Service inclusion empowers customers to self-determine their life and future. Using the motivation-opportunity-ability framework and a strengths-based approach to vulnerability, this study aims to examine the lived experience of secondary school students experiencing vulnerability to better understand how they are motivated, provided the opportunity and able to co-create an inclusive mass public education service.
Twenty secondary school students who attend high school in a low socioeconomic area undertook semi-structured interviews and co-design activities to investigate how customers experiencing vulnerability co-create value in public secondary education services. This grounded theory approach used inductive-deductive thematic analysis to analyse interviews transcript and data artefacts from the co-design activities.
The results show that customers experiencing vulnerability in public secondary education services are intrinsically motivated to co-create inclusive services. Customers provided with opportunities to co-create will use their agency to drive co-creation, perceiving that they are competent to co-create when drawing on past practices and being facilitated by structured freedom. Co-creation is supported by a sense of belonging but impeded by a range of micro-, meso- and macro-level barriers. Customers that co-create inclusive services are subsequently more likely to exhibit engagement.
This research provides empirical evidence to support transformative service research theorising that enabling opportunities and offering choice leads to more inclusive service experiences for customers experiencing vulnerability. Perceptions of service captivity can also be improved by co-creation.
1. Introduction
Since inception, transformative service research (TSR) has focused on improving the wellbeing of customers who experience vulnerability, marginalisation, or disadvantage through service systems (Alkire et al., 2023; Anderson et al., 2011). TSR has recently evolved to focus on fostering service inclusion for customers experiencing vulnerability (Ostrom et al., 2015; Fisk et al., 2018). Service inclusion is an “egalitarian system that provides customers with fair access to a service, fair treatment during a service and fair opportunity to exit a service” (Fisk et al., 2018, p. 842). Fisk and colleagues (2018, 2023) propose that service inclusion comprises four pillars: enabling opportunities, offering choice, nurturing healing, and fostering happiness. At its core, service inclusion aims to empower customers to live fully in society and exercise their right to self-determination (Fisk et al., 2018).
Education is a transformative service by nature as it can “reduce inequality by promoting social, economic and political inclusion” (Russell-Bennett et al., 2024, p. 149), but even public education is not always perceived to be inclusive. Providing a quality education, particularly for women and girls (SDG5), is one of the United Nations’ Sustainable Development Goals (SDG4; Raciti et al., 2024). However, education scholars continue to highlight the negative impacts neoliberalism continues to have on public education (Hogan et al., 2018; Hogan and Thompson, 2019). There are significant differences in educational achievement between students who are experiencing vulnerability and their peers who are not. In Australia, students from low socioeconomic areas are 18 months behind their higher socioeconomic peers by the age of 15, so decreasing this gap could have a significant positive economic impact at an individual and national level (Deloitte Access Economics, 2016, 2019). This significant social problem is influenced by many factors, such as parents’ socioeconomic position (Bardsley, 2007), high levels of mobility during schooling (Sorin and Iloster, 2006), truancy, and negative attitudes towards education (Attwood and Croll, 2006). While these issues are systemic, secondary schools may be able draw on TSR principles of service inclusion, particularly the pillars of enabling opportunities and offering choice, to minimise some of the educational disadvantage endured by students experiencing vulnerabilities.
Although most of the extant TSR research exploring co-creation is focused on health care (e.g. McColl-Kennedy et al., 2012; Frow et al., 2016; Keeling et al., 2020), secondary education is an impactful service deserving examination because education allows customers to experience large-scale improvements to their wellbeing early in life. All customers of secondary education − adolescents − experience vulnerability due to their age, but many experience additional vulnerability due to their ethnicity, socioeconomic status, disability, and gender (Raciti et al., 2024). Secondary education has significant transformative power because the service facilitates upward social mobility, enabling opportunity for lifelong improvements to wellbeing that may not have been possible otherwise (Australian Institute of Health and Welfare, 2019; United Nations, 2020). Successful completion of secondary education can also reduce reliance later in life on other public service systems that aim to improve wellbeing, such as health care, housing, and welfare. However, as Raciti et al. (2024, p. 166) note, “the value of education as a transformative service that provides opportunities for all humans is yet to be fully realised”.
Initial evidence of service inclusion in secondary education would be a service design that enables opportunities and offers choices for students to co-create their learning, which are the first two pillars of service inclusion. Traditional secondary schooling in Australia, however, is a well-controlled and regulated service experience. Australian schools are bound by national curriculum and pedagogical choices are often constrained by school-based pedagogical frameworks. There is, however, scope for individual teachers to contextualise the curriculum to meet the needs and interests of students while also using their chosen pedagogical strategies that will enhance engagement. Consequently, the first and second pillars of opportunity and choice are interesting service facets to explore because enabling opportunities and offering choice would be entirely directed and controlled by the service organisation. Service providers can identify when and how they provide customers with opportunities to co-create and which touchpoints or encounters will include opportunities for co-creation, assuming customers experiencing vulnerabilities also have the motivation and ability to engage in value co-creation. Exploring how students are offered opportunities to co-create their learning, in tandem with understanding their motivation and perceived ability to make the most of this opportunity, is critical to understanding how education can better facilitate the wellbeing and social inclusion of customers experiencing vulnerabilities.
Consequently, this research explores the lived experience of customers experiencing vulnerability (in this case, students who attend a secondary school in an area of low socioeconomic status) to better understand how they are motivated, provided opportunities, and perceive they have the ability to engage in value co-creation in an inclusive mass public education service, to improve engagement. Using the motivation-opportunity-ability (MOA; Rothschild, 1999) framework and a strengths-based approach to vulnerability (Raciti et al., 2022) as a theoretical lens, we use semi-structured interviews and co-design activities with 20 students attending a secondary school in a low socioeconomic status area to examine how value co-creation for service inclusion occurs in a mass public secondary education service. We address the following research questions (RQs):
How are customers experiencing vulnerability (a) motivated, (b) provided the opportunity and (c) able to co-create an inclusive service?
How can co-creating an inclusive service enhance engagement for customers experiencing vulnerability?
This strengths-based approach examines how co-creation can be used to foster more inclusive public services such as public secondary education and ultimately heighten engagement for customers experiencing vulnerability.
The paper contributes to the literature on inclusive services, TSR, value co-creation, and engagement by developing an empirical understanding of how service providers facilitate opportunities to co-create the design of inclusive services. These findings provide valuable practical insight into the strategies service providers can use to enhance the opportunity for customers experiencing vulnerability to participate in value co-creation activities and work with the organisation to design an authentically inclusive service that improve wellbeing and lead to higher levels of customer engagement.
