Designing and delivering youth mental health services for young people, with young people: what works? A protocol for a realist eDelphi study on effective co-production.

introductionResearch and mental health services agree that more youth co-production in service design and delivery is needed, but there is little consensus on how to do it well. This study is trying to find agreement about the best ways to do this. METHODS AND ANALYSIS: A realist eDelphi study will be conducted. People with experience of co-production and engagement in youth mental health services will be invited to participate. This will include young people with relevant lived experience, family members/carers of young people with mental ill health, youth mental health researchers and other professionals with experience of youth engagement work (eg, mental healthcare staff, mental health service managers and participation/engagement professionals in the sector). The target is to recruit 10-20 participants from each of these four groups (40-80 participants total).The following steps will be taken: (1) an advisory group of young people will use results from a realist literature review completed prior to this study, to generate the first list of items for the survey; (2) using the online survey tool Qualtrics, participants will be invited to rate these items in an online survey. A prompt question formatted using a realist framework will allow participants to comment on their rating and how this survey item works (or does not work) in this context, for young people or other stakeholders. Participants will be able to add further suggestions at this stage; (3) using Qualtrics, a second survey round will be completed which will include the new suggestions from participants, and original items with their average participant ratings and comments displayed. Participants will be asked to rerate items in this round; (4) a list of items will be generated that comprises survey items believed to be 'essential' or 'important' by 80% or more of the participants; (5) this list will be discussed with the Youth Advisory Group to generate a final recommendations document and consider creative outputs and dissemination methods. Data analysis will include raw numbers, means and frequencies. ETHICS AND DISSEMINATION: Ethical approval has been granted by the University of Birmingham Research Ethics Committee (Ref: ERN_1550-Apr2024). Both traditional and non-traditional outputs will be created (eg, conference presentations, publications, a plain English summary and social media infographics).