Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation

Abstract Background Co-creation has emerged as a crucial strategy for addressing complex public health challenges, including promotion and prevention of mental health concerns. While the evidence base for effective interventions continues to grow, significant gaps remain in their implementation and...

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Main Authors: Raquel Teixeira, Cláudia de Freitas, Liuska Sanna, Eleonora Prina, Giulia Turrini, Amber S. Brizar, Cătălin Gherdan, Evaldas Kazlauskas, Austėja Dumarkaitė, Henrik Wasmus, Leonie Fleck, Ulrich Reininghaus, Melanie Mack, Chiara Scarampi, Maritta Välimäki, Maija Satamo, Wietse A. Tol
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Health Research Policy and Systems
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Online Access:https://doi.org/10.1186/s12961-025-01349-1
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author Raquel Teixeira
Cláudia de Freitas
Liuska Sanna
Eleonora Prina
Giulia Turrini
Amber S. Brizar
Cătălin Gherdan
Evaldas Kazlauskas
Austėja Dumarkaitė
Henrik Wasmus
Leonie Fleck
Ulrich Reininghaus
Melanie Mack
Chiara Scarampi
Maritta Välimäki
Maija Satamo
Wietse A. Tol
author_facet Raquel Teixeira
Cláudia de Freitas
Liuska Sanna
Eleonora Prina
Giulia Turrini
Amber S. Brizar
Cătălin Gherdan
Evaldas Kazlauskas
Austėja Dumarkaitė
Henrik Wasmus
Leonie Fleck
Ulrich Reininghaus
Melanie Mack
Chiara Scarampi
Maritta Välimäki
Maija Satamo
Wietse A. Tol
author_sort Raquel Teixeira
collection DOAJ
description Abstract Background Co-creation has emerged as a crucial strategy for addressing complex public health challenges, including promotion and prevention of mental health concerns. While the evidence base for effective interventions continues to grow, significant gaps remain in their implementation and integration into real-world settings. Co-creation offers a valuable tool for strengthening mental health promotion strategies, ensuring that interventions are evidence-based, contextually relevant, culturally sensitive, sustainable and acceptable to those directly affected. However, there is a paucity of studies examining the evaluation of co-creation research, particularly regarding how participatory methods foster adaptation and influence outcomes and long-term sustainability. This protocol outlines a study designed to implement, evaluate and strengthen co-creation methodologies through a participatory and formative evaluation approach. Methods This study adopts a mixed-methods design within the ADVANCE project, a multi-country initiative focused on co-creating mental health promotion and prevention interventions with groups in vulnerable situations across seven European countries. End-users, healthcare professionals, and decision-makers will be engaged throughout the project in both intervention design and evaluation. Co-creation activities initiated with intervention scenario building and prioritization, drawing on desk reviews and online Delphi surveys co-developed with locally-set Society Advisory Groups (SAGs). The selection of intervention scenarios for implementation was performed using scenario-based workshops involving stakeholders in six partner countries. A second goal is to evaluate the co-creation process, which was co-designed in consultation with country teams and SAGs. A longitudinal qualitative study based on semistructured interviews with co-creators across two time points will be conducted, following the co-development of the interview guide through an online World Café. Discussion This study introduces an innovative approach by embedding participatory and formative evaluation into the co-creation process, enabling ongoing adaptation of co-creation activities. Through continuous stakeholder engagement, the project seeks to address barriers deriving from power imbalances, conflicting priorities, and resource limitations. Qualitative and participatory methods will be combined to elicit stakeholders’ views, identify drawbacks and promote adjustments to ensure meaningful collaboration and reduce participation fatigue. Expected outcomes include actionable recommendations to inform policy, reduce stigma and foster the co-creation of more inclusive, effective, sustainable and scalable mental health promotion and prevention strategies across Europe.
