Abstract / Summary
Abstract Background Aligning co-creation principles with Implementation Science (IS) frameworks is increasingly recognized as important for building effective collaborations between researchers and stakeholders to implement meaningful and feasible healthcare innovations. However, there is limited understanding of how research teams apply these principles with IS frameworks while maintaining project timelines. This study examines the pre-implementation phase of the A-Disease Inclusive Pathway for Transitions in Care (ADAPT) study, focusing on how co-creation principles were integrated with two IS frameworks to support collaboration with primary care (PC) teams to improve post- discharge transitions. Methods Four PC teams and one network-based pharmacy discharge program participated in ADAPT. The Quality Implementation Framework and the Interactive Systems Framework guided pre-implementation activities. Co-creation principles - equity , reciprocity & mutuality , and relationships facilitated – were intentionally embedded to support collaboration. We conducted a qualitative analysis of multiple data sources, including a Practice Facilitator Diary, co-creation and quarterly meeting notes, and Individual Interviews with PC team members, to examine how these principles were applied in practice and assess their effectiveness in supporting collaboration and timely implementation progress. Results Integrating co-creation principles within IS-guided activities supported the development of shared understanding and locally relevant approaches to follow-up care. Actively incorporating diverse team perspectives ( equity ), integrating clinical knowledge and expertise ( reciprocity & mutuality ), and allocating dedicated time and space for engagement ( relationships facilitated ) enabled teams to co-design and implement follow-up practices. Several teams leveraged expanded team roles to enhance patient support through more coordinated, team-based care. Strategies that supported both collaboration and adherence to timelines included a working group charter, process mapping, structured and flexible check-ins, and ongoing facilitation support. Conclusion IS frameworks provided the structure to guide pre-implementation work, while deliberate integration of co-creation principles strengthened collaboration and enabled teams to align goals, knowledge, and workflows. This combined approach supported the development of feasible and contextually relevant practices and contributed to implementation progress within project timelines.