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Exploring the frontiers of research co-production: the Integrated Knowledge Translation Research Network concept papers


Research co-production is about doing research with those who use it. This approach to research has been receiving increasing attention from research funders, academic institutions, researchers and even the public as a means of optimising the relevance, usefulness, usability and use of research findings, which together, the argument goes, produces greater and more timely impact. The papers in this cross BMC journal collection raise issues about research co-production that, to date, have not been fully considered and suggest areas for future research for advancing the science and practice of research co-production. These papers address some gaps in the literature, make connections between subfields and provide varied perspectives from researchers and knowledge users.

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Research co-production, sometimes referred to by such terms as participatory research, engaged scholarship, Mode 2 of knowledge production, collaborative research or integrated knowledge translation (IKT), is about conducting research with those who use it. Research co-production is a model of collaborative research, where researchers work in partnership with knowledge users (comprising patients and caregivers, clinicians, policy-makers, health system leaders and others) who identify a problem and have the authority or ability to implement the research recommendations [1]. As noted by Gagliardi et al. [2], IKT appears to increase researcher understanding of the research user context and needs, thereby enhancing the relevance of the generated research, and at the same time increase knowledge-user understanding of the research process, awareness of the research, and appreciation for how and when it can be applied.

Research co-production is promoted by funders and interested parties as a means of achieving research impact. The expectation is that the collaboration of researchers and knowledge users generates research that is particularly relevant, useful, useable and used. Research co-production is an appealing approach to addressing the ethical imperative of rapidly increasing the use of known effective healthcare innovations and decreasing over-use of ineffective ones. For others, it is about the democratisation of science and the right of citizens, who are taxed to pay for research, to participate in and influence the entire research process, not to just be considered for their role as passive research participants or subjects [3]. Other motivations are the desire to improve the quality of research which is believed to happen with inclusion of knowledge users by increasing researcher understanding of the issue, solutions and context, and partnering with knowledge users for political or strategic reasons [4].

Research co-production is not a new concept. It could be argued that participatory research, as espoused first by Kurt Lewin in the 1940s [5, 6] and then by Paulo Freire in the 1970s [7], was one of the first research traditions to focus on co-production. In Canada, while representing a very small proportion of national health research funding, the concept has been officially part of the health research ecosystem since the late 1990s, when funding programmes requiring inclusion of knowledge users as co-applicants were first launched [8]. Research co-production in health has been globally gaining interest. The funding of health research co-production is now taking place around the world. For example, in the United States, the Veteran Administration Quality Enhancement Research Initiative (QUERI) [9] and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) [10] encourage stakeholder engagement in research and the Patient-Centered Outcomes Research Institute [11] only funds research co-produced with patients and other stakeholders. The Australian Academic Health Centres [12,13,14], Dutch Academic Collaborative Centres [15], United Kingdom Academic Health Science Centres [16], United Kingdom Collaborations for Leadership in Applied Health Research and Care (CLAHRC), now known as Applied Health Centres [17, 18], all promote greater knowledge user participation in research and are premised on the theory that partnerships between universities/researchers and healthcare entities will increase the relevance and impact of health research. More evidence of the recognition accorded to research co-production is the emergence of what is being called ‘engagement science’, a field that investigates the methods for, and practice of, engagement, the development of evidence-based approaches or guiding frameworks for engagement, and the application of these resources to guide meaningful engagement of non-traditional stakeholders in research [19]. A recent series of papers on research co-production in the prestigious journal Nature further signals the growing attention this approach is receiving within the research community [20].

In 2015, the Canadian Institutes of Health Research approved funding for a 7-year foundation grant to contribute to building the science base for health research co-production or IKT, as it is referred to in Canada. This programme of research, known as the Integrated Knowledge Translation Research Network (IKTRN), comprises more than 30 knowledge-user experts (e.g. health research funders, health charities, regional health authorities and other organisations), over 40 IKT experts, a dozen knowledge translation/implementation science experts, and over 25 trainees from nearly 50 organisations in six countries (Canada, United States of America, England and Scotland, South Africa, Australia, Ireland) [21]. Kothari et al.’s definition of IKT (or research co-production) is, “a model of collaborative research, where researchers work with knowledge users who identify a problem and have the authority to implement the research recommendations” is the one adopted by the IKTRN [1]. The IKTRN also distinguishes between knowledge users (those who would make decisions or take actions based on study findings) and stakeholders (those with an interest in the research but who would not themselves directly act on the findings). While recognising that there are many research engagement frameworks that conceptualise a continuum of knowledge user engagement in research, typically ranging from more passive communication with knowledge users through to full partnership (researchers and knowledge users sharing power and decision-making), the IKTRN focuses on co-production in research collaborations where the researchers and the knowledge users aspire to regard themselves as equal partners. The goals, objectives and outputs of this research programme are described in the IKTRN’s research programme protocol, which is the first paper in this cross-journal collection [8].