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spelling doaj-art-a29e33cbc24c48c8a6b0dfb54d414fed2025-08-20T03:45:39ZengBMCHealth Research Policy and Systems1478-45052025-07-0123111510.1186/s12961-025-01349-1Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluationRaquel Teixeira0Cláudia de Freitas1Liuska Sanna2Eleonora Prina3Giulia Turrini4Amber S. Brizar5Cătălin Gherdan6Evaldas Kazlauskas7Austėja Dumarkaitė8Henrik Wasmus9Leonie Fleck10Ulrich Reininghaus11Melanie Mack12Chiara Scarampi13Maritta Välimäki14Maija Satamo15Wietse A. Tol16EPIUnit ITR, Institute of Public Health of the University of Porto, University of PortoEPIUnit ITR, Institute of Public Health of the University of Porto, University of PortoMental Health EuropeWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of VeronaWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of VeronaDepartment of Experimental and Applied Psychology, Institute for Brain and Behavior Amsterdam, Vrije Universiteit AmsterdamDepartment of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit AmsterdamCenter for Psychotraumatology, Institute of Psychology, Vilnius UniversityCenter for Psychotraumatology, Institute of Psychology, Vilnius UniversityDepartment of Public Mental Health, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg UniversityDepartment of Public Mental Health, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg UniversityDepartment of Public Mental Health, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg UniversityCenter for the Interdisciplinary Study of Gerontology and Vulnerabilities (CIGEV), University of GenevaCenter for the Interdisciplinary Study of Gerontology and Vulnerabilities (CIGEV), University of GenevaSchool of Public Health and Helsinki University Hospital, University of HelsinkiSchool of Public Health and Helsinki University Hospital, University of HelsinkiDepartment of Public Health, University of CopenhagenAbstract Background Co-creation has emerged as a crucial strategy for addressing complex public health challenges, including promotion and prevention of mental health concerns. While the evidence base for effective interventions continues to grow, significant gaps remain in their implementation and integration into real-world settings. Co-creation offers a valuable tool for strengthening mental health promotion strategies, ensuring that interventions are evidence-based, contextually relevant, culturally sensitive, sustainable and acceptable to those directly affected. However, there is a paucity of studies examining the evaluation of co-creation research, particularly regarding how participatory methods foster adaptation and influence outcomes and long-term sustainability. This protocol outlines a study designed to implement, evaluate and strengthen co-creation methodologies through a participatory and formative evaluation approach. Methods This study adopts a mixed-methods design within the ADVANCE project, a multi-country initiative focused on co-creating mental health promotion and prevention interventions with groups in vulnerable situations across seven European countries. End-users, healthcare professionals, and decision-makers will be engaged throughout the project in both intervention design and evaluation. Co-creation activities initiated with intervention scenario building and prioritization, drawing on desk reviews and online Delphi surveys co-developed with locally-set Society Advisory Groups (SAGs). The selection of intervention scenarios for implementation was performed using scenario-based workshops involving stakeholders in six partner countries. A second goal is to evaluate the co-creation process, which was co-designed in consultation with country teams and SAGs. A longitudinal qualitative study based on semistructured interviews with co-creators across two time points will be conducted, following the co-development of the interview guide through an online World Café. Discussion This study introduces an innovative approach by embedding participatory and formative evaluation into the co-creation process, enabling ongoing adaptation of co-creation activities. Through continuous stakeholder engagement, the project seeks to address barriers deriving from power imbalances, conflicting priorities, and resource limitations. Qualitative and participatory methods will be combined to elicit stakeholders’ views, identify drawbacks and promote adjustments to ensure meaningful collaboration and reduce participation fatigue. Expected outcomes include actionable recommendations to inform policy, reduce stigma and foster the co-creation of more inclusive, effective, sustainable and scalable mental health promotion and prevention strategies across Europe.https://doi.org/10.1186/s12961-025-01349-1Mental healthPrimary preventionPublic healthCo-creationStakeholder participationEvaluation
spellingShingle Raquel Teixeira
Cláudia de Freitas
Liuska Sanna
Eleonora Prina
Giulia Turrini
Amber S. Brizar
Cătălin Gherdan
Evaldas Kazlauskas
Austėja Dumarkaitė
Henrik Wasmus
Leonie Fleck
Ulrich Reininghaus
Melanie Mack
Chiara Scarampi
Maritta Välimäki
Maija Satamo
Wietse A. Tol
Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
Health Research Policy and Systems
Mental health
Primary prevention
Public health
Co-creation
Stakeholder participation
Evaluation
title Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
title_full Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
title_fullStr Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
title_full_unstemmed Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
title_short Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation
title_sort co creating mental health promotion and prevention interventions with groups in vulnerable situations in europe a mixed methods study protocol for co creation implementation and participatory evaluation
topic Mental health
Primary prevention
Public health
Co-creation
Stakeholder participation
Evaluation
url https://doi.org/10.1186/s12961-025-01349-1
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