Helena Holmström Strehlenert

Research problem and specific questionsWorldwide, welfare societies strive to overcome fragmentation of services through increased integration. Despite this, evidence and support is lacking to guide local actors in social services and primary care on how to co-create integration with and for end users, such as older people. The aim is to, together with local actors and older people, develop and evaluate a research-based toolbox to integrate services for older people in need of both social services and primary care.What support do local actors need to co-create, test and monitor improvements of integrated services?What content, structure and design are needed in a toolbox to support local actors in co-creating, testing, and monitoring integrated services?What is the feasibility, perceived value, and impact of the toolbox?Data and methodThis participatory action research project comprises of three work packages (WP). In WP 1, we will use a participatory, longitudinal multiple case study design including four cases to explore actors’ need of support. In WP 2, we will use a Delphi-study design and participatory methods to develop the toolbox. In WP 3, we will use an observational case study design to evaluate feasibility, value, and impact. Data will be generated through structured and semi-structured observations, focus group and individual interviews, and surveys. Data will be analyzed with qualitative and quantitative methods.Societal relevance and utilisationA welfare society reform is launched in Sweden to integrate services and meet the needs of an aging population. However, the task of developing, implementing, and evaluating integrated services is a complex challenge that requires collaborative approaches, involving multiple stakeholders and end users. Yet, this task has been delegated primarily to local actors with limited decision-making mandates and possibilities to involve end users. The toolbox will support local actors with practical tools to co-create integrated services with and for older people.Plan for project realisationThe project will be conducted in collaboration between five Research and Development Units in Stockholm with partnering stakeholders in social services, primary care, and pensioner organizations. Costs for stakeholders’ involvement are included in the budget.

Research problem and questions: Older people are rarely involved in developing homecare services targeted to them, despite policies clearly stating the value of user involvement and person-centeredness. The overall aim is to generate scientific knowledge on the development of homecare services through co-creation and co-research. In partnership with stakeholders, i.e., significant others, staff at frontline, managerial, and policy levels, and especially older people, we address identified improvement areas throughout the care trajectory from “debut”, i.e., first-time use of homecare to end of life. Overarching research questions:How does the current scope of homecare correspond to stakeholders’ needs and competencies, and what priorities do stakeholders have in co-creating the development of homecare services?What models, tools and innovations are co-created with stakeholders to enable involvement of older people in homecare services´ delivery and development from debut to EoL?What changes on individual, organizational, and policy levels do stakeholders value when using co-created models, tools and innovations that facilitate older people’s involvement in homecare delivery and the development of homecare services, and what changes do they call for?What is the impact of co-creation and co-research on homecare practice and knowledge generation with respect to e.g., competence development, novelty, relevance, usability, and how can this impact be captured?Data and method: Multiple case participatory action research design with multiple methods. Data will be generated through verbal and non-verbal approaches, surveys, and registers, and analyzed with qualitative and quantitative methods.Societal relevance and utilization: The urgent need for innovation in developing homecare services arises from issues of aging populations, the growing and complex care needs among older people, their limited influence and involvement in homecare and a lack of (qualified) homecare staff. This program contributes to strengthening social services as a knowledge-based organization, and influence how old age is viewed and socially constructed.Plan for project realization: We draw on the collective multi-perspective expertise of our partnering stakeholders and researchers in the areas of homecare services, user involvement, participatory approaches. Costs for user involvement, collaboration and research competence building in eldercare are included in the budget.