Written by Anjuli Clare
“Cake is medicinal” I’ve often jokingly said, in moments when it felt like a justification for enjoying it was needed. Joking aside, there’s always an element of truth in these comments — cake can demonstrate manaakitanga (showing respect and generosity for others), care, support and solidarity. When accompanying conversations and interactions, cake can help develop social connectedness, and build relationships, especially when a cuppa is included. This can also make it easier to have vulnerable conversations, such as ones about our health experiences. It’s no wonder then that a ‘Cuppa & Cake’ underpins the methods used in my research as part of The Co-production Project.
What is Co-Production?
Embedded in The Co-production Project, my PhD explores the use of participatory public engagement, specifically co-production, through a case study of women’s health in an Aotearoa New Zealand context. There are many definitions for ‘co-production’ and sometimes it has been used interchangeably with co-creation and co-design (even though they are all different) adding to the confusion. Broadly speaking, co-production means an approach to research in which communities, organisations or groups who are meant to benefit from — or who otherwise will be affected by — the research become partners in formulating, designing, carrying out, analysing, and reporting the research (Willyard et al., 2018). In essence the research is contributed to by the participants — they become co-researchers in the project. Co-production has four foundational principles; to build capability, to prioritise relationships, to share power and use participatory methods (McKercher, 2020). Co-production also values plurality of knowledge, in particular elevating lived experience.
While co-production is used in many disciplines, such as sustainability studies, geography, psychology, it is particularly appropriate in the health space. Whether it is designing services or products, or creating knowledge, balancing out power asymmetries between health professionals and lived experience experts is beneficial for most project aims.
When thinking about how to embed the co-production principles, a lot of the methods, tools and actions came down to care. For The Co-production Project having an ethics of care sits at the core of the project (Muller & Brown, 2024). These moments of care can often be invisible, or at least not outrightly mentioned in project reports, and are frequently taken for granted. We hope this project will elevate these moments of care by making them explicit. Care tasks also tend to be left to women — an example of the unequal division of unpaid labour seen in academia (Järvinen & Mik-Meyer, 2024).
Acts of Care — some examples
Our engagement with women through conversation about women’s health, used the method of ‘Cuppa & Cake’, alongside a kitchen table’ approach. The intent was to create an atmosphere that was warm, safe and comfortable — similar to sitting round a kitchen table with other women having a chat. While the venues we used weren’t actual kitchens this intent was what we held in mind when choosing venues, and making decisions about hospitality and resources. This even included posting out ‘Cuppa & Cake Packs’ for our online conversations (yes, these packs did have cake in them!).
One of these acts of care included taking the time to email each participant (there are 85 of them) individually to get their input into a specific part of the project. We noticed early on that the project newsletter was great for keeping people connected to the project, but it didn’t elicit much direct correspondence. We received limited interaction to specific requests, and group emails had a similar low uptake. While it would have been easier, and quicker, to continue with the group emails this wouldn’t have been in keeping with our co-production principles.
A critique of co-production is that due to its varied definitions and good intentions, it can easily become a tokenistic process (Mark & Hagen, 2020). If we genuinely want to change the way research is done, to shift power asymmetries and value different forms of knowledge, we need to be committed to using methods and tools that allow for this — even when, or especially when, they are time and resource heavy.
Continuing with Care
As part of our case study we co-created with our participants a library of research questions about women’s health that are a priority for women. Through a facilitated process we developed 100 possible research questions, which have since been consolidated and refined with the continued input of the contributors to our project. Future plans for this library are still being clarified but are likely to involve inviting others to use them and finding ways to initiate other collaborations and interdisciplinary research projects building off them. Taking ‘care’ of these questions is a privilege and a responsibility, and we are determined to ensure they contribute to future research endeavours, rather than getting left unattended.
There is a lack of research, especially lived experience research, into most women’s health related areas, and in general 85% of health research is wasted (due to poor design, incomplete studies and non-reporting) (Slattery et al., 2020). Co-production as a methodology was well suited to an exploration of women’s health. It gave the women involved a chance to be heard, their experiences valued and to be involved in the process of developing potential research questions. Co-production is also well suited to many other topic areas and is a useful method to employ in trans- or inter-disciplinary research.
Acts of care are integral to research, especially participatory approaches, and by making them more visible we can apply them to other projects more easily. I recommend you get yourself a cuppa and some cake, and pause for a moment to consider all the acts of care that often go unmentioned in your research.
About the Author
Anjuli Clare is currently a PhD student at the College of Creative Arts, Te Kunenga ki Pūrehuroa Massey University of New Zealand. Her PhD is exploring co-production and participatory public engagement through a case study of women’s health in Aotearoa New Zealand. Previously, Anjuli worked in the not-for-profit sector, where she managed the charity Good Bitches Baking. She completed her BA(Hons) in Psychology in 2019, with her research focusing on people’s experiences of social connectedness through volunteering.
References
Järvinen, M., & Mik-Meyer, N. (2024). Giving and receiving: Gendered service work in academia. Current Sociology, 00113921231224754. https://doi.org/10.1177/00113921231224754
Mark, S., & Hagen, P. (2020). Co-design in Aotearoa New Zealand: A snapshot of the literature, Auckland Co-Design Lab, Auckland Council. 38.
McKercher, K. (2020). Beyond Sticky Notes: Doing Co-design for Real book.
Muller, A., & Brown, A. (2024). Head and heart—An ethical tightrope. DRS Biennial Conference Series. https://dl.designresearchsociety.org/drs-conference-papers/drs2024/researchpapers/172
Slattery, P., Saeri, A. K., & Bragge, P. (2020). Research co-design in health: A rapid overview of reviews. Health Research Policy and Systems, 18(1), 17. https://doi.org/10.1186/s12961-020-0528-9
Willyard, C., Scudellari, M., & Nordling, L. (2018). How three research groups are tearing down the ivory tower. Nature, 562(7725), 24–28. https://doi.org/10.1038/d41586-018-06858-4