Co-Design With Mothers and Professionals to Enhance Care for Mothers Experiencing Adversity: Development of the METIC Model

Introduction: Co-design is increasingly used to partner with key stakeholders to facilitate user-driven improvements to health and social care services. Successful co-design relies upon stakeholder partnerships that promote empowerment and value diverse perspectives—which can be challenging when stakeholders are from diverse or marginalised backgrounds. Within this context, our research aimed to co-design a research and translation action plan to enhance non-stigmatising care for mothers experiencing adversities during pregnancy or their children's early years. 

Methods: Theoretical frameworks (social constructionism, knowledge translation and experience based co-design) and local guidelines (ethical and consumer participation) informed successful co-design with stakeholder groups with power differentials and experiences of marginalisation. We developed the novel MEdiated Trauma-Informed Co-design (METIC) model remain sensitive to power differentials and experiences of trauma by embedding trauma-informed approaches. 

Results: We engaged two stakeholder groups (professionals and service users) to promote equity and enable safe spaces for discussions using the METIC approach. The METIC approach includes five steps: (1) building relationships and triangulating evidence, (2) recruitment and data collection, (3) data analysis and feedback, (4) sharing outcomes and (5) ongoing engagement. Key learnings included the importance of taking time to build trusting relationships and using communication strategies tailored to diverse audiences, such as easy-read visual summaries. 

Conclusions: Success was demonstrated through the co-design of an accessible research and translation action plan, which received overwhelmingly positive participant feedback. Key methodological challenges for future consideration include how researchers should respond to broader and systemic factors that impact equitable engagement in co-design. 

Patient or Public Contribution: Members of the public contributed to the conceptualisation of this research as described in detail within the manuscript. 

Trial Registration: Not applicable.