The failure of governments and other agencies to implement true co-design into evaluations is undermining the integrity of research, evaluation and program delivery for Aboriginal and Torres Strait Islander people, according to important new research.
The “bastardisation” of co-design continues a long history of exploitative, often harmful research on Indigenous communities and people, and concerted action is required to ensure co-design frameworks and their implementation adhere to Aboriginal and Torres Strait Islander epistemologies and viewpoints, it found.
This is the second in a series of sponsored content articles published as part of research translation activities under a National Health and Medical Research Council funded project (GNT1165913), Indigenous engagement and leadership in the evaluation of Indigenous health and wellbeing programs: Taking steps to improve government and non-government commissioning practices.
Croakey Professional Services writes:
Governments and other agencies must transform their approaches to co-design when working with Aboriginal and Torres Strait Islander people including through sharing power and control, and agreeing what co-design is, new research suggests.
Otherwise, they will undermine trust and program delivery, and potentially cause further harm to Indigenous health, says the study.
The research, published recently in the Public Health Research & Practice journal, found that co-design terminology in Aboriginal and Torres Strait Islander research evaluation is often overused or misused to the point of making it “a meaningless buzzword”.
One non-Indigenous participant in the research observed that many of the co-design processes currently in use across Aboriginal and Torres Strait Islander health program evaluation is about doing design ‘to’ communities, not ‘with’.
“They are still coming with an already, non-Aboriginal worldview, and a non-Aboriginal way of reaching consensus,” the participant said of commissioning agencies.
The paper, titled ‘Tokenistic co-design: participation without power in Indigenous health evaluations’, is part of a wider project, funded by the National Health and Medical Research Council, which is looking at Indigenous engagement and leadership in the evaluation of Indigenous health and wellbeing programs.
It examines the “perceived use” of co-design in the commissioning of Indigenous health and wellbeing program evaluations in Australia and highlights “the deep disconnect” between perceptions of co-design and its actual use.
Lead researcher, Associate Professor Summer May Finlay, a Yorta Yorta woman and public health expert at the University of Wollongong, said co-design is generally understood as a research, policy and program methodology underpinned by principles of power-sharing, collaboration, and the active engagement of research participants.
“It’s generally envisioned as a democratising process, whereby those directly impacted by research and policy decisions are deeply involved in the process of making those decisions,” Finlay told Croakey Professional Services.
That has made it especially important for Aboriginal and Torres Strait Islander policy development, particularly in health settings, in response to decades of “exploitative and often harmful research” performed on Indigenous communities and people, she said.
More broadly, co-design has also become a prolific and lauded research and policy approach, touted as best practice by government departments, non-governmental organisations, and academic researchers, she said.
Lack of strong definition
The study involved analysis of qualitative interview data gathered from 35 Indigenous and non-Indigenous participants who were experienced commissioners, evaluators, and service providers.
It found, from those interviews, that various stakeholders, particularly government departments which exercise power and control through the allocation of funding, understand or apply co-design in ways that are “nebulous and mystifying enough to minimise critique of its misuse”.
Participants reported that genuine co-design practices are “generally at odds with current government policies around evaluation commissioning, particularly in relation to power-sharing and governance, and expected timelines”.
The study said such a disconnect has “a detrimental effect on the utility of program evaluations, the implementation of Indigenous ethical and research frameworks in a genuine way and risks co-design becoming relegated to a meaningless buzzword”.
A tool for harm
Critically, initiatives branded as co-design “often fail at the first hurdle due to them not organically arising from a need within a community”.
The researchers found there was clear underlying mistrust resulting from the misuse of co-design, and the impact that can have on the efficacy of evaluations.
This goes beyond a missed opportunity, they said, warning that poor co-design “has itself become another potential tool for poorly planned and harmful research and policy work”.
“If commissioners label evaluations as co-design, the evaluations themselves must adhere to the basic tenets of what Aboriginal and Torres Strait Islander people consider co-design, through sharing power and ensuring Aboriginal and Torres Strait Islander people are engaged at all stages of the commissioning process,” they concluded.
The researchers said further research is required to refine co-design frameworks, ensuring adherence to Aboriginal and Torres Strait Islander epistemologies and viewpoints.
“Without these more stringent guidelines, the bastardisation of co-design has the potential to minimise the utility of health and wellbeing evaluations, eroding trust within communities and effecting harm,” they wrote.
Four main themes
The researchers said four main themes around co-design emerged from the research.
