{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:01:43Z","timestamp":1777723303236,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009776","name":"McMaster University","doi-asserted-by":"publisher","award":["SAF2019"],"award-info":[{"award-number":["SAF2019"]}],"id":[{"id":"10.13039\/100009776","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Co\u2010creation processes are part of a movement to create change in collaboration with people with lived and living experience (PWLLE); in this paper we focus on experience with health and social services. Research co\u2010creation with PWLLE is increasing, however, processes tend to include people who are well connected in health and research environments, often excluding equity\u2010deserving groups (EDGs) who experience barriers to engagement in research and society more broadly (e.g., people with mental health conditions, immigrants, refugees, people who are unhoused).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an evaluation to understand how equity\u2010based co\u2010creation (EqCC) is enacted in health and social services and what outcomes are produced. Informed by realist evaluation methods, we used multiple case study methodology to explore and describe how co\u2010creation was enacted in four sites that were actively conducting EqCC projects. The case study sites were engaging in projects on student mental health and well\u2010being; youth mental health transitions; individuals in critical care; and women experiencing complex long\u2010lasting homelessness. A variety of data sources were collected including interviews with 2\u20103 key members of each project, organisational documents (e.g., meeting minutes, ethics approvals, reports), and observations. Data analysis included identifying the contexts, mechanisms, and outcomes, and causal configurations to develop a deductive coding scheme and codebook.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The causal configurations were found to be consistent with the data collected at the four sites: (1) Values (the culture and values that enable co\u2010creation); (2) Driving Issue (a community\u2010identified problem as the catalyst for the co\u2010creation to occur); (3) Organisational Infrastructure (the organisation's tangible infrastructure to support long\u2010term co\u2010creation, including funding, time, and training among others); and (4) Experiential Knowledge Network (people involved in the co\u2010creation, including the networks and partnerships created prior to, during, and as a result of the co\u2010creation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The causal configurations explored in this evaluation identify the key contexts, mechanisms and outcomes that support co\u2010creation with people from EDGs. These may inform inclusive co\u2010creation project design and the development of a middle range theory of equity\u2010based co\u2010creation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This research was co\u2010designed and co\u2010produced by researchers and PWLLE who were members of the McMaster University Co\u2010Design Hub at the time of the project. The research questions guiding this work were informed through ongoing conversations with members of different communities affiliated with the McMaster University Co\u2010Design Hub. Co\u2010author LML identifies as a PWLLE and was instrumental in developing the research question, writing and discussing the causal configurations, and contextualising findings. We shared project updates at numerous team meetings (which included researchers and PWLLE) over the course of the research. Insights and feedback were sought at these meetings which helped to contextualise the work and understand the topic from multiple lenses, including PWLLE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70647","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T14:31:31Z","timestamp":1774708291000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Is Equity\u2010Based Co\u2010Creation Enacted in Health and Social Services? An Evaluation of Four Case Studies"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1357-1158","authenticated-orcid":false,"given":"Samantha K.","family":"Micsinszki","sequence":"first","affiliation":[{"name":"McMaster University Hamilton Canada"},{"name":"CanChild Centre for Childhood Disability Research Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Mulvale","sequence":"additional","affiliation":[{"name":"McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Moll","sequence":"additional","affiliation":[{"name":"McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Bruce","sequence":"additional","affiliation":[{"name":"McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Murray\u2010Leung","sequence":"additional","affiliation":[{"name":"McMaster University Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Phoenix","sequence":"additional","affiliation":[{"name":"McMaster University Hamilton Canada"},{"name":"CanChild Centre for Childhood Disability Research Hamilton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmqr.2023.100342"},{"key":"e_1_2_13_3_1","unstructured":"F.BuchananPatients\u2019 equal status in health care: \u201cSeparate\u201d isn't the same as \u201cequal.\u201d Healthy Debate. 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