2. Literature review
2.1 Vulnerability
TSR aims to support and improve the wellbeing of customers experiencing vulnerability. TSR is the “integration of consumer and service research that centres on creating uplifting changes and improvements in the wellbeing of individuals (consumers and employees), families, social networks, communities, cities, nations, collectives, and ecosystems)” (Anderson et al., 2011, p. 3). Although service organisations have the capability to impact the wellbeing of all customers positively or negatively, this impact is particularly profound for customers who are experiencing vulnerabilities (Rosenbaum et al., 2011).
Consumer vulnerability is traditionally defined as “a state of powerlessness that arises from an imbalance in marketplace interactions or from the consumption of marketing messages or products” (Baker et al., 2005, p. 134). The experience of vulnerability, whether permanent or transient, can be caused by many factors, such as individual characteristics, external conditions, inequity and service exclusion, dependence, and macro-environmental forces (Johns and Davey, 2019). Furthermore, some groups of people may be more likely to experience vulnerability than others when entering a service experience. This is reflected in the growing body of literature on vulnerability, exploring intersectionalities such as socioeconomic status (e.g. Gupta and Pirsch, 2014), disability or impairment (e.g. Abney et al., 2017), older age (e.g. Tomazelli et al., 2017), sexual orientation (e.g. Minton et al., 2017), and immigrant status (e.g. Davis et al., 2017). In some cases, the experience of vulnerability heightens service captivity (Rayburn et al., 2024), which is “a customer’s perceptions of being constrained regarding choice, voice, and power during service provision” (Rayburn et al., 2024, p. 414). Service captivity can occur in many services, especially transformative services such as compulsory education.
While our understanding of vulnerability has developed significantly in recent years (Hill and Sharma, 2020; Riedel et al., 2021), much of the existing research has taken a deficit-based approach to examining the concept. We draw on a strengths-based approach suggested by Raciti et al. (2022, p. 29), who note that “experiences of vulnerability are subjective perceptions of susceptibility, which are part of the human condition that may come to pass with the passage of time, prompt introspection and give rise to greater strength and resilience”. A strengths-based approach externalises the problems being faced by individuals and allows customers who may be experiencing vulnerabilities to draw on their strengths and contribute to the solution (Raciti et al., 2022). This approach is also beneficial because vulnerability can be transient and thus all customers are likely to experience vulnerability at some points in their lives and/or in different services systems (Baker et al., 2005; Raciti et al., 2022; Dietrich et al., 2017). Customers experiencing vulnerability are a research priority for service research and this paper responds to the call to better “[design] services for vulnerable customers” (Ostrom et al., 2015, p. 140) with the aim of fulfilling the United Nations Sustainable Development Goal 4 of providing quality education to all.
2.2 Co-creating inclusive services
As the complexities of the vulnerabilities experienced by customers increases, service design has become a critical component of creating transformative services. Good service design can minimise the potential for customers to perceive themselves as captive in a service, which can diminish their wellbeing and heighten their experience of vulnerability (Rayburn, 2015). Service design is an inherently multidisciplinary field drawing on theories from various disciplines to create human-centric services (Joly et al., 2019). Inclusive service design has become a key focus for researchers and practitioners as services can deliberately or unintentionally exclude customers, especially those experiencing vulnerabilities, from the service experience (Fisk et al., 2018; Davey et al., 2021). This exclusion ultimately diminishes customers’ wellbeing. One approach to effectively design inclusive services that mitigate the risks associated with service captivity for customers experiencing vulnerability is value co-creation (Andreassen et al., 2016).
Value co-creation has been acknowledged in the academic literature since the 1990s (Bettencourt, 1997), with interest from service scholars accelerating through the emergence of service-dominant logic (Vargo and Lusch, 2004). Co-creation is commonly acknowledged to be facilitated through the integration of resources and capabilities by multiple actors (Vargo and Lusch, 2011; Zeithaml et al., 2020). This perspective on co-creation is reflected in the definition of service co-creation proposed by Oertzen and colleagues (2018, p. 657):
[T]he co-creation of services denotes collaborative activities in the customer-provider interface associated with the service; it necessitates the involvement, engagement and participation of at least one customer and one service provider and may lead to beneficial and/or counterproductive outcomes through resource integration.
In the context of this research, co-creation would occur through the integration of resources and capabilities between secondary school students, teachers, school leaders, and other educational actors.
As value co-creation has become a strong focus for service research, research has examined various commercial and transformative contexts including health care (McColl-Kennedy et al., 2012), hospitality (Chathoth et al., 2013), and tourism (Kabadayi et al., 2019). There has been limited research on value co-creation in education, with most of the extant research focused on tertiary education (Judson and Taylor, 2014; Bovill, 2020). Thus, this research explores the opportunity to co-create value in the context of secondary education. Secondary education presents a different challenge to service researchers and managers as students have different motivations to engage in secondary and tertiary education and therefore interact with the services in different ways. Furthermore, students experiencing vulnerabilities, such as low socioeconomic status, may engage in negative educational behaviours such as truancy, develop negative attitudes towards the teacher, or refuse to follow a teacher’s instructions in the school environment (Khoo and Oakes, 2003; Attwood and Croll, 2006). The co-creation of inclusive services may offer a fresh perspective to mitigate these negative behaviours and enhance the likelihood of positive customer behaviours in this service context as co-creation enables the service to be driven by a strengths-based approach.
2.2.1 Motivation, opportunity and ability.
A classic strengths-based performance framework that can be applied to service co-creation is the MOA model (Rothschild, 1999). The framework explores an individual’s desire, opportunity, and capability to perform a particular role or behaviour, operationalising a strengths-based approach to vulnerability (Raciti et al., 2022). Motivation is defined as “goal-directed arousal” (Rothschild, 1999, p. 31). Service researchers have previously explored the motivation for customers to co-create and highlighted that motivation is context specific (Neghina et al., 2017). Ability is defined as “individual skill or proficiency at solving problems and may include breaking a well-formed or addictive habit or countering the arguments of peers” (Rothschild, 1999, p. 32). Customers can co-create value when they have the necessary resources and capabilities to participate in the co-creation process. These resources and capabilities may be physical, intellectual or financial depending on the requirements of the service and the value proposition the service provider has provided for co-creation (Zhang, 2014). This research uses the customer value cocreation activities (McColl-Kennedy et al., 2012) typology as an analytic framework to explore the ability of customers in this service context to co-create. Finally, while Rothschild (1999, p. 31) does not define opportunity, he states that a lack of opportunity comprises “situations in which the individual wants to act but is unable to do so because there is no environmental mechanism at hand”. Service organisations are responsible for providing the opportunity to co-create (Grönroos, 2008) and service marketers often assume this opportunity is always available. In some service environments (e.g. mass services with limited customisation) or for some customers (e.g. customers experiencing vulnerabilities such as age, disability, and socioeconomic status) that opportunity may be rarely (if ever) presented.