Wanting to advance thinking and discussion on the science and practice of research co-production, in 2017, the IKTRN launched a call among Network members for critical concept papers that would begin defining areas of research co-production, advancing understanding of research co-production and focus for further research efforts, and provide an opportunity to generate discussion within the research community about research co-production. Some members of the network also offered empirical papers about research co-production they were working on. We believe the result to be a collection of innovative, thoughtful and timely papers about the theory, ethics, methods, evaluation and impact of research co-production as well as patient engagement and research co-production. This collection considers some of the key issues currently facing the science and practice of research partnerships, and collectively begins to identify elements of a research agenda for research co-production. For example, some papers consider how a research co-production approach relates to:

  • Research methods (e.g. ethnography [22], community-based participatory research [23], evaluation of IKT [24])

  • Indigenous health research [25]

  • Global health governance [26]

  • Patient engagement in research [27, 28]

  • Creating impact [29]

Other papers include:

  • A protocol for five scoping and systematic reviews on areas of research co-production [30]

  • A review of what research funders around the world do to support knowledge translation and research co-production [31]

  • A multiple case study of knowledge user participation in cancer health services research [32]

Many of these papers raise issues about research co-production that, to date, have not been fully considered and suggest areas for future research for advancing the science and practice of research co-production. These papers address some gaps in the literature, make connections between subfields, and provide varied perspectives from researchers and knowledge users.

In the Fall of 2018, the IKTRN brought together the authors of these papers to advance our thinking about these issues and to start charting what a research co-production research agenda might look like.

It is our hope that, collectively, these papers will inform, provoke thought and discussion, and generate interest in the concept and practice of research co-production.

Availability of data and materials

Not applicable.



integrated knowledge translation


Integrated Knowledge Translation Research Network


  1. Kothari A, McCutcheon C, Graham ID. Defining integrated knowledge translation and moving forward: a response to recent commentaries. Int J Health Policy Manag. 2017;6(5):299–300.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gagliardi AR, Kothari A, Graham ID. Research agenda for integrated knowledge translation (IKT) in healthcare: what we know and do not yet know. J Epidemiol Community Health. 2017;71(2):105–6.

    Article  PubMed  Google Scholar 

  3. Bowen SJ, Graham ID. From knowledge translation to engaged scholarship: promoting research relevance and utilization. Arch Phys Med Rehab. 2013;94(1 Suppl):S3–8.

    Article  Google Scholar 

  4. Oliver K, Kothari A, Mays N. The dark side of coproduction: do the costs outweigh the benefits for health research? Health Res Policy Syst. 2019;17(1):33.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lewin K. Action research and minority problems. J Soc Issues. 1946;2(4):34–46.

    Article  Google Scholar 

  6. Lewin K, Lewin GW. Resolving Social Conflicts. Selected Papers on Group Dynamics. New York: Harper & Row; 1948.

    Google Scholar 

  7. Freire P. The Pedagogy of the Oppressed. New York: Herder and Herder; 1970.

    Google Scholar 

  8. Graham ID, Kothari A, McCutcheon C. Integrated Knowledge Translation Research Network Project Leads. Moving knowledge into action for more effective practice, programmes and policy: protocol for a research programme on integrated knowledge translation. Implement Sci. 2018;13(1):22.

    Article  PubMed  PubMed Central  Google Scholar 

  9. US Department of Veterans Affairs. QUERI-Quality Enhancement Research Initiative; 2018. Accessed 26 Sept 2019.

    Google Scholar 

  10. Administration for Community Living. About the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR); 2019. Accessed 26 Sept 2019.

    Google Scholar 

  11. PCORI. Improving Outcomes Important to Patients; 2019. Accessed 26 Sept 2019.

    Google Scholar 

  12. Central Australia Academic Health Science Centre. About Us. Accessed 26 Sept 2019.

  13. Fisk NM, Wesselingh SL, Beilby JJ, Glasgow NJ, Puddey IB, Robinson BG, Angus JA, Smith PJ. Academic health science centres in Australia: let's get competitive. Med J Aust. 2011;194(2):59–60.

