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Background:  Evidence-based guidelines provide clinicians with best practice recommendations but not the means to implement them. Although co-design is increasingly promoted as a way to improve implementation there is frequently insufficient detail provided to understand its contribution. The presented case study addresses this by providing a detailed account of how a specific co-design approach contributed to an improving back pain education project in line with national guidance.  Aim:  The aim was to use creative co-design to produce prototype evidence-based back pain educational resources that were sensitive to context.  Objectives:    Assemble a group of relevant stakeholders for a series of workshops.  Use creative activities that encourage divergent and convergent thinking to iteratively understand the problem and develop prototype solutions.  Thematically analyse outputs of each workshop to determine content of subsequent workshops.  Present a final prototype ready for implementation.   Key conclusions:    This approach produced an innovative system of thematically linked back pain educational resources that were contextually sensitive, evidence-based and ready for implementation.  Research knowledge was successfully blended with stakeholder experiential knowledge.  The creative methods helped diverse stakeholders develop trusting relationships and ensured everyone’s experiences and ideas were included.  The process of co-creation and the objects created had vital roles in surfacing and understanding stakeholder knowledge, promoting innovation and facilitating implementation.  The design process facilitated an evolving understanding of a complex problem alongside prototype development.  It is recommended that these methods be considered by other project teams.    Key messages    To bring about meaningful change, evidence-based guidelines need to be implemented in ways that are sensitive to context and the complexity of healthcare.   Co-production has the potential to produce better solutions but has its own challenges.   Creative co-design can be an effective approach for overcoming these challenges.

The creative co-design of low back pain education resources