In this research, we explore a service where the opportunities to co-create might be naturally restricted and examine how customers engage in such a service. Furthermore, we gather empirical evidence of how co-creation facilitates the first two pillars of service inclusion, enabling opportunities and enabling choices (Fisk et al., 2018), which in turn facilitates the additional pillars (relieving suffering and fostering happiness) experienced by customers in this service context. While there is no known application of the MOA model to help increase engagement in secondary schooling, the framework has been used in the education context to help solve social problems such as racism (Madill and Abele, 2007) and excessive alcohol consumption (Dietrich et al., 2016). Thus, there is scope for further empirical evidence of how the MOA model can be used to understand value co-creation.
2.3 Engagement
Engagement is commonly defined as “a psychological state that occurs by virtue of interactive, co-creative customer experiences with a focal agent/object (e.g. a brand) in service relationships. Engagement occurs under a specific set of context-dependant conditions generating differing customer engagement levels; and exists as a dynamic, iterative process within service relationships that cocreate value” (Brodie et al., 2011, p. 260). Engagement is a multidimensional construct comprising cognitive, affective, and behavioural dimensions, which occurs when a customer interacts with a focal object for a service outside of a purchase behaviour (Brodie et al., 2011; Marbach et al., 2019). Engagement has been explored in many contexts with many focal objects, such as health care (Hammedi et al., 2017), retail (So et al., 2016), higher education (Sim et al., 2018), and artificial intelligence (Hollebeek et al., 2021). Since inception, engagement has become an area of interest for TSR researchers and managers who hope to enhance the wellbeing of customers experiencing vulnerability. Consequently, this paper positions engagement, whether cognitive, affective, and/or behavioural, as the desired outcome of co-created, inclusive secondary education. Our research seeks to understand if the co-creation of inclusive services would facilitate engagement among secondary school students in schools in low socioeconomic areas.
3. Method
3.1 Sample
Secondary education is by nature a transformative service; however, educational outcomes vary significantly between students who do and do not experience vulnerability in this service system. The sample comprised 20 students − 10 male and 10 female participants aged 15–17 − who attended a secondary school in a low socioeconomic area of Australia. The sample characteristics are outlined in Table 1. The school is rated below the Australian average on the Index of Community Socio-Educational Advantage, with the school’s score fluctuating between 968 and 985. This score indicates the students exhibit higher levels of educational disadvantage than average (Australian Curriculum, Assessment and Reporting Authority, 2018). Almost 40% of students at this school are in the bottom quarter of the Index of Community Socio-Educational Advantage. The geographic area around the school has a Socio-economic Indexes for Areas (SEIFA) score of 875. SEIFA scores range from 1 to 1200 (lowest currently 448; highest currently 1171). The score synthesises Australian census data about household income, level of education, employment status, occupation, housing type, and family structure to identify the socioeconomic status of the area (Australian Bureau of Statistics, 2023). A SEIFA score of 875 places this community in the lowest decile (i.e. lowest 10%) of both state and national socioeconomic statistics (Australian Bureau of Statistics, 2018), further demonstrating the low socioeconomic status of the school and the students enrolled. Students attending this school are demonstrably experiencing socioeconomic disadvantage.
Summary of participants
| # | Participant pseudonym | Gender | Age | School year level |
|---|---|---|---|---|
| 1 | Emily | Female | 16 | 11 |
| 2 | Hana | Female | 15 | 11 |
| 3 | Chloe | Female | 16 | 11 |
| 4 | Josh | Male | 17 | 12 |
| 5 | Kate | Female | 17 | 12 |
| 6 | Taylah | Female | 16 | 12 |
| 7 | Lachie | Male | 16 | 11 |
| 8 | Lily | Female | 16 | 12 |
| 9 | Jayden | Male | 16 | 11 |
| 10 | Rachael | Female | 16 | 11 |
| 11 | Sienna | Female | 16 | 11 |
| 12 | Kyle | Male | 16 | 11 |
| 13 | Jorja | Female | 16 | 11 |
| 14 | Tiana | Female | 16 | 12 |
| 15 | Jason | Male | 15 | 11 |
| 16 | Brad | Male | 16 | 11 |
| 17 | Brendan | Male | 16 | 11 |
| 18 | Luke | Male | 17 | 11 |
| 19 | Mark | Male | 15 | 11 |
| 20 | Zane | Male | 16 | 11 |
Source(s): Authors’ own work
The lead researcher, who is an experienced secondary school teacher that has lived experience in this secondary school (see Section 3.4), approached the school principal for approval to undertake the research and access the sample in the school environment. Ethical approvals (see Section 3.2) had already been obtained from the Queensland Department of Education and the university. Once the Principal had approved access to the population, purposive sampling was used to recruit participants with varying self-reported levels of achievement and engagement in schooling (see Table 1). Given the participants are not yet adults and experiencing socioeconomic disadvantage, the sample was challenging to recruit as participants may already be disengaged from education, have low literacy, and become confused (along with their parents) by research terminology on consent forms (McDonald and Graham, 2011). Consequently, the primary researcher conducted multiple recruitment presentations at the school and simplified the process of consent as much as possible. To manage social desirability bias, consent forms were collected privately to ensure that other students were not aware if an individual was participating in the research.
3.2 Ethical considerations
As this research was undertaken in a secondary school using student participants with identified vulnerabilities, there were several processes undertaken to minimise any ethical concerns. As per the requirements of the Queensland Department of Education (2017), the researchers adhered to the National Health and Medical Research Council’s ethical guidelines to receive departmental research approval and ethics approval from their university. To conduct the research, the researchers gained informed and voluntary content from students (who were all minors), the student’s primary caregiver (i.e. legal guardian with ability to consent), and the school’s principal. Participant data was deidentified and a pseudonym was allocated to each participant to report the findings.
