Co-design Approach Research Articles

Development of the Huntington Support App (HD-eHelp study): a human-centered and co-design approach.

eHealth seems promising in addressing challenges in the provision of care for Huntington's disease (HD) across Europe. By harnessing information and communication technologies, eHealth can partially relocate care from specialized centers to the patients' home, thereby increasing the availability and accessibility of specialty care services beyond regional borders. Previous research on eHealth (development) in HD is however limited, especially when it comes to including eHealth services specifically designed together with HD gene expansion carriers (HDGECs) and their partners to fit their needs and expectations. This article describes the qualitative human-centered design process and first evaluations of the Huntington Support App prototype: a web-app aimed to support the quality of life (QoL) of HDGECs and their partners in Europe. Prospective end-users, i.e., HDGECs, their partners, and healthcare providers (HCPs), from different countries were involved throughout the development process. Through interviews, we captured people's experiences with the disease, quality of life (QoL), and eHealth. We translated their stories into design directions that were further co-designed and subsequently evaluated with the user groups. The resulting prototype centralizes clear and reliable information on the disease, HD-related news and events, as well as direct contact possibilities with HCPs via an online walk-in hour or by scheduling an appointment. The app's prototype was positively received and rated as (very) appealing, pleasant, easy to use and helpful by both HDGECs and partners. By involving end-users in every step, we developed a healthcare app that meets relevant