Making co-production a reality: ExpertAge
In recent years there has been a strong emphasis on ‘service user involvement’ and co-production in research. There are many possible benefits: better quality research, innovation and broad dissemination channels to name a few. Having experience of co-production, through working with volunteer peer facilitators, I have experienced these benefits. In addition, the approach has helped me grow as a researcher and changed my approach to identifying questions and interpreting findings through the inclusion of older people in the research.
At Age NI we strive to put older people at the heart of everything we do, and as a result, we feel our approach to research should be no different. Different levels of co-production exist and we have found that involvement of older people, from conceptualisation to dissemination, is key in producing high quality, informed work.
This article outlines a model of co-production that we know works well for us (and of which we are very proud). We use this model to help shape and develop services and policy and it ensures the views of older people are heard. As a researcher I get a lot out of this approach, not least the opportunity to find out what really matters to older people. Our peer facilitators also get a lot out of this experience,
‘As a peer facilitator I had the privilege of people telling me about experiences that had sometimes been very difficult for them and may have had a negative impact on their confidence and self esteem. I had known some people I interviewed for a long time and others not at all, but I was given insight into their lives which I would not have otherwise have had. This was an enriching and humbling experience for me. (peer facilitator feedback)
Older people are experts by experience
We are all getting older. Individually of course, but also as a population.1 And I think we should celebrate this and all doors it opens to new opportunities in later life. An important part of this is that people are given the opportunity to age well and enjoy later life. Older people face a range of barriers which can impact on ageing well including access to quality health and social care, access to information about the help they are entitled to, ageist attitudes and discrimination. It is these areas we most want to understand through our research. More recently we have been working to understand what makes a ‘good life’ for older people and how they understand the term ‘frailty’. Older people are their own experts, with lived experiences of what works and what does not and, as all researchers know, experts are the best place to start.
The older people involved in developing our research are enthusiastic and dedicated volunteers. Their passion and insight helps us ensure our research is accurate and reflective of older people in Northern Ireland.
Co-production takes place through our ExpertAge team; a group of peer facilitators, supported by an Engagement Manager, who support our research in various ways. Those involved receive bespoke training around facilitation and data collection. The model is based on the understanding that people are more comfortable talking to peers than to professionals,
‘Many of us have a tendency to feel less judged or dismissed by people to whom we feel similar, or perhaps be better understood.’ (Feedback from peer facilitation)
Peer facilitators provide feedback on research approaches in terms of understanding and relevance. This helps us ensure we are getting to the core of the issue and doing it in a way that is accessible for older people. They provide insight into developing research within an ethical framework – for example, will asking this question cause distress, and if so, is it necessary or what would mitigate distress? They help us recruit participants, ensuring older people from a range of backgrounds are included, especially those who might belong to lesser heard groups; those who are isolated for example.
One of the most valuable aspects of peer facilitator involvement is their role in data collection. They support older people to complete questionnaires, and carry out one-to-one interviews. These peer to peer conversations allow for a more in-depth exploration of the areas being addressed, and our peer facilitators are able to take the time to spend with people, to do this at their own pace,
‘the interview was quite long, so we stopped for tea and cake in the middle, to give the person a rest’ (peer facilitator feedback)
We know that older people want to be heard, and that being listened to is an essential part of feeling involved and valued. Using co-production and supporting co-researchers, allows us to do this in a meaningful way.
Finally, our peer facilitators support dissemination of results. They provide feedback from their perspective about the data collection, they provide input into preliminary discussions around results and they participate as co-presenters in events to launch findings. Marian, a peer facilitator, co-wrote this post with me.
For me, co-production starts before the project and continues on afterwards. Co-researchers are part of the research team and the project benefits from their inclusion. As a researcher I should support them, ensure they receive adequate training, brief and debrief them and build relationships. This all takes time, but in seeing the quality of the work delivered, I know it is worth it. And it isn’t just my view; over the last year we have worked with a local council and Public Health Agency using this model. To end, I would encourage others to adopt such an approach and put those impacted by research at its heart.
2 For an example of work the peer facilitators have been involved in see here
About Annie, Marian and Age NI:
Annie has a psychology background, graduating from her PhD at Queen’s University, Belfast in 2017. She currently works in the voluntary sector in Northern Ireland as Impact and Evaluation Manager at Age NI. Her research interests are in wellbeing, understanding the needs of older people and service evaluation. She is an advocate of co-production and includes older people in the development of her current work.
Marian Cinnamond: Marian is an Age NI peer facilitator and has been involved in several projects, supporting older people in Northern Ireland to share their views.
Age NI’s vision is a world where everyone can love later life. We provide a range of services to help support older people across Northern Ireland; Advice and Advocacy service provides support and information for older people; Wellbeing Services seek to improve the lives of older people, empowering them to live the lives they want and our Care Services provide care for those who need it. Our policy and influencing activities ensure that policy decisions made today support more older people in Northern Ireland to love later life. We also support sub regional older people’s networks and offer a wide range of volunteer roles. To find out more about Age NI you can see our website: http://www.ageuk.org.uk/northern-ireland