3.3 Data collection process
Taking a grounded theory approach, data were collected via semi-structured interviews of 40–60 min with co-design elements that were held at the participants’ school. This site ensured that participants were in a familiar setting and mitigated access issues that participants may have encountered due to their age, geographic location, and experiences of vulnerability (Lichtman, 2014). Participants were initially asked open-ended questions about their motivations, opportunities, and abilities to engage in the co-creation of their education, as well as any outcomes they had experienced due to co-creation. Example questions included, “Did this freedom make you feel more motivated to complete the task?”, “Do you think you have the opportunity to have more say about how school works?” and “If you could make these changes in real life, what skills would you need? Do you have these skills?”. Participants were prompted to consider their schooling experiences and how the service could be better designed, drawing on value co-creation and co-design principles, to be more inclusive. Due to the participants’ experiences of vulnerability and age, each question was carefully worded so the interview questions and co-creation activities could be understood by a young person with low literacy levels.
Next, two co-design activities were used to heighten participation and aid discussion. The first activity focused on how participants felt they could co-create the service design of the classroom experience, drawing on the service blueprint (Bitner et al., 2008). Students identified elements of the classroom experience that they felt they could co-create (e.g. physical layout, curriculum, assessment design, and lesson structure) and explained how they believed these aspects could be co-created. During this the researcher probed for a deeper understanding of the participants’ motivation, opportunity, and ability regarding these co-creation suggestions. The second activity focused on the participants’ lived experiences with value co-creation and additional ways in which they thought value co-creation could occur, drawing on a suite of eight customer value cocreation activities (McColl-Kennedy et al., 2012; see Table 2). These activities include co-operating, collating information, combining complementary activities, co-learning, changing ways of doing things, connecting, co-production, and cerebral activities, which escalate in complexity. The participants identified whether they had any experience undertaking each of the eight co-creation activities in their education by allocating emojis (e.g. a happy face symbolising they had experience and a sad face symbolising they did not) to each activity. Following this, participants described their own experience conducting each activity and highlighted what they hoped to achieve by undertaking the co-creation activity. These data artefacts required minimal writing to manage the impact of potentially low literacy, and ongoing probing was used to minimise communication barriers to data collection. During interviews where participants struggled with writing legibly or low literacy, the researcher copied down participant responses. During each activity, participants were given time to complete the task while speaking to the researcher about their thoughts and experiences. The researcher continued to probe as the participants completed each activity to ensure they were able to elicit the richest data from the interview and each additional data artefact.
Participant experienced with customer value co-creation activities
| Customer value co-creation activities | Rate of experience | Examples |
|---|---|---|
| Cooperating Accepting information or complying during co-creation | High |
|
| Collating information Sorting and assorting information | High |
|
| Combining complementary activities Use of supplementary activities | Moderate |
|
| Co-learning Actively seeking and sharing information from other sources | High |
|
| Changing ways of doing things Involvement in activities that help make a change | Moderate |
|
| Connecting Building and maintaining relationships | High |
|
| Co-production Assisting with the redesigning of the service or elements of the service | Low |
|
| Cerebral activities Having a positive attitude and reframing thinking | Moderate |
|
Source(s): Authors’ own work
The co-design activities were beneficial because adolescents can be particularly difficult to elicit insight from during semi-structured interviews (Bassett et al., 2008). The co-design activities embedded in the semi-structured interviews allowed the research to use a participatory design methodology (Raciti et al., 2022), which positions the creation of knowledge as an outcome of the interaction between participants and artefacts during the research process. In addition, this approach allowed the research to be conducted in a strengths-based manner, highlighting the participants’ strengths and how they could be used to foster a more inclusive service. Finally, this approach allowed the researchers to triangulate co-design artefacts with interview data, heightening the reliability of the research. Each interview was recorded and transcribed verbatim prior to analysis of the transcripts and co-design artefacts being conducted.
3.4 Tacit knowledge of the researcher
Researchers can draw on their tacit knowledge, which is a consequence of their lived experience, when researching with customers experiencing vulnerability because the researcher has an authentic understanding of the context (Lam, 2000; Raciti et al., 2022). In this research, the lead researcher is an experienced secondary school teacher who has worked with students from an array of backgrounds and has lived experience as a school student in this service context throughout their secondary schooling. These lived experiences allow the researcher to have an authentic understanding of the experiences and vulnerabilities of students and teachers in this service context. A high level of tacit knowledge allowed the researcher to elicit deep insight from participants because they shared a frame of reference.
3.5 Data analysis
Data were analysed using inductive-deductive thematic analysis (Fereday and Muir-Cochrane, 2006), which is a hybrid method of qualitative thematic analysis that combines Boyatzis (1998) inductive and Crabtree and Miller’s (1999) deductive approaches. The resulting themes are partially elicited a priori drawing on the theoretical frameworks driving the research, and partially derived from the data in line with grounded theory (Glaser and Strauss, 2017). The thematic analysis was undertaken using NVivo in a reflexive and iterative manner. To ensure reliability and validity of the findings, each researcher scrutinised the data and findings to ensure investigator triangulation.
4. Findings
This section synthesises the findings from the interviews and co-design activities to explore what facilitates and inhibits customers experiencing vulnerability from co-creating an inclusive service. Our key findings are represented in Figure 1 and discussed below.
Enablers and barriers to co-creating inclusive service for customers experiencing vulnerability
Enablers and barriers to co-creating inclusive service for customers experiencing vulnerability
4.1 High levels of intrinsic motivation across varied levels of existing engagement
The first strength that was identified during thematic analysis was the high level of intrinsic motivation participants had towards value co-creation in a public education context, despite varied levels of existing engagement. Service providers should not assume that disengaged customers will be unmotivated to co-create, but rather consider how co-creation activities could be used to mitigate disengagement. Participants reported that they were motivated to co-create their curriculum, pedagogy, and assessment to enhance their service experience. This is illustrated in the following quotes:
I feel like [the curriculum] should be what kids find interesting. If you’re doing history, for example, you could go around and be like, “Okay, what do you wanna learn? Why did you take this? What did you wanna learn when you joined history?”. Chloe (discussing curriculum)
I’d like input into certain activities, not the content but how it’s taught, “cause that allows students to be more engaged in a lesson, I would say”. Jason (discussing pedagogy)
I really like assessment pieces and stuff that really allow me to explore things. Not just monotonous tasks. Zane (discussing assessment)
As participants discussed their intrinsic motivation to co-create, narrative threads emerged around students’ innate interest in certain topics, intense curiosity for learning, and a desire for more freedom when learning (see bolding above). Participants reported that they are drawn to certain content, becoming more intrinsically motivated to co-create when content aligns with their personal interests. These data also demonstrate that some participants have intense curiosity to learn. This curiosity motivates participants to seek opportunities to extend their learning or align their learning to their interests and needs. Some students found motivation not in interesting topics, but in the capacity to explore topics in unique ways. This suggests that both what might be co-created and how that co-creation process might unfold can facilitate intrinsic motivation to co-create an inclusive service.
