Engaging Equity-Deserving Populations in Co-Creation

Abstract

Background: Refugee families in Canada experience significant mental health challenges and face heightened barriers to accessing mental healthcare services, yet their voices remain underrepresented in the design of those services. A co-creation approach offers a way to meaningfully engage those equity-deserving populations by centering their experiences and perspectives. However, limited research has specifically examined how to engage refugee families in co-creation processes. This study aimed to review the literature on engaging equity-deserving groups in co-creation and to develop a tailored engagement strategy as part of the Thriving Together co-design project. Methods: A two-phase approach was used. Phase one involved a structured narrative review guided by Arksey and O'Malley's framework. Three databases (PubMed, Web of Science, and Scopus) were searched, along with grey literature and citation searches. A total of 45 studies were included in the review, and findings were charted across definitions, guiding principles, theoretical frameworks, phases of co-creation, engagement methods, barriers, and enablers. Phase two synthesized these findings with field insights from the Thriving Together project to inform a context-specific engagement strategy. Results: The included studies, primarily from high-income countries, focused on equity-deserving populations and revealed inconsistent terminology but recurring emphasis on key engagement principles, such as trust, power-sharing, and flexibility. Common phases of co-creation included preparation, discovery, ideation, and implementation, with frequent use of creative methods like storytelling and visual tools. Reported barriers included power imbalances and logistical challenges. These findings and the practical insights informed the engagement strategy, which is conceptualized as a journey, guided by principles, structured around clear phases, supported by practical tools, and designed to proactively address barriers and promote meaningful participation. Conclusion: More research is needed to advance co-creation with refugee populations. Achieving equitable and impactful engagement relies on operationalizing guiding values such as reflexivity, adaptability, and authentic partnership with the communities involved.