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. 2021 Mar 17;7:16. doi: 10.1186/s40900-021-00259-0

Table 1.

Well-documented shortcomings of public involvement and their possible negative effects in the health and social care field. In grey, the factors/outcomes revealed by the analysis of co-production processes

ANTECEDENT BARRIERS PROCESS BARRIERS NEGATIVE EFFECTS
Citizens Team (Citizens and Researchers/Providers) Citizens
Lack of competences [15, 20, 2225] Conflicts [22, 26] Damage to ethics obligations [27]
Lack of trust [26, 2830] Different culture [26, 28, 29]
Lack of training of citizens [21, 27, 3133] Different opinions and strong personalities [34] Damage relationship [35]
Lack of citizens’ motivation [24, 31] Lack of feedback exchange [34] Additional burden on citizens [1]
Lack of healthy and cognitive condition [1] Lack of attention to individual needs [21] Fatigue to participate [1]
Being frail/with severe illness [1] Tokenism [22] Citizens felt compelled and disempowered [22]
Lack (or perceived) of power [1, 22, 23, 28, 3436] Usage of technical language [22] Increasing inequalities [24]
Lack of citizens’ financial compensation [21, 37] Low citizens’ satisfaction toward results [24]
Citizens speaking different languages [25]
Low citizens’ awareness [24]
Researchers/Providers Researchers/Providers
Lack of skilled facilitator [35] Damage research careers [35]
Lack of motivation [1, 15, 31] Damage research credibility [35]
Lack of competences [35, 36] Damage relationship [35]
Perceived lack of citizens’ competences [1] Misrepresent findings [27]
Additional fatigue [38]
System System System
Lack of resources [1, 27] Misuse of resources [15] Overuse/underuse of resources [15]
Lack of time [25, 29, 37] Lack of transparency [21, 23, 34] Damage interpersonal relationship [27]
Lack of funding [34] Unreliable and unsatisfied results [24]
Complexity of the network [20] Additional costs & effort [24]
Initiatives’ project related [1, 26]
Lack of inclusion of marginalized citizens [35, 39]
Does not clarify expectations [1, 21, 36]
Does not clarify roles [1, 22]
Does not clarify purpose of involvement [22]
Mobility issues [20, 21, 28, 30, 35, 39]