Several participants had co-created educational outcomes previously, such as choosing topics of interest to work on or choosing the format of assessment to submit (see next section). These participants indicated they felt more intrinsically motivated to participate in the service when they had contributed to service design, as illustrated in the following quote:
[I] definitely [was] more motivated, because it’s something I would wanna learn about, something that I chose. Hana
The intrinsic motivation to co-create their education aligned with participants’ desire for more freedom and a more equal distribution of power between the customer and service provider in this context (see next section).
Not all students, however, were motivated to co-create their secondary schooling. Several participants discussed their (or their friends’) experiences of feeling demotivated in their secondary education, demonstrating that motivation is contextual (Neghina et al., 2017) and that some students preferred to pursue alternative behavioural goals such as entertainment. This is illustrated in the following quote:
Basically, it’s […] their phone’s right there; they know they got games on it; they know they got social media on it. They know the teacher will be focused during class on other people who actually need help, so they can just play their phone. Kyle
Other participants were demotivated to co-create learning activities that have low perceived value, as illustrated in the following quote:
[L]ike the math labs I feel like would probably be more [valuable if they were] based on things you’re gonna do outside of school like taxes and stuff. Because we learn trigonometry and you’re like, “What am I gonna use this for?” Chloe
Finally, some participants reported demotivation in subjects where they underperform or are falling behind, suggesting that failure avoidance impedes co-creation in education. However, existing demotivation may not inhibit future intrinsic motivation to co-create if service providers can leverage disengaged students’ innate interest, curiosity and desire for freedom, as the following quote indicates:
Not very many of my friends like coming to school at all. They like to stay home and play their games and stuff. [But] even if they are less motivated, they are more interested in doing something that have chosen than just what the teachers have chosen. Kate
Overall, high levels of intrinsic motivation to co-create despite varied levels of existing engagement contrasts with existing education literature, which takes a deficit-based approach to working with students from lower socioeconomic backgrounds. Martin (2003) argues that students from low socioeconomic backgrounds experience lower rates of control and high levels of failure avoidance, which inhibit motivation towards their learning. Conversely, our findings indicate that students from lower socioeconomic backgrounds can be highly motivated to co-create value, which aligns with a desire for self-determination (Deci and Ryan, 2000). Students from lower socioeconomic backgrounds have higher levels of aspirational capital (Raciti et al., 2022), which may explain this motivation to co-create their education.
4.2 Opportunity enhances perceived strengths by providing agency
Most participants reported that they had experienced some opportunities to co-create their educational experience, providing them with a sense of agency over their secondary education. Agency is defined as “a person’s ability to control their actions and, through them, events in the external world” (Haggard and Tsakiris, 2009, p. 242). The opportunity to co-create learning typically involved exercising choice or autonomy, allowing participants to draw on their strengths and work with the service provider to create an inclusive service that meets their needs. Other embodiments of agency included participatory decision-making and the ability to voice their preferences, which provides a sense of control to students. The emergent themes of choice, autonomy, decision-making, and voice are illustrated in the following quotes:
Yeah, last year […] I did an essay on a song. We had to choose a song; we could choose any song we wanted that had anything to do with Indigenous Australia. I liked the fact that I chose Blue Sky Mine by Midnight Oil. That was good because I actually like that song, so I got to write about something that I liked, and it made me feel more engaged with the topic. Brad
I picked the idea; I formulated the idea; I did my research with the idea. It was all mine… Brendan
Exercising agency appears to create a self-reinforcing motivation loop, as the data demonstrated that participants felt empowered when given these opportunities to co-create their educational experience. Students could also tell that their classmates were more engaged in their learning (and thus drawing on their strengths) when given the opportunity to co-create, as illustrated by the following quote:
Most of [the other students] seemed to be a lot more engaged being able to choose their own topic and what they had opinions on, instead of getting given a certain one where they might not care what happens or not. Lachie
Conversely, the inclusivity of the service was diminished when student agency was inhibited. Participants perceived a range of micro-, meso-, and macro-level barriers to co-creation, including service provider resistance, governance resistance, state and federal education regulation requirements, and a strongly asymmetrical power dynamic between service provider and customers. Micro-level service provider resistance was perceived to be the biggest barrier to co-creation, with many participants feeling their perspectives or contributions would be considered invalid by the service provider. This is well illustrated by the following quote, which demonstrates that students can feel silenced by teachers:
I get it, like teachers are teachers and students are students, but I think students need to have a say. Most of the time, when students have a say [about their learning] they get knocked down pretty fast. Jorja
This finding suggests that service providers in one-to-many service platforms may experience more challenges co-creating value than one-to-one platforms due to the limited customisation opportunity and complex nature of this engagement platform. Participants also perceived that their agency is inhibited by meso-level operators, as illustrated in the following quote:
Students have tried to make change and [teachers and school leaders] always just say, “Well, it comes down to what the [Parents and Citizens' (P&C) association] wants”. We can’t join the P&C because we’re students. Sienna
The second most common barrier to co-creation was the perception of a strongly asymmetrical power dynamic, which meant that customers felt disempowered and disadvantaged compared to the service provider. This perceived asymmetry is theoretically consistent with the dialogue, access, risk assessment, transparency (DART) framework of value co-creation, specifically transparency (Prahalad and Ramaswamy, 2004). Participants acknowledged teachers rightfully hold expert and legitimate power in education services, which is critical to cultivate a psychologically safe climate, but participants felt the distribution of this power is too highly skewed towards teachers, mitigating opportunities for co-creation. When students discussed how they might instead co-create a more inclusive service, a strong narrative thread emerged around interdependence, which allows students agency while acknowledging teachers’ professional expertise. Evidence of both power dynamics and interdependence are illustrated in the following quotes:
The power, because I feel like everyone believes the teacher should have more power over students. Hana
I really respect teachers that put a lot of time into students—and you can see that they’re passionate about helping students and teaching—that invest their time and don’t just brush the students away. Especially if they can see that they’re struggling with something. Tiana
