Tokenistic co-design: participation without power in Indigenous health evaluations.

OBJECTIVES: Co-design evaluation methodology can be appropriate for Aboriginal and Torres Strait Islander health and wellbeing programs due to its principles of power-sharing and collaboration. We argue, however, that commissioners of evaluations use the term, co-design, uncritically to describe activities that are misaligned with contemporary co-design theory.

METHODS: Through qualitative interview data with key stakeholders in the commissioning process (commissioners, evaluators and service providers), we examined perceptions and sentiments towards the use and misuse of co-design in the process of commissioning Indigenous health and wellbeing evaluations.

RESULTS: A disconnect between the understanding of co-design theory and its use in practice is evident, with perceptions of what constitutes genuine co-design varying considerably across participants involved in the commissioning process.

CONCLUSIONS: The misuse of co-design to describe commissioning and evaluation practices that do not genuinely adhere to co-design principles has a detrimental effect on the utility of program evaluations, the implementation of Indigenous ethical and research frameworks in a genuine way, and risks co-design becoming relegated to a meaningless buzzword.