Co-Creating Health - Examining the Effects of Co-Creation in a Lifestyle Intervention Service Targeting Physical Activity

Karita Reijonsaari

Research output: ThesisDoctoral ThesisMonograph


Health behavior is an important determinant of an individual's health. The increase in chronic diseases in developed countries has been, to a large extent, caused by unhealthy, e.g., sedentary lifestyles. The results are unnecessary suffering and substantial cost to society. Lifestyle interventions as a service seek to co-create improved health behavior with individuals. The objective of using them is to prevent or manage chronic illness. Employers are gradually becoming more interested in investing in the health of their employees and are hoping to capture value from these investments. In this context, value refers to improved health and increased capability. As employers seek these goals, lifestyle interventions are being increasingly implemented in an occupational setting. However, there is limited evidence concerning their effectiveness. This research examines the effects of co-creation in lifestyle interventions targeting physical activity in an occupational setting. Co-creation of value in a service relationship has been widely discussed by service research, particularly in the domain of Service-dominant logic. Co-creation in the context of health, on the other hand, has received limited attention. This dissertation contributes to the discourse on Service-dominant logic and co-creation of health. It extends conceptual models on co-creation to account for the particular characteristics of a lifestyle intervention service context, as well as the role of an employer as a third party in co-creation. The empirical research was conducted as a randomized controlled trial examining the effects of co-creation in a physical activity intervention. The lifestyle intervention that was examined was found to be ineffective in changing health behavior: no effects of co-creation on physical activity were observed, nor were work-related outcomes of increased productivity or reduced sickness absence seen. This suggests that these types of interventions may not be as effective as popularly believed. This study demonstrates that although interaction takes place in a service relationship, value is not always co-created, and improved health and increased capability may not occur. Thus, co-creation is interaction, but not all interaction is co-creation. The results of this study highlight the idea that employer investments in lifestyle interventions should be based on evidence of their effectiveness in the specific context.
Translated title of the contributionTerveyden yhteisluonnin vaikutukset elämäntapainterventiossa
Original languageEnglish
QualificationDoctor's degree
Awarding Institution
  • Aalto University
  • Lillrank, Paul, Supervising Professor
  • Taimela, Simo, Thesis Advisor, External person
  • Helkkula, Anu, Thesis Advisor
Print ISBNs978-952-60-5131-4
Electronic ISBNs978-952-60-5132-1
Publication statusPublished - 2013
MoE publication typeG4 Doctoral dissertation (monograph)


  • co-creation
  • lifestyle
  • physical activity intervention
  • service
  • health outcome
  • capability
  • interaction
  • RCT
  • effectiveness

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