often hinges on community engagement. The Fylde Coast has active community organisations, support groups, and outreach programs that facilitate collaboration between health and social care providers and the local population.
A number of organisations were involved in the running of the project.
Blackpool Council: In the context of health and social care, Blackpool Council, like other local authorities in the UK, plays a crucial role in coordinating and delivering services to meet the needs of the local population.
Blackpool Teaching Hospitals NHS Foundation Trust: The Trust is responsible for providing healthcare services to the local population and is recognised as a teaching hospital, indicating its involvement in medical education and training.
BoingBoing Foundation: The foundation is a charity that was established to add to the scope and impact of work focused on social justice rooted resilience research and practice.
Groundwork: It typically works on projects related to environmental sustainability, community development, and improving the quality of life in local areas.
Lancaster University: The university is involved in public health initiatives, contributing to research and interventions that aim to improve public health outcomes. This includes addressing issues such as health inequalities, health promotion, and disease prevention.
NIHR Applied Research Collaboration North West Coast focuses on applied health and care research with the goal of translating research findings into practical applications that can improve health and social care services.
Showtown: It is a museum that will open in 2024, with a focus on entertainment, creative arts and performing arts. The museum has been co-designed with young people.
University of Brighton: The University of Brighton is involved in public health initiatives and contributes to research and expertise to address public health challenges. This includes community-based projects, health promotion campaigns, and efforts to tackle health inequalities.
University of Liverpool: The university is actively involved in research across various health and social care domains. This research contributes to the development of new healthcare practices, the understanding of public health issues, and the improvement of social care services.
6.Purpose of project
The Fylde Coast, home to Blackpool, one of the most deprived areas in England. The project aimed to address the research and practice improvement needs of the Fylde Coast specifically, but we also connected with other coastal areas, i.e., Hastings - the most deprived local authority in the South of England, sharing similar characteristics and health outcomes with Blackpool. Most research activities took place on the Fylde coast. We focused on the local place-based partnership area, as they cover a smaller area and, therefore, have greater potential to redesign services and build relationships across organisations and communities, compared to the larger ICS. The project`s further focus was to involve the stakeholders from different sectors and members of the public in generating solutions for integrating services, improving partnership working, and co-producing plans for future research.
Aim 1: Deepen understanding of multiple drivers of deprivation across our and other coastal communities by mobilising the knowledge of and building research skills in people living and working in the area.
Objectives for Aim 1:
1a) Map and engage the fullest practical range of community-based providers aiming to improve public health and wellbeing on the Fylde coast.
1b) Conduct a consultative rapid review of key drivers of ill-health and relevant interventions in coastal communities using the expertise of local people.
1c) Build community research capacity via regular research workshops to foster skills necessary to produce evidence-base and hence to work towards sustainability.
Aim 2: Explore different collaborative models for integrating co-production into health systems improvement by co-producing ideas for an integrated place-based care model with local people to solve local problems.
Objectives for Aim 2:
2a) Use creative research methods to co-produce the future @TheGrange community hub for integrated community-based provisions.
2b) Create a dedicated space to identify barriers & facilitators to a culture that supports integrated working (health, social care, VCFSE sector). Co-produce tangible action plan to facilitate sustainable cross-sector partnership working and a model of place-based partnership.
2c) Co-develop a research agenda for coastal communities for the next five years (2023-2028) based on the consultative rapid review and consultations with the broader community.
2d) Explore opportunities for establishing an integrated research infrastructure.
Aim 3: Explore how our co-produced model may benefit our and other communities.
Objectives for Aim 3:
3a) Conduct two social network analyses, one before and one after the co-production activities.
3b) Hold a knowledge exchange event to share learning and lay the foundations of future collaborations with other place-based partnerships and with other coastal communities.
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7.Description of the project
The project received funding from the Arts and Humanities Research Council/ UK Research and Innovation (UKRI).
