Co‐creation of services to maintain independence and optimise well‐being: Learnings from Australia’s Older Women Living Alone (OWLA) project

Abstract

For many populations at risk of social isolation, including Older Women Living Alone (OWLA), existing services to maintain independence and optimise well-being are difficult to access, unsuitable or unavailable. Co-creation is a strategy to develop 'person-centred' services that meet the needs of individuals. We adapted an existing framework for co-creation and used participatory action research methods, supported by an evidence base comprising a systematic review, analysis of routinely collected data and interviews, to develop person-centred services for OWLA. This approach achieved co-creation through an iterative process of consultation and review, involving a series of facilitated discussions with women living alone and stakeholders. A total of 13 women living alone, aged ≥55 years, and 11 stakeholders representing service providers and advocacy groups, were recruited to participate in these discussions. Sessions with between three and five OWLA, were held across Melbourne. The information was compiled and presented to service stakeholders in a single facilitated forum, held in central Melbourne. Smaller facilitated sessions with OWLA followed, to review and discuss the collated service stakeholder input. The information from these OWLA sessions were again compiled and directed back to the service stakeholders for consideration and further discussion. The two groups came together for a final forum to prioritise the co-created ten services that they believed would be feasible and would address unmet need to support OWLA maintain independence. The process of co-creation was time-consuming and required considerable preparation to facilitate input from the target population. Small groups, gathering at convenient local locations, with transport support were essential in removing barriers to participation. However, co-creation was a viable method of eliciting the women's preferences and developing services more likely to meet their needs.

Volunteer peer support frameworks supporting older women living alone

“…The key components of these existing frameworks were incorporated, which were: identifying gaps and support systems, gathering funds, engaging with local organisations and gaining participant trust. The key missing components centred around elements older women living by themselves identified in previous research as important: trust, safety and relationships (Ogrin et al, 2020 ).…”

“…A previous project had been undertaken with women living by themselves to identify the barriers and enablers of supports, to help women to maintain their independence, and to co‐design supports that would help them do this (Ogrin et al, 2020 ). That project highlighted the importance of social support for women living by themselves, particularly from within their local communities.…”

“…The key components of these existing frameworks were incorporated, which were: identifying gaps and support systems, gathering funds, engaging with local organisations and gaining participant trust. The key missing components centred around elements older women living by themselves identified in previous research as important: trust, safety and relationships(Ogrin et al, 2020).Our Volunteer Peer Support Framework combines elements from the existing Australian National Standards for Volunteering and the Peer for Progress framework(Boothroyd & Fisher, 2010) to form the backbone framework for our program. Our research highlights the need to focus and build on the interpersonal aspects of volunteer supports that was missing in previous frameworks.…”

Commentary: Strength-based co-design that EMPOWERs – Lessons from codesigning with older adults

“…In other cases, researchers may have difficulties gaining access to marginalised groups. For example, Ogrin et al (2020) highlight the limitation of their service co-creation study with older Australian women living alone: they were all English-speaking and highly educated. Although unintentional, these instances reproduce stigmas associated with marginalised groups, propagating lingering perceptions about those experiencing vulnerabilities.…”

Developing healthy weight maintenance through co-creation: a partnership with Black African migrant community in East Midlands

“…Co-creation is defined as an approach or strategy for developing 'person-centred' services that meet the needs of individuals and communities 1 . The collaborative process of producing new initiatives by involving both the service provider and the recipient relies on the knowledge that the successful development of the innovative services should meet the needs and satisfaction of communities, as well as depending on the perspective of the end-users 2 .…”