Alyssa Clare Milton ^1,2,3* Kristin Ballesteros ⁴ Helen Hernandez ¹ Yenni Hwang ¹ Nick Glozier ^1,2 Tom Mcclean ⁴ Haley M LaMonica ³ Karen Thorpe ⁵ Ian B Hickie ³

• ¹ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
• ² ARC Centre of Excellence for Children and Families over the Life Course (Life Course Centre), Sydney, Australia
• ³ Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
• ⁴ Uniting NSW.ACT, Sydney, Australia
• ⁵ Science of Learning Research Centre, Brain Institute, University of Queensland, St Lucia, Queensland, Australia

There is scant research examining processes and practices that delineate how to include the voices of children in service design and delivery in School Age Care environments such as Outside of School Hours Care (OSHC). A possible structure to support children to have a meaningful voice in decision making is co-production; whereby children and their OSHC communities have the opportunity to co-plan, co-design, co-deliver and co-evaluate OSHC program activities. The Connect Promote and Protect Program (CP3) is a social connection and wellbeing program providing a structured method of co-producing with children, educators and their OSHC communities. To explore the response to a co-production approach in OSHC settings as part of participation in the CP3, we conducted qualitative interviews and focus groups with 12 OSHC staff (educators, coordinators, managers, volunteers) and 12 children attending OSHC as part of a wider mixed-methods implementation-effectiveness stepped wedge trial of CP3 in 12 OSHC services located in urban and regional areas of Australia. Participants undertook semi-structured interviews/focus groups (face-to-face, phone or video-conferencing platforms). A representative research team (including researchers, OSHC educators/ coordinators, OSHC administrators, clinicians, and parents of children in OSHC) used an inductive thematic analysis process. Two researchers undertook iterative coding using NVivo12 software, with themes developed and refined in ongoing team discussion. Nine sub-themes relating to child co-production and voice in CP3 were identified and organised into two super-ordinate themes: (1) Processes that enable child agency and voice; (2) The impact of child agency and voice. Process related sub-themes included: Co-production (ko-production) as a key driver; High quality programming practice in a demanding environment; Structure balanced with flexibility; The importance of being agile and having a willingness to adjust; and, Implementation factors supporting child voice. The impact related sub-themes included: Empowerment of children through meaningful engagement; We all have a role in the team; A spark through engagement and enjoyment; and, Being and belonging. This is the first known qualitative study to examine the use and impact of co-production processes in OSHC. The findings indicate that the co-production process provides a structured, yet flexible, way of supporting children's voice and leadership.