The project united stakeholders from the VCFSE and public sectors to build partnerships, identify ways to address health disparities, and improve wellbeing on the Fylde Coast. This project deepened understanding of multiple drivers of deprivation across our and other coastal communities by mobilising the knowledge of people living and working in the area. The approach taken included a comprehensive mapping exercise, research capacity building workshops in the community (7x), co-production groups (3x), and a social network analysis. First, we mapped and scoped the Fylde Coast to understand the range of services, scale of provision, key stakeholders, and existing partnerships. We created social network maps to illustrate collaborative patterns in the area and identify organisations on the periphery. Based on the mapping, we invited VCFSE organisations, and members of the public and other stakeholders to research capacity building workshops and co-production groups. We explored different collaborative models for integrating co-production into health systems improvement by establishing three co-production groups. These co-produced ideas served a basis for an integrated place-based care model with local people to solve local problems. We explored how our co-produced integrated care model may improve partnership working in the area, and whether it is transferable to other coastal communities by holding a knowledge exchange event. We repeated the social network analysis at the end of the project to explore changes in collaborative patterns at the end of the project.
The project began in November 2022, and will end in March 2024.
The project was led by the University of Liverpool, but most research activities took place in Blackpool.
In the project,
Sixteen co-investigators took part from, Blackpool Council – 4x, Blackpool Teaching Hospitals NHS Foundation Trust-2x, Boingboing Foundation – 2x, Groundwork-1x, Layton Medical Centre-1x, University of Brighton-3x, University of Lancaster – 2x, University of Liverpool-1x.
Nine project partners from, Applied Research Collaboration-Northwest Coast, Centre for Early Child Development, Citizen Advice Blackpool, Clinical commissioning group (Blackpool; Fylde & Wyre), East Sussex County Council- Public Health, Empowerment Charity (Blackpool), Grundy Art Gallery (Blackpool), Health a Social Care Carrier Academy Blackpool and the Fylde College, The Grand Theatre (Blackpool).
We had an independent Advisory Group with members representing the University of Oxford, Manchester University NHS FT, Community Futures, Mental Health & Wellbeing Helpline, University of British Columbia, and one public advisor with lived experience of living and working in Blackpool.
8.Why was this approach taken?
This project is built upon the recommendations of the Chief Medical Officer’s Annual Report (2021), including strategic planning for improving health and wellbeing in coastal communities, and with the priorities outlined in the NHS Long-Term Plan, such as commitment to enhancing preventative approaches and addressing health inequalities. The project`s main objective was to involve key stakeholders in planning a better integration of services and find better ways for community-based health and social care providers to work together.
The project team identified that in order for the project to be successful, a better and a more comprehensive understanding of the health and social care landscape is necessary (holistic understanding). Consequently, it was necessary to explore what is being offered on the Fylde Coast in this context. The provision mapping and the social network analysis was found to be relevant to this objective, as this approach provided opportunities for a holistic understanding of available community support resources and organisations.
The co-production groups enabled hands-on experiences for key stakeholders to become shapers and makers of integrated systems. The research capacity building workshops were planned to support the work of co-researchers in the co-production groups, but also to develop skills in representatives of VCFSE organisations to evidence the impact of their important work in the area.
There are numerous key datasets that are collected routinely across Blackpool and the Fylde Coast within health, social care, and the wider community sector. We sought to understand how we might collaborate and utilise these datasets in order to support the delivery of these key research projects. Understanding these data sets and the potential for an integrated research infrastructure is vital to support research to improve outcomes for our community now and in the future. The research infrastructure sub-team decided to conduct one-to-one interviews. A qualitative approach was taken as it quickly became clear that this is a complex area of work with multiple organisations having a specific interest in collating and using health and social care data. Time limitations directed this approach as the opportunity to run surveys/come together as a focus group were not feasible
Even though, the Chief Medical Officer’s Annual Report highlighted the collective needs of coastal communities, each coastal community is likely to be culturally different, therefore via the project it was important to recognise the tailored needs of the Fylde Coast to find solutions to as such. Co-production Group 1`s (2a) objective characterised in a tailored vision for the future @TheGrange community hub based on the identified needs. Therefore, the discussions of local residents in the group were concerned with what they would like their community hub to be in the future in terms of resources and services being offered.