Finally, at a macro level, the data indicated that participants perceived that the State Government (i.e. the regulatory body for school-based education) limited opportunities to co-create inclusive education. Interestingly, participants identified an opening for change to occur at the meso-level, with a focus on change happening for individual schools as opposed to a state-wide approach directed by the State Government. Participants believed the meso-level approach to co-creation was a feasible solution to enable opportunity, allowing both customers and service providers to draw on their strengths and remove some of the barriers to co-creation. This insight is illustrated in the following quote:
I think it would be possible to make change. I don’t know how easy it would be to do it, overall, over every school over [the state/country]. But on an individual basis of school, I think it would be easier to change certain aspects. But everything, I think, will be difficult. Josh
4.3 (Perceived) competence is driven by co-creation practices and supported by structured freedom
Participants thoughtfully discussed their (perceived) competence to co-create inclusive education. This was most evident when participants explored past experiences where they had been given agency over their learning and their subsequent success and pride in the outcome of their work, as the following quote illustrates:
There was a bit of pride wrapped up in [my chosen assessment], I guess. Brendan
Several participants noted that some of their peers experienced difficulties when provided more agency over their learning as they were socialised to accept rigid (or captive) learning experiences and less confident in their perceived competence, but quickly identified that support from the teacher to create “structured freedom” would help these students overcome these barriers to ability and reduce perceptions of captivity within the service. This is illustrated in the following quote:
[T]here were some difficulties because some people chose different tasks to do. So I do think that there should be a teacher recommendation in it, but still allow the students freedom of choice. Josh
To better understand the varied (perceived) competencies of participants displayed in their past co-creation experience, we asked participants to reflect on their experience engaging in the eight types of co-creation activities: co-operating, collating information, combining complementary activities, co-learning, changing ways of doing things, connecting, co-production, and cerebral activities (McColl-Kennedy et al., 2012). Identifying, understanding and reflecting on the variety of possible co-creation activities may lead to a more inclusive service by recognising more diverse co-creation contributions. Table 2 details participants’ experiences with the different co-creation practices. It presents the rate of experience, which indicates the self-reported frequency of behaviours derived from the interviews and second co-design activity. Participant responses were collated and aggregated for reporting in the table.
The data indicate that all participants have engaged in cooperating behaviours. Arguably, this is a simplest co-creation behaviour and most closely aligned with traditional schooling activities. Cooperating is defined as accepting information or complying during co-creation (McColl-Kennedy et al., 2012). Participants reported that cooperating benefits all actors in the service experience.
The next most common behaviour reported in the data was collating information. Collating is defined as “sorting and assorting information” (McColl-Kennedy et al., 2012, p. 378). Almost all participants identified experiences where they had collated information, usually outside of the classroom, to enhance their experience with the service. Some participants highlighted their experiences and how they conducted the behaviour, while others indicated that this was just something they did because they felt collating information was important for their learning. Behaviours identified by participants included revising notes and corroborating information with other sources to complement their learning.
The data indicated that participants actively engaged in co-learning behaviours. Co-learning is defined as “actively seeking and sharing information from other sources” (McColl-Kennedy et al., 2012, p. 378). In many cases, this happened outside of the classroom when students would work together to study or on group assessment. One participant also highlighted how they shared their notes with their friends in some classes. Other participants reflected on how co-learning behaviours enabled them to enhance their learning by being exposed to perspectives other than just theirs and the teacher. The high level of co-learning behaviours could be a way for cutomers experiencing vulnerability to co-create social value, and potentially epistemic value, in an education service. Like co-learning, the data showed participants actively engaged in connecting behaviours. Connecting is defined as “building and maintaining relationships” (McColl-Kennedy et al., 2012, p. 378). Participants identified their relationships with their teachers as a resource to enhance their learning.
Perhaps not surprisingly, the data identified less experience of co-production behaviour, which suggests there are limited opportunities for more complex co-creation. Co-production is the most intensive co-creation activity outlined by McColl-Kennedy and colleagues (2012) as co-production enables customers to co-design aspects of the service experience. Participants identified areas for co-production, which included providing input into lesson planning, redesigning classroom layouts, and actively being involved in the creation of learning activities and assessment. When discussing the possibility of engaging in co-production activities, participants believed there would be great benefits to their learning.
Overall, the high rate of experience with cooperating, collating, co-learning, and connecting illustrates a well-developed perceived competence for customers experiencing vulnerability to co-create value in their education service. While co-production had the lowest rate of experience, almost all participants showed interest in co-production practices as they believed this would benefit their service experience. Participants were willing to draw on their strengths to conduct more complex co-creation activities, even if they had not yet experienced these practices. An absence of any one of these practices would be considered a barrier to co-creating an inclusive service due to perceived incompetence.
4.4 Co-creating an inclusive service requires belonging
While the MOA (Rothschild, 1999) framework provides useful starting point for exploring individuals’ desires, opportunities, and capabilities to perform a particular co-creation role or behaviour, an additional concept emerged from the data to facilitate inclusive service co-creation. This concept, termed belonging, speaks to the deep human need to be part of something bigger than oneself. All participants identified that they needed to feel a sense of belonging for co-creation activities to occur. Conversely, feeling excluded was a significant barrier to co-creation.
Two clear themes emerged relating to belonging: respect and relatedness. Participants desired respect from both the service provider (teacher) and other customers (fellow students). Participants particularly focused on feeling mutual respect with the service provider. The importance of respect to create belonging (and disrespect that creates exclusion) is illustrated in the following quotes:
[I]t’s really just the teaching style, but […] all the old class kind of teachers are all about, “I’m in charge, respect me”, whereas some teachers (and this is my preferred kind of teaching style), they will treat you with respect as long as you give them respect back.
