Abstract
BACKGROUND: Meaningful involvement of underserved communities in health research requires consideration of structural, cultural and linguistic diversity. Games offer promising ways to foster engagement with complex topics and create shared language. However, there is limited evidence on the effectiveness of games for enabling meaningful Public Involvement in health research and minimal methodological guidance on how to facilitate games-based co-design with underserved groups. This paper evaluated a combined participatory Listening Café and games-based approach to public involvement, aimed at supporting meaningful conversations about health with community members, reflecting on the process and lessons learned to establish a replicable methodological model for inclusive public involvement in health research. DESIGN: We collaborated with community partners from two Family Hubs in Southern England to plan and deliver co-design sessions. Initial meetings addressed preferred ways of working, event locations, accessibility, ownership of the final product and budgeting. The sessions took place in the community and adopted the Listening Café model, which is a participatory approach for public involvement that builds trust through shared food and informal conversations. The process included three co-design sessions and a follow-up 3 months later. Evaluation methods included feedback forms, verbal check-ins and written reflections from researchers, community partners and community members. RESULTS: Through a series of Listening Cafés, we co-designed the card game, 'Me: Inside and Out', to encourage conversations about the challenges of living with health conditions with underserved groups. The game facilitated rich, meaningful conversations, fostered empathy and enabled community members to share their lived experiences. Community members reported feeling heard, valued and more connected from being involved in the co-design process, playing the game and understanding more about each other. CONCLUSION: A combined participatory Listening Café and games-based co-design approach for public involvement can effectively involve underserved communities in health research. Cultural sensitivity, shared ownership and relationship-building are crucial processes for fostering inclusion. The Listening Café model proved effective in creating safe, informal spaces for dialogue. Researchers can adopt this methodological approach for public involvement to address perceived barriers to involving underserved communities, co-producing outcomes that reflect the voices of those it aims to serve. PATIENT OR PUBLIC CONTRIBUTION: Community partners (Sarah and Julie) supported planning the sessions. Community members attended and contributed to co-design sessions.