1. Conflicting philosophies and definitions of co-design
Overwhelmingly, participants in the research viewed current co-design practices as not genuine, not faithful to its principles, and sitting “uncomfortably” against longstanding commissioning philosophies, processes, and practice, particularly within government departments, which are used to determining processes and outcomes.
As one Indigenous evaluator said: “If you’re taking something to people, that’s not co-design…the government’s commissioned the work, they’ve said what are the aims and objectives…there’s no co-design happening there right from the outset.”
Other stakeholders talked about public servants feeling “thrown” by attempts to incorporate co-design practices. They said the use of co-design was largely dependent on who in government is leading the commissioning, with government branches outside of Indigenous health less likely to employ collaborative approaches.
Stakeholders described a conflict of basic epistemologies and underpinning philosophies between those employing the term co-design, and those on the receiving end.
“The government have got…different accountabilities, back to the Ministries and back to [the] taxpayer eventually,” one non-Indigenous service provider said.
“Whereas the communities have got accountabilities…to the community board, and the people…you’ve got two different…groups, and different drivers, and different policies.”
“A lot of this stuff is about worldviews and philosophies,” the participant said. “…if you’re designing a co-design process, you’re probably designing it from that worldview and that philosophy.”
2. Imbalances in power and control
The researchers said lack of power-sharing and community control emerged as a crucial issue preventing authentic co-design.
This was particularly acute when the commissioning body is a government entity, where longstanding processes and policies complicate the incorporation of co-design principles, they said.
Participants raised questions about whether something can be described as co-design “if it is being brought to, or imposed, upon a community”.
One Indigenous evaluator talked about how communities wanted a “blank piece of paper” when they began co-designing, but too often were met already with blueprint and/or framework that had already been determined.
“Co-design is also not about having an agenda at the beginning and then asking Aboriginal people, organisations and communities what they define as success,” another said.
3. Variable evaluator and commissioner skill
A lack of skill and understanding of co-design methodologies and cultural capabilities among commissioners and evaluator was another barrier to authentic co-design highlighted in the research. This was particularly evident in those working outside Aboriginal and Torres Strait Islander specific departments or branches.
One Indigenous evaluator warned that inexperienced evaluators may cause “downstream failures” if their co-design work is poorly undertaken – impacting both the efficacy of the evaluation and the potential utility to communities.
“I don’t think we’re talking about bad people,” he said. “I think what we’re talking about is a lack of knowledge, experience and grounding that will be able to make that evaluation accurate and useful and effective for us.”
Another said it doesn’t matter how much co-design or collaboration there is: “It still has to be balanced out with the skill levels of evaluators.”
4. Time and timing
The research also highlighted a lack of understanding of the time-consuming nature of co-design, “resulting in inadequate resourcing”, which could affect the whole process and outcome.
One non-Indigenous evaluator commented that co-design needed “a minimum of six months before you collect a scrap of data”.
An Indigenous evaluator agreed: “You can’t come in then and say, ‘well we’ve only got a year, and the co-design process is going to take us six months, so we can’t do that, but we’ll give you three meetings, and we’ll call that co-design and community-developed’.”
The researchers also heard that co-design requirements were introduced at inconsistent or inappropriate moments across the commissioning process, such as being tacked on to the end of evaluations, rather than embedded in evaluation frameworks from the beginning.
Study details
The research was undertaken by Finlay with other senior Indigenous investigators: Professor Bronwyn Fredericks, University of Queensland; Dr Amohia Boulton, Whakauae Research Services in Aotearoa; Professor Yvette Roe, Charles Darwin University; and Janaya Pender from Lowitja Institute.
Their non-Indigenous colleagues included: Professor Jenni Judd, Central Queensland University; Professor Margaret Cargo, Flinders University; and Professor James A. Smith, Flinders University; working with University of Wollongong researchers Dr Helen Simpson, Sophie Kerrigan and Dr Anna Temby, and, from Flinders University, Dr Melissa Opozda.
Further Indigenous oversight was provided by a Project Advisory Group, chaired by Professor Tom Calma, a Kungarakan Elder and member of the Iwaidja tribal group.
The researchers applied Indigenous Standpoint Theory as the theoretical lens in the collection, analysis, and interpretation of the data, “ensuring Indigenous leadership across all stages of the project”.
• This article was written by Marie McInerney for Croakey Professional Services with editing by Associate Professor Summer May Finlay and Dr Melissa Sweet. Bookmark this link to follow the #CommissioningIndigenousEvaluations series.
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