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Co- Production and Participatory Evaluation in combination - Is this approach more than the sum of it's parts?


Kate Dharmarajah

London North West University Hospitals Nhs Trust, GB
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In the UK one in five children are overweight or obese by the time they start primary school. Following a national measurement program at school entry, letters with height and weight are sent home to all parents. Parents on a deprived local housing estate considered these ‘fat letters’ unhelpful and lacking information to help them make change.  We therefore worked with parents to assess the feasibility and acceptability of a local multi-level intervention to support behaviour change associated with childhood obesity.

Participatory research is a useful method for investigating health promotion and health inequity and for raising research quality. Co-production of health services is becoming more routine, but equity in involvement of citizens (even less children and young people) in research is lagging behind.  Our aim was to involve children as researchers in developing and evaluating this intervention.


Connecting Care for Children (an integrated care collaborative) supported volunteers to co-design and deliver a health and well-being intervention called the Parkview Olympics in the locality. The model was a 6- week ‘sprint’ of physical activity and healthy living sessions and was assets based drawing from existing community resources to aid sustainability. 2 young evaluators were identified and helped design, conduct and analyse a peer-led evaluation with repeat follow-up at 2 years. We used mixed methods with qualitative and quantitative assessment.


26 children were involved over a 6 week period, with a diverse range of activities, with 7 followed to 2 years. Participants recorded self-reported Physical activity, Nutrition and Self Esteem Scores using validated tools.

Following training our young evaluators designed and delivered focus groups and also aided with thematic analysis of the results.

In the 2 year follow up analysis, retention of the following themes were identified; the value of healthy eating, retained skills to cook healthy meals, on-going participation in activities, self-reported increased motivation to stay active, on-going friendships and sense of community.

We observed the value of the peer evaluation.  Young people aged 12 and older universally felt they could communicate their views better in a focus group led by a local young person with established trust and agency.

Discussion and Conclusion

The use of a local, citizen-driven solution allowed penetrance through some of the established barriers within hard to reach communities .In addition the role of a young evaluator allowed us to gain more meaningful results and overcome further barriers. 

Lessons learned

We have demonstrated the desirability and acceptability of participatory research with children and young people. This intervention also reinforces that small, community–designed and delivered initiatives have the power to effect change sustained at 2 years.


Our pilot is small,and due to it's size and scale a control group was not possible so a before and after approach was adopted.

Suggestions for future research

We believe the combination of the approaches of co-production and participatory evaluation is more than the sum of its parts and further exploration of these should be performed. Young people have much to offer the field of research.

How to Cite: Dharmarajah K. Co- Production and Participatory Evaluation in combination - Is this approach more than the sum of it's parts?. International Journal of Integrated Care. 2021;21(S1):22. DOI:
Published on 01 Sep 2021.


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