    Article  PubMed  Google Scholar 

  14. The Health-Science Alliance. The Health-Science Alliance [Home Page]; 2017. Accessed 26 Sept 2019.

    Google Scholar 

  15. ZonMw. Academic Collaborative Centres Public Health; 2019 Accessed 26 Sept 2019.

    Google Scholar 

  16. The AHSN Network. About Academic Health Science Networks. 2019 Accessed 26 Sept 2019.

    Google Scholar 

  17. National Institute for Health Research. Collaborating in Applied Health Research. Accessed 26 Sept 2019.

  18. National Institute for Health Research (CLARHCs). About. 2019. Accessed 26 Sept 2019.

    Google Scholar 

  19. Dungan R, Angove R, Cope E, Peay H. Engagement Science: Introducing Inclusive Research Practices & Potential Impacts. Academy Health; 2019. Accessed 26 Sept 2019.

  20. The Best Research is Produced When Researchers and Communities Work Together. Nature 2018;562(7725):7.

  21. IKT Research Network. (n.d.). What We Do. https://iktrnohrica/. Accessed 26 Sept 2019.

  22. Baumbusch J, Wu S, Lauck SB, Banner D, O'Shea T, Achtem L. Exploring the synergies between focused ethnography and integrated knowledge translation. Health Res Policy Syst. 2018;16(1):103.

    Article  Google Scholar 

  23. Jull J, Giles A, Graham ID. Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge. Implement Sci. 2017;12:150.

    Article  Google Scholar 

  24. Kreindler SA. Advancing the evaluation of integrated knowledge translation. Health Res Policy Syst. 2018;16:104.

    Article  Google Scholar 

  25. Jull J, Morton-Ninomiya M, Compton I, Picard A. Fostering the conduct of ethical and equitable research practices: the imperative for integrated knowledge translation in research conducted by and with indigenous community members. Res Involv Engagem. 2018;4:45.

    Article  Google Scholar 

  26. Plamondon KM, Pemberton J. Blending integrated knowledge translation with global health governance: an approach for advancing action on a wicked problem. Health Res Policy Syst. 2019;17:24.

    Article  Google Scholar 

  27. Rolfe DE, Ramsden VR, Banner D, Graham ID. Using qualitative health research methods to improve patient and public involvement and engagement in research. Res Involv Engagem. 2018;4:49.

    Article  Google Scholar 

  28. Banner D, Bains M, Carroll S, Kandola DK, Rolfe DE, Wong C, Graham ID. Patient and public engagement in integrated knowledge translation research: are we there yet? Res Involv Engagem. 2019;5:8.

    Article  Google Scholar 

  29. Beckett K, Farr M, Kothari A, Wye L, le May A. Embracing complexity and uncertainty to create impact: exploring the processes and transformative potential of co-produced research through development of a social impact model. Health Res Policy Syst. 2018;16:118.

    Article  Google Scholar 

  30. Hoekstra F, Mrklas KJ, Sibley KM, Nguyen T, Vis-Dunbar M, Neilson CJ, Crockett LK, Gainforth HL, Graham ID. A review protocol on research partnerships: a coordinated multicenter team approach. Syst Rev. 2018;7:217.

    Article  Google Scholar 

  31. McLean RKD, Graham ID, Tetroe JM, Volmink JA. Translating research into action: an international study of the role of research funders. Health Res Policy Syst. 2018;16:44.

    Article  Google Scholar 

  32. O'Brien MA, Carson A, Barbera L, Brouwers MC, Earle CC, Graham ID, Mittmann N, Grunfeld E. Variable participation of knowledge users in cancer health services research: results of a multiple case study. BMC Med Res Methodol. 2018;18:150.

    Article  Google Scholar 

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The concept paper collection was initiated by the IKTRN, which is funded by a Canadian Institutes of Health Research Foundation Grant (CIHR FDN #143237).

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IDG, CM and AK conceptualised the ideas for this Commentary. IDG wrote the initial draft. All authors participated in revising the initial draft and approved the final version.

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Correspondence to Ian D. Graham.

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Graham, I.D., McCutcheon, C. & Kothari, A. Exploring the frontiers of research co-production: the Integrated Knowledge Translation Research Network concept papers. Health Res Policy Sys 17, 88 (2019).

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