A large national technical assistance (TA) centre in the US provides TA to Head Start regions to help strengthen their use of implementation science frameworks. In administration of TA to regions, the centre has used a 'co-creation' model. Aims and objectives: This paper describes the co-creative TA approach, including level of dosage (frequency and duration) provided, and interim outcomes achieved. Methods: The descriptive paper relies on secondary data analyses of information gathered in the course of delivering the technical assistance. The information gathered included observations of events, surveys, and listening sessions with TA participants. Findings: Analyses revealed that the TA providers were successful in the provision of co-created TA and that interim outcomes of trust, mutual accountability, and some integration of implementation science concepts into ongoing regional work were achieved. Discussion and conclusions: The TA providers succeeded in delivering TA that was perceived by both observers and participants as involving participants and being tailored to their settings and needs. Limitations include a small sample that was selected based on interest and readiness for engaging in TA and descriptive analyses that did not allow for claims of causality. The promising co-creation approach deserves additional exploration and may provide guidance to others designing technical assistance.