The next step was to explore better ways of working together. It was recognised early on, that new collaborations will require a culture shift. Co-production Group 2 explored cultural barriers to collaboration by involving health and social care providers who are familiar with the healthcare landscape to foster a sense of collective responsibility. The group also addressed barriers to collaboration, ensuring that the solutions identified are realistic and achievable within the health and social care landscape of the Fylde Coast.
Interdisciplinary and cross-sector collaborations were major contributing factors to the success of the project; co-production Group 2 and Group 3 as well as the research capacity building workshops brought together health and social care service providers, experts by experience/ community members, and academic researchers, to create an inclusive and diverse approach.
Additionally, the team`s goal was to ensure that these efforts will create sustainable solutions toward the communities` needs, and result in a long-term positive impact. The co-production groups and research capacity building workshops empowered community members to actively contribute and express their opinions freely when it came to improving their integrated services, to ensure their vision and needs align with future projects, fostering a sense of self-efficacy.
9.Who took part?
How have people with lived experience been involved with this project?
Lived experience experts included people living and/or working on the Fylde coast, many of them with firsthand experience of facing multiple systemic disadvantages and health inequalities. Lived experience experts were involved as part of the project investigator team, helping to design and implement the different components of the project. Lived experience experts were also involved in co-production groups, and participated in research capacity building workshops. We also had a public advisor involved in the Independent Advisory Group. For more information on the number and characteristics of co-researchers and participants, please see the research activity specific sections below.
Provision mapping/ Social Network Analysis:
Organisations were invited to participate in the study via publicly available email addresses. The participants were representatives of community-based organisations identified through the mapping exercise. Representatives of these organisations were asked to complete the adapted version of the Template for Intervention Description and Replication (TIDieR). Forty-nine representatives/ organisations participated (from which 48 were from the VCFSE sectors). Demographic information of the representatives was not recorded, as this was not relevant to the activities and services being offered by the organisations.
Co-production Groups:
Thirty co-researchers took part in co-production groups: 11 members of the public, 16 health and social care service providers, three academic researchers. The co-researchers were recruited using, online flyers (including online social media), physical paper-based flyers, referral, word-of-mouth, and through existing relationships. Their demographic information is presented in Table 1.
Table 1. Demographic characteristics of co-researchers
Research capacity building workshops:
Fifty individuals took part in the capacity building workshops, recruited via online flyers (including online social media), physical paper-based flyers, referral, word-of-mouth, and through existing relationships. Table 2 demonstrates their age and gender, please note that ethnicity information was not collected for the capacity building workshops.
Table 2. Demographic characteristics of the research capacity building workshops
Knowledge Exchange Event:
Sixty-nine community members, health and social care providers, and academic researchers participated in a knowledge exchange event held @theGrange community hub in Blackpool in November 2023. The attendees were informed about the event via online flyers (including online social media), physical paper-based flyers, referral, word-of-mouth, and through existing relationships. Demographic information was not collected during the event registration process; however participants were asked to identify their affiliations. Table 3, below, includes these details.
Table 3. Knowledge Exchange Event participants` area of employment
10.How was data collected for this case study?
Provision mapping/ Social Network Analysis:
Research Methods: Network Mapping
The areas to be covered on the Fylde Coast by the provision mapping exercise was decided, based on the team members` experience and knowledge of the areas. It was also decided that a number of publicly available documents (e.g., released by councils, public agencies, and authorities) would be scanned for information on available health and social care services. This represented our geographical boundary. Methods for engaging providers were also discussed, whereby time challenges and capacity of our team were factors that were considered. This was followed by establishing the type of data to be collected, whilst being aware of GDPR regulations and the potential need for any data sharing agreements. Next, inclusion and exclusion criteria were set for the type of services to be included and consequently the search terms to be used for the online search. Additionally, we also discussed whether any of the team members have currently available, relevant data, and how do the current contacts could be used to collect more comprehensive information that aligns with the project`s objectives (chain-referral sampling/ snowballing).