[Teachers] need to be in work mode and not hold grudges against students, not be petty, not be rude [or] disrespectful to us, because nothing’s worse than going into a class and your teacher’s rude to you and there’s nothing you can do because you have to follow the rules, but they can be petty and rude to you. Lily
You should be able to sit wherever you want, not in alphabetical or this person sits here, and you have to sit next to a boy, you have to sit next to a girl, you have to sit next to this person. Because I feel that’s very demeaning and belittling. And standing outside in two lines? I do not like that. It makes me feel like I’m three, getting ready to go into a classroom with other three-year-olds. Taylah
Respect is a form of moral conduct that protects customers experiencing vulnerability from a reduction in their intrinsic dignity (Palmer and Hedberg, 2013). Mutual respect between teachers and students in low socioeconomic schools is particularly salient when we consider that for some students, their teacher may be the only adult in their life they interact with positively (and thus experience intrinsic dignity from) on any given day.
Alongside respect, participants desired relatedness with each other. One of the key findings from the service co-design activity was that participants desired their classroom layouts to be changed to create more open, dialogic space. Participants generated their ideal classroom layout, which were synthesised into five key shapes: U-shape, semi-circle, T-shape, groups and rows. When participants discussed these five layouts, the U-shape and semi-circle were perceived as most desirable. Participants explained that these layouts enhance the ease of class discussions, student collaboration, and for the teacher to work with students more equally. This is illustrated in the following quotes:
I feel like when you’re in straight lines, you feel very shut out, so having some sort of circular or even semi-circle shape, you have an idea of who you’re talking to rather than having to move your body to see everything. Taylah
It’s just a U-shape around the teacher. I feel like it gives the teacher space so they can see everyone. It opens up [opportunities] for the teacher to engage with the class a lot more because no one can hide in a U-shape. I, personally, am one of the kids that hides in the back row. Kyle
Our findings indicate that students from lower socioeconomic backgrounds require a sense of belonging to co-create an inclusive service, which aligns with a desire for self-determination (Deci and Ryan, 2000). Feeling disrespected or isolated creates a feeling of exclusion from service co-creation as the social facets of co-creation are undermined. Similarly, students reported that misbehaviour from fellow students, such as arson (reported by Luke), deliberate provocation or acting like a “class clown” (reported by Chloe), and back chat (reported by Jorja and Kate), cause all students to be excluded from co-creation in public services with one-to-many delivery. Belonging, which is an interpersonal resource similar in nature to social capital (Sandberg et al., 2022), helps to insulate customers from vulnerability and provide a gateway to service inclusion through co-creation.
4.5 Co-creation leads to engagement
The data demonstrate that value co-creation leads to higher levels of customer engagement in this service context. Participants reported that they experienced cognitive, affective, and behavioural engagement (Brodie et al., 2011) from co-creation activities, with affective engagement being the most prevalent engagement experienced by participants. Affective engagement was evident in participants’ feelings of enhanced control, respect from the service provider and positive attitudes towards the activities. This is illustrated in the following quotes:
Yeah, it’d make me feel like I have more control over what I’m learning. When we get told what to write about and we aren’t interested, we’re not going to want to research and do study. But if you say choose and write about a topic you want, well you obviously enjoy that a lot more. So, I think control is important. Brad
This was also the case when participants considered the prospect of co-creation:
With the days that I took off [truanting], I feel like if I had more say, I feel like I would probably show up more. It’s hard to put into words. You feel like you’re more a part of it so you’re more obligated to be there, but not by like a rule, just emotionally obligated, I guess. Jason
Strong experiences of affective engagement led to behavioural engagement. Specifically, participants’ experiences of co-creation lead to higher levels of participation in the service, which was driven by the high level of affective engagement in the service during co-creation.
5. Discussion
Service inclusion empowers customers to self-determine their life and future. The purpose of this research was to explore the lived experience of secondary school students experiencing vulnerability to better understand how they are motivated, provided opportunities, and able to engage in value co-creation in a mass public education service to improve their service inclusion. This research answers Fisk and colleagues’ (2018) call for research to explore design for service inclusion, and Raciti et al. (2024) call to undertake more qualitative research using co-design methods in school-based educational contexts to meaningfully progress SDG4. By conducting research with a hard-to-reach sample of students attending public secondary school while demonstrably experiencing socioeconomic disadvantage, this research provides insight into how co-creation can be used as tool in public secondary education to uplift wellbeing and enhance educational outcomes for all.
RQ1 was addressed by finding that these customers are highly motivated to co-create different elements of the service. This motivation is driven by participants’ innate interests, curiosity, and desire for freedom in their secondary education. Opportunities to co-create an inclusive service afforded these customers a strong sense of agency, fuelled by choice, autonomy, decision-making, voice, and interdependence with the service provider. Unfortunately, the opportunity to co-create was impeded by a range of micro-, meso-, and macro-level barriers, as well as asymmetrical power distribution. However, customers perceive they are competent to co-create when drawing on past practices and being facilitated by structure freedom. Beyond having a desire, opportunity and capability to co-create an inclusive service, customers need to feel a sense of belonging to the service. RQ2 was addressed by the finding that co-creation leads to strong levels of engagement in this context with customers experiencing cognitive, affective, and behavioural engagement from co-creation activities. Overall, this research provides empirical evidence of how the first two service inclusion pillars proposed by Fisk and colleagues (2018) − enabling opportunities and offering choices − might be realised in a transformative service context.
5.1 Theoretical contributions
This research makes three key theoretical contributions to service inclusion, which aims to provide “fair access to a service, fair treatment during a service and fair opportunity to exit a service” (Fisk et al., 2018, p. 842). Firstly, most of the existing literature on service inclusion within TSR is highly conceptual (Fisk et al., 2018, 2023) and presents limited empirical investigation of the proposed tenets of the field. Fisk and colleagues (2018, 2023) propose that service inclusion comprises four pillars, beginning with enabling opportunities and offering choice. This research advances our theoretical understanding of service inclusion by empirically investigating two of the foundational conceptual arguments of service inclusion: that inclusion is facilitated by enabling opportunities and offering choice to customers experiencing vulnerabilities. Our findings demonstrate that when opportunity is enabled, customers experiencing vulnerability demonstrate a sense of agency. This agency stems from enacting choice, autonomy, decision-making, voice, and interdependence with the service provider. Our findings show that enabling opportunities and offering choice may not be separate pillars of service inclusion, but rather deeply intertwined concepts promoting agency.
