Moving together to facilitate equity and inclusion in research. The co-production of interventions for clinical trials to facilitate participation of people from ethnically diverse communities

Background: People from ethnically diverse backgrounds are underrepresented in clinical trials, reinforcing healthcare inequity. Co-production involves users of research (knowledge users) as partners in the research process. A premise of co-production is that it enhances ethicality of research by responding to the needs and preferences of those it is designed for while facilitating adoption and impact. Research reporting co-production in ethnically diverse communities is emerging; however, reporting of specific strategies to support effective co-production remains sparse, particularly when designing interventions for clinical trials. We draw on our experience of co-production with ethnically diverse communities to address this gap in the research literature using the exemplar, MOVE Together: Reduce falls, a co-produced intervention to support people aged over 65 years from ethnically diverse communities to develop exercise habits and reduce their risk of falls.

Methods: Utilizing an integrated knowledge translation (IKT) approach to co-production, our team of 24 partners, including people aged over 65 years from ethnically diverse communities, representatives from ethnically diverse community groups and service providers developed our intervention over five stages. Two stages engaged 75 participants including 63 (84%) people aged over 65 years from three ethnically diverse communities (Chinese, Italian and Arabic-speaking) and 12 service providers. The remaining three stages involved the co-production research team.

Results: Strong participant satisfaction (96%) and co-production team consensus regarding the readiness of our intervention for progression to clinical trial (100%) support the success of our approach. Strategies to optimize communication and uphold the principles of co-production were identified by our team as important to the process. Drawing on research evidence and our experience we highlight potential strategies to support alignment with the principles of co-production when co-producing with people from ethnically diverse communities. These include additional time and financial resources, tailored approaches to information provision and a culturally responsive approach.

Conclusions: When co-producing interventions for clinical trials with ethnically diverse communities, co-production teams must be prepared for the additional resources necessary to ensure genuine partnership. In this exemplar, we describe an iterative approach to health research co-production that may inform future health research involving under-served populations.