The research assistant on the project conducted the online search to identify organisations and collect information on their vision/ descriptions, on the Fylde Coast. . For this purpose, the Google search engine and Google Maps, as well as social media websites, such as Facebook, Instagram and Twitter (X), were used.
Inclusion and exclusion criteria is available upon request.
The identified organisations were then contacted and invited to complete the adapted version of the Template for Intervention Description and Replication (TIDieR) as an online survey (via Qualtrics). For example, description of activities the organisation delivers, data on specific populations involved in the organisations` activities, project outcome delivery types, information dissemination to user populations, user feedback systems, modes of support and so on.
No demographic information was collected from the organisations` representatives.
Co-production groups:
Research method: Participatory Action Research
Qualitative data was collected in the form of audio recordings during the co-production groups. The data was collected by the co-production group facilitators. Also, demographic details were collected on, gender, age, ethnicity, relationship status, education, employment status, occupation and place of residence. Each group produced a tangible output, i.e., creative collage for integrated services at the community hub, action plan for improved cross-sector partnership working, and a research agenda for coastal communities.
The research infrastructure sub-theme of co-production group 3, utilised one-to-one discussions (N = 6) to explore the available data sets and next steps for data sharing and utilising data in future research.
Research capacity building workshops:
Method: Presentation-based workshop
Demographic data was collected from participants upon registering to the workshops, email address, gender, name, age, education, affiliation, role title. Feedback was also collected from the participants after attending each workshop, via online surveys.
The data was collected by the co-investigator, who organised the workshops. Each workshop was recorded and made publicly available.
11.Project impact and outcomes
Provision mapping (1a):
The results/ list of the organisations will be forwarded to social prescriber link workers (SPLW). This could have a number of positive results:
- A comprehensive list of health and social care providers allows SPLWs to have a better overview of available services, which can help addressing more diverse needs of the communities.
- SPLWs can more efficiently link specific services to individuals that are a better fit to individual needs, and in turn increase the likelihood of individuals engaging with the services and lead to better health outcomes.
- Such list can also help in streamlining the referral process and minimise delays.
- SPLWs can make more informed decisions in relation to resource allocation, optimising the use of available resources.
- SPLWs are also provided with a better opportunity to create more comprehensive networks.
Social Network Analysis (SNA) on collaborations between organisations on the Fylde Coast (3a):
- SNA results can uncover trends and patterns in the network, providing insights into the relationships between organisations, opening up research opportunities to explore the impact of collaborations on health outcomes, healthcare delivery methods, and quality of life in the population.
- SNA results can provide opportunities to make recommendations on how to improve collaborations between specific organisations and in turn contribute to the development of more effective health and social care policies.
- SNA results can be forwarded to the effected organisations to shed light on the current state of collaborations and potentially highlight learning points, consequently aiding the organisations on what potential steps to take for organisational growth.
- Providing health and social care providers with the SNA results can enhance academic-healthcare provider partnerships to foster mutually beneficial relationships.
The preliminary results of provision mapping and the social network analysis were presented at a public conference in July 2023 (18th European Congress of Psychology).
Co-production Group 1 (2a):
The co-production group identified a number of future plans on how to make the @TheGrange community hub`s services more suited to the community`s needs:
- Hair braiding groups (consensus that this is good for mental health and meets a base human instinct/need)
- Bingo – brings community together
- Cookery classes from fork to plate – grow your own food, cook your own food. Cheap and encourages healthy eating.
- Making the most out of the pizza oven, selling @TheGrange pizza. This could upskill community members, provide local jobs and a source of income for @TheGrange whilst also getting the word out about the place. Everyone loves pizza! – inspired by Homebaked in Liverpool.
- Community tool swap. Tools are expensive and this can be a barrier to people e.g., doing DIY, improving their homes, fixing bicycles etc., which is a barrier to wellbeing and health.
- On-site childcare. This would free up time for parents to socialise and get involved with the other activities @TheGrange, whilst also providing a safe space for the children to socialise.
- Youth club with games and social worker.