Secondly, service inclusion aims to empower customers to live fully in society and exercise their right to self-determination (Fisk et al., 2018). We consequently used the MOA (Rothschild, 1999) framework as a strengths-based performance model to examine individuals’ desire, opportunity, and capability to perform co-creation behaviour. This novel operationalisation of a strengths-based approach to vulnerability (Raciti et al., 2022) demonstrates that intrinsic motivation, agency, and perceived competence are necessary (but not sufficient) strengths that customers experiencing vulnerability engage to co-create an inclusive service. Alongside these strengths, customers experiencing vulnerability need to feel a sense of belonging to exercise their right to self-determination. The process of co-creation, given it is the resource integration by multiple actors (Vargo and Lusch, 2011; Zeithaml et al., 2020), is inherently social and thus requires a sense of belonging for it occur. Furthermore, the absence of belonging − exclusion − can create barriers to co-creation.
Thirdly, this research deepens our understanding of service captivity (Rayburn, 2015) by examining how co-creation might minimise the effects of captivity on customers experiencing vulnerability using mass services. Public education is a transformative service by nature (Russell-Bennett et al., 2024), but compulsory mass public services such as education are likely to be perceived as “constrained regarding choice, voice, and power during service provision” (Rayburn et al., 2024, p. 414). This research demonstrates that co-creation is a useful tool to manage the challenges of perceived captivity by allowing customers agency to co-create their service using a range of co-creation practices within structured freedom to enhance the inclusion of the service. Consequently, the effective use of co-creation in captive services can enhance the wellbeing of customers, even when captivity remains.
5.2 Managerial contributions
From a managerial perspective, this research has important implications for practitioners looking to co-create inclusive services by drawing on the strengths of customers experiencing vulnerability. These implications are particularly useful for managers in public sector and social services who are targeting adolescents and other young customers, especially in situations where these young customers may perceive captivity. Firstly, practitioners need to decouple existing disengagement from a lack of intrinsic motivation to co-create future services. While some students are demotivated to co-create their education due to alternate goals, low perceived activity value, or failure avoidance (Martin, 2003), students from lower socioeconomic backgrounds are innately interested, curious, and capable of co-creating for service inclusion. Using inclusive service practices, such as value co-creation, facilitates positive future customer engagement.
Secondly, micro-level practitioner resistance needs to be addressed given that service inclusion can be undertaken in mass public services such as public secondary education. Practitioners could consider how to provide meso-level opportunities for customers experiencing vulnerability to co-create to authentically design inclusive public services that meet the needs of all customers. The results of the research show that there are multiple touchpoints in public secondary education that would allow such opportunities to be implemented while meeting regulatory requirements.
Educators, however, cannot be expected to know how to effectively co-create an inclusive service without explicit pedagogical and regulatory support. Therefore, it is recommended that policy amendments are made to support teachers and school leaders implementing co-creation in public secondary schools. State and national education bodies could provide professional learning to school leaders about how to lead the implementation of co-creation in public secondary schools. Furthermore, a co-creation framework could be developed by a state or national education body to support schools with implementation. Finally, Initial Teacher Education programmes provided by universities should include co-creation as part of their curriculum to ensure new graduates understand how co-creation can be implemented.
Thirdly, practitioners need to be aware that belonging is a key facet of co-creating for service inclusion. Although teachers might struggle with customer misbehaviour in learning environments, feelings of respect and relatedness draw students into more functional interactions with their teachers. Students experiencing vulnerability are particularly susceptible to violations of intrinsic dignity (Palmer and Hedberg, 2013) and require belonging to insulate themselves from further vulnerability.
While these managerial contributions are focused on the mass utilitarian service of public secondary education, we believe these findings make a useful contribution beyond public secondary education. This research provides insight into how service providers could enhance engagement through co-creating inclusive services in other mass utilitarian services targeted at young consumers who may be experiencing service captivity. Transformative youth services focusing on preventing homelessness, rehabilitating criminal offenders, preventing recidivism, and preventing or minimising drug use might all be consumed by young people experiencing vulnerability. These services are often captive, undertaken with limited or no choice of service provider and potentially be legally mandated in some cases. Regardless of their transformative nature, the perception of captivity in these services can lead to a high level of resistance from consumers, or the pursuit of alternative goals, in the same manner as public secondary education. Co-creating these services to ensure service inclusion would be beneficial in enhancing engagement and allowing young consumers to fully realise the benefits of these services.
5.3 Limitations
This study has three main limitations. The first limitation of the research is that only a single public secondary school in Australia was used for data collection. The choice to focus on this public secondary school, where students exhibit higher levels of educational disadvantage than average (Australian Curriculum, Assessment and Reporting Authority, 2018) and come from a community in the lowest decile (lowest 10%) of socio-economic advantage (Australian Bureau of Statistics, 2018), was made to examine social inclusion and TSR in a school where it was genuinely meaningful to do so. We believe, however, that the findings from this research are likely to apply to customers experiencing vulnerabilities in other captive services in low socioeconomic contexts such as nursing homes, detention centres, and addiction treatment facilities. The second limitation of the research was that the study focused on the lived experience of secondary school students experiencing vulnerability and thus did not collect data from service providers (e.g. teachers, heads of department, principals) or governing bodies (e.g. State Government Department of Education). While multiple stakeholder perspectives would triangulate our findings and make them more robust, our aim was to provide a focused exploration of co-creating inclusive services from the perspective of a customer experiencing vulnerability. The third limitation of the research was the potential self-report bias that may have occurred in the study. This research required participants to self-report school attendance within the context of their socioeconomic status. The self-reported data on attendance was easier to collect but may be inflated due to social desirability or recall bias.
5.4 Future research
The research presented provides an empirical understanding of how co-creation can be used in public services to design more inclusive services for young customers experiencing vulnerability while undertaking secondary education. The results present a strong qualitative foundation for future research to be conducted. There are four key avenues for future research in this area. Firstly, additional studies could be conducted to understand if less vulnerable young customers or students from private/non-government schools would conduct co-creation activities in the same manner. Secondly, future research could combine the perspectives of students with the perspectives of other actors such as teachers and school leadership teams to improve the robustness of the research and shed light on the challenges of implementing co-creation. Thirdly, co-creation could be explored in other mass public services to understand if these findings are generalisable across (often captive) public sector services that young customers experiencing vulnerability may interact with, such as youth services for homelessness, alcohol and drug use prevention/minimisation, and recidivism. Fourth, additional further research using quantitative designs would be beneficial to provide further insight into co-creation and customer engagement in education services. Experimental design would allow researchers to manipulate particular aspects of the service design to see how best to co-create inclusive services, which would provide greater insight into this phenomenon. Alternatively, further qualitative research using participatory action research would be useful to evaluate the success of any implementation of co-creation in this service context.
