Table 4.

Facilitators to co-production and achieving impact at each level

Level	Key elements, activities and mechanisms
Individual (micro)	• Regular interaction and communication between all parties • Keeping all parties on track and involved • Appreciative facilitation techniques • Trust, respect and openness • Being flexible and accommodating diversity of views • Reflexivity concerning one’s own values and social position, considering how to facilitate more equal relations with stakeholders who may hold less powerful positions
Group/interpersonal (micro)	• Defining roles and partnership infrastructure in large scale projects • In smaller ones, fluid and flexible relationships can work • Use of social media and information technology • Sustained supportive relationships • Regular meetings (face-to-face or web-based) • Facilitation and proactive management of potential power imbalances • Involving all parties in iterative cycles of data analysis • Flexibility to allow others to lead and suggest alternative routes • Ability to share knowledge, be open to others’ expertise and to admit gaps in one’s own • Core team members with boundary spanning and co-ordinating experience/roles
Organisational (meso)	• Scale, size and scope of project clearly defined and suited to the project question and team • Use of software to permit collaborative development of case study materials/outputs • Use of iterative dynamic and flexible processes that are responsive to contextual challenges and changing circumstances • Relevance and significance of the work to key stakeholders • Mechanism/integrated knowledge translation process or impact • Shared ownership, power and control of research study design, aims and outcomes • Involvement of experienced boundary spanners or individuals with dual clinical/academic roles
Societal (macro)	• Presenting information in engaging, accessible and creative forms, e.g. stories and film • Inclusion of authority figures/decision-makers • Use of more diverse, creative and/or accessible means of research dissemination
Paradigmatic (macro)	• Adherence to the principles and practice of co-production • Maintaining networks, brokering relationships and engaging with opportunities that arise from co-produced research • Wide and diverse dissemination of research outputs and methods • Advancing the practice, promotion and impact assessment of co-produced research