· A space that young people could feel ownership over, e.g., by having the freedom to design the space themselves for how they want to use it. Graffiti wall etc.
· The group identified a particular need for around the year 6 age (ages 10-12 approx.)
- More spaces for the community to use. This was part of a broader discussion where community members expressed feelings of dispossession as @TheGrange seemed increasingly used by people in suits who didn’t interact with the community; and the rooms they use are out of bounds to community members. This ultimately didn’t make it onto the collage because it was recognised that room hire is a valuable source of income for the sustainability of the hub - but worth noting the sentiment within the community. Ideas for community use of rooms:
- Community co-production meetings / steering group to embed community voice within the @TheGrange developments.
- Upcycling group, with a means of selling on the products. Make this available for younger people as a way of making a bit of money.
The group has also proposed some ideas on how to motivate community members to be more involved with the community hub:
- Welcome pack for new residents (and existing ones)
- Fayres
- Official launch of the laundry service to make more people aware of it
- Winter Warm Club – change the name (consult with community)
- Sculpture / teddy bear hunt (advertised as an attraction)
Subsequently, the conduct of Co-production Group 1 generated the following impacts:
- The use of creative methods encouraged active participation from the community, ensuring the participants` voices were heard, fostering belonging and empowerment in the community.
- The use of creative methods also inspired holistic understanding of the community-members` needs, which otherwise may have not been explored via more traditional ways such as requiring the completion of questionnaires, surveys, or other structured data collection methods. This method goes beyond the analysis of numbers and provides visual representations of the community members’ ideas, needs, and the cultural context the community hub is expected to operate at.
- Collaboration during the sessions facilitated decision-making processes via enabling individuals to build positive relationships.
- During the sessions, visual representations and social activities were used to overcome language barriers to create a more inclusive environment within the community.
The created collage has been on display at the reception of the @theGrange community hub, where residents are able to interact with a collage using post-its and placing hearts on ideas they like. The collage will also provide basis for future consultation with local residents about the improvement work of the community hub taking place in the near future.
Co-production Group 2 (2b):
Co-production Group 2 identified barriers and facilitators to better integrating relevant services.
Cultural barriers identified:
- Different visions and values
- Different systems
- Terminology and language
- Workforce perceptions of different orgs and different
- Approaches to leadership, including willingness to stick to values and principles when under pressure
- Resistance to change/ aversion to risk
- Competition for resources and ownership
- Lack of experience of previous successful multi-disciplinary working
- Rigid approach to model of service delivery
- Power imbalances between organisations and disciplines
- Lack of trust between different organisations and workforce
- Lack of joint ownership of the problems and the solutions
- Not all services/organisations have embedded approach to co-producing change and being trauma-informed
- Value placed on reason for integration i.e., government mandate vs natural progression of previous collaboration
Non-cultural barriers identified:
Process barriers
- Existing complexity of the system, making it difficult for people to navigate
- Different policy drivers
- Different inspection/contractual requirements
- Perception/accessibility of the physical locality of the service
- Lack of Information sharing agreements to support practice
- Over professionalisation of community spaces
- Different lanyards/different uniforms/clothing etc.
- Lack of understanding of the work needed to prepare for the integration
- Lack of understanding of the test and learn, then scale up approach
Resource barriers
- Lack of integrated data/case management systems – difficulties in developing integrated data/case management systems
- Infrastructure to maintain workforce resilience and passion
- Workforce feeling unsupported/overstretched
- Lack of resource to support the planning of delivery of the integration
- Lack of time needed to plan and deliver integration
Facilitators identified (linked to solutions on the action plan)
- Don’t assume we know what’s best, develop a vision “with” people not “for” people
- Inclusive, non-stigmatising service branding and information
- Warm, friendly accessible space/building/services
- Willingness to adapt the model over time (in line with people’s needs)
- Use of community navigators, social prescribing roles etc.
- Shared systems e.g., referral mechanisms and no wrong door approach
- Support for staff, group supervisions/shadowing etc.
- Overall staff development, time to reflect
- Multi-agency/disciplinary meetings
- Valuing the lived experience of people
- Access to specialist knowledge
- “We all want to make this work”.
- Having fun and accessible activities to attract people into the space
- Access to peer-support
- Knowing what people want and need
Consequently, the conduct of Co-production group 2 generated the following impacts:
- The co-produced action plan will be shared with the Place-based partnership and hence has a great potential to lead to improved collaboration among health and social care providers on the Fylde Coast. The place-based partnership model has a positive impact on the community`s wellbeing by stimulating more efficient collaborations to address the broader determinants of health. As a result of the sessions, relevant and specific actions are more likely to address health disparities and lead to a more equitable access to healthcare. Exploring better ways of working together ensures that relevant processes are more likely to be streamlined, leading to optimised resource allocation.
Co-production Group 3 (2c and 2d):
2c:
- A weekly newsletter was produced on the progress of the co-production group.
- Participants were introduced to what health inequalities meant and the impact they had on coastal communities, like the Fylde Coast. Participants gained a better understanding of the importance of avoiding duplicate efforts in this context.
- Participants were made aware of the language of health inequalities and learned how to generate research topics to address health inequalities.
- The participants generated, reviewed, refined and prioritised the research questions to address health inequalities and consulted with other members of the community to help to prioritise the identified research questions.
The impact of the participants generating and prioritising research questions based on the needs of the community is as follows:
- A set of 11 research questions were produced to inform future research on the Fylde coast, which will be shared with key partners in the area to inform future grant applications and research.
-Participants felt empowered during the sessions as a result of developing a sense of ownership.
- As the sessions were attended by community members, health and social care providers and researchers from academia, power dynamics were addressed to ensure the voice of the community was heard.
- Positive future impact on community members` lives, as the questions promoted improved economic support for the communities.
- Participants became more committed to long-term community development, potentially ensuring that relevant resources become more available.
- Participants also became more committed to improving the wellbeing of people with disabilities, fostering a supportive and inclusive environment.
- Participants established the need for practical application and better translation of research findings into policy and practice.
2d:
The subgroup that explored opportunities for establishing an integrated research infrastructure has the following impacts.
Information through one-to-one discussions with key partners was collected on the following:
1. Mapping relevant datasets collected across Blackpool and the Fylde Coast and their purpose (understanding governance arrangements, Identifying Data Controllers, where data is stored (IT systems), accessibility, resources needed to support this data collection/oversight etc).
2. Understanding current regional and national approaches to data collection and sharing, relevant to this work (NIHR CRN, Trusted Research Environments, NEXUS Intelligence) and understanding examples from other communities.
3. What is required to establish a data sharing agreement/framework working closely with partners including colleagues from Information Governance, IT, Local Authority, Legal Depts etc.
4. Understanding resources available and needed to implement such agreements, working towards the establishment of a joint dataset which can be utilised to support the research plan.
These interviews were done in conjunction with desk research to identify publicly available datasets that already support work across the region. Seven key dataset types were identified and explored with participants, that are well established in the public domain and are free to use. These included: Census data, public health profiles, council assets, NIHR assets, third sector, integrated care system, secure data environment (SDE).
The findings highlighted the importance of:
- a more comprehensive understanding of data governance arrangements to promote compliance with data privacy regulations (GDPR) and other data protection laws.
- A clear mitigation strategy of potential risks in terms of data security and data collection and sharing.
- improved knowledge of the importance of aligning data with universal management processes, to promote more consistent data handling.
- agreement on necessary steps to take to ensure data sharing aligns with the policies of the affected organisations (e.g., data ownership, access controls, data integrity QC).
- a better understanding of the resources required and/ or the steps to be taken to ensure necessary resources are available to implement data sharing agreements.
As a research agenda for the Fylde Coast is developed, data assets provide the best opportunity to deliver research which is important to our community. Tin addition to UKRI, the NIHR also continues to invest within coastal communities such as Blackpool notably through the HDRC, ARC and CRN and this funding develops research capacity which can run these projects and deliver results. Importantly, we must continue to work with our VCFSE sector partners to showcase their vital projects that are delivered, and share resources developed so as not to duplicate work that has already been done. It is critical that we continue to work hand in hand to answer key research questions that will make a difference to the lives of people living in our community and make the best use of our data.
Research capacity building workshops (1c):
The workshops:
- enhanced the involvement of community in research projects.
- empowered participants to be able to better understand research findings and in turn improved their ability to carry out research that is in line with the needs of the community.
- enabled participants to better understand the economic aspects and the economic impacts of the resources and support provided to them and/ other service users in the community.
- increased awareness of types of health inequalities in the communities, potentially promoting advocacy for the improvement of health inequalities.
- provided a sound basis for acquiring informed knowledge to promote enhanced cultural capacity in research projects and enabled organisation to carry out evaluation evidence the impact of their work.
Knowledge Exchange Event (3b):
- The event was co-hosted with East Sussex County Council. The audience listened to stories from both sites, including learning from this project, about how we can mobilise community assets in coastal communities.
-The event was very well attended, and all stakeholder groups were represented from both East Sussex and the Fylde Coast.
- The table-based discussions during the event helped in exploring ideas and addressed power dynamics by providing everyone with an equal voice. Attendees used table cloths to record their thoughts during the event, and the agenda for next steps and further discussions were co-created.
-The event helped the translation of research to actionable strategies.
- The event also included presentations on the insights of community members who took part in the project, promoting inclusivity and a sense of ownership over the research findings and its impact.
- The event fostered the generation of new connections among attendees, potentially leading to future collaborations to address similar challenges faced by coastal communities (e.g., health inequalities).
- The recorded discussions from the event are currently thematically analysed and graphically illustrated. The final report will be circulated to all attendees to generate further collaborations on the identified action points.
Unexpected challenges:
The co-production group co-researchers highlighted that they perceived the co-production group activities to be too predefined by the investigator team. They felt that they were limited from shaping the activities the way they have seen them to be ideal, which impacted on their sense of ownership and perceived autonomy and risked their engagement during this project. Upon discussing this with co-researchers, addressing these issues became a focus for a period to ensure the co-production group sessions generated a collaborative atmosphere via an inclusive and participatory approach. It was important to us to promote an environment where participants feel confident to contribute meaningfully during each co-production session. Furthermore, one of our co-researchers had a hearing impairment and whilst funding was available to make the sessions as accessible as possible, time to find solutions, e.g., book interpreters, was very limited due to the short timeline of the project. Therefore, it was only in the later stages that we identified appropriate solutions – although this has still been hit-and-miss. Further projects must actively and regularly seek information on the needs of participants and potential solutions to meet those needs before the start of the co-production groups.
12.Enablers and barriers
Factors that supported the project and any positive outcomes:
- The project involved a large team of dedicated lived experience experts and professionals with diverse skills, which improved the project`s quality.
- The co-researchers recruited to the project were enthusiastic, and the activities were engaging, ensuring that the project had a continuous positive progression.
- The project had clearly defined aims and objectives, which helped counteracting the short timeline set out for completing the project parts, whilst improving the utilisation of available resources.
- Each part of the project, provision mapping, the co-production groups, research capacity building workshops and the knowledge exchange event as well as the investment of efforts from team members, proved to be invaluable resources in engaging community-based stakeholders and ensuring that the project has a long-lasting positive effect.
Factors that prevented the project from being more successful:
- The project’s aims were to address health inequalities on the Fylde Coast. Consequently, participants were recruited from underrepresented regions. It was difficult to recruit populations, who are in the most difficult health and social care situations, often marginalised, and excluded from research. Such individuals may not have access to digital devices, data packages, or they are not engaging with services where the project was advertised.
- Consequently, some co-production sessions had fewer co-researchers being present than expected.
- The project targeted a geographical area that is one of the most deprived local authorities in the UK. As a result, co-production group co-researchers were observed to express pessimistic opinions and feelings of resistance to change toward academic research with the focus of improving the lives of local communities.
-Short timeline for the project made meaningful engagement challenging.
-Ideas for the co-production groups were perceived as top-down, which made the development of ownership and engagement more challenging.
13.Key learning
Provision mapping and social network analysis
Most important lesson learnt: Response rates maybe low, therefore engaging with a high number of participants is important to acquire enough data to be able to conduct a project relevant analysis.
Key advice: Aim to gather quantitative and qualitative data to be able to utilise a holistic approach and consequently better understand the dynamics at play.
Co-production groups:
Co-researchers came from diverse backgrounds, each with unique lived experiences that can create barriers to engagement, such as:
• Unfamiliarity with research and methods
• Negative perceptions and/or experiences of traditional research
• Limited background knowledge
• Lack of confidence in expressing views or discussing ideas
They were not ready, nor expected to engage fully from the first session. The significance of taking time to build relationships and capacity within the group must be in the forefront of any future work. This is crucial, especially when co-researchers are expected to make collective decisions about group activities rather than simply participating. Achieving true shared power necessitates a shared understanding of the project and a comfortable environment for expressing views, challenging others, and being open to challenges. This deliberative democratic approach we adopted in co-research is a lengthy process, which would have required more time for ideas to be comprehended, discussed openly, and considered fairly, and to accommodate diverse learning styles. Our facilitators had to work very hard to counterbalance the short amount of time and prevent disengagement of the co-researchers.
We learnt that co-researchers would like to be less involved in some co-production processes that they deem to be more relevant to academic members (e.g., 2nd iteration of research questions refinement) and the need to be flexible in approaches and methods used in co-production research.
Key advice: Future research should ensure enough time is built into the project to build trusted relationships with communities and fully engage co-researchers in the design of the objectives, approaches, and methods. Academic researchers should be accessible and be an integral part of the co-production groups to break down barriers and distrust in the research process.
14.Next steps and sustainability
We are fortunate because our project originated from the Fylde Coast Research Collaborative, an initiative for partnership working in the area bringing together committed partners who aim to use impact-led research to improve the wellbeing of residents, which was established in December 2021. Our team comprises of academic and community partners from local authority, NHS, and VCFSE sectors. The Collaborative has been successful in bringing people together over the past two years and obtaining other investments directly contributing to its sustainability.
Tangible outcomes and outputs from this project will be taken back to the Collaborative and its key partners/members. For instance, the co-produced research agenda will be considered in the future research of the Collaborative and will inform future grant applications, the agenda will also be shared with key partners, such as the Health Determinant Research Collaboration and the Applied Research Collaboration North West Coast. The co-produced action plan will be shared with the Place-based partnership to aid cross-sector partnership working. Data generated through the mapping exercise and social network analysis will be shared with social prescriber link workers, and the ICB also expressed interest in using the mapping data in the future. The collage visualising the future @theGrange will inform future consultation with local residents about improvement work taking place at the hub. Co-researchers will be invited to join the collaborative.
Scalability to work across different coastal communities require funding, and we have been fortunate to receive further funding to extend the collaboration and work with other coastal communities, such as Weston-super-Mare. This will directly aid our sustainability and scalability and provide opportunities for strategic planning for integrating community assets to tackle health inequalities in coastal communities.
15.Further information
A blog advertising the project on ARC NWC (NIHR) website: https://arc-nwc.nihr.ac.uk/news/new-coastal-consortium-will-feature-arc-staff/
Research capacity building workshop recordings on BoingBoing`s website: https://www.boingboing.org.uk/community_research_workshops/
A blog on the Knowledge Exchange Event: Blackpool event shares the benefits of Mobilising Community Assets in Coastal Communities - NIHR
The collage created via creative methods during Co-production Group 1 (2a): https://sites.google.com/view/futureofatthegrange/home
Community solutions for health equity (CSfHE)- a project of the Fylde Coast Research Collaboration / Knowledge Exchange Event Report:
https://sites.google.com/view/csfheknowledgeexchangeevent/home
18th European Congress of Psychology Conference: “The Fylde Coast Research Consortium-mobilising coastal community assets to tackle health disparities” https://doi.org/10.1024/2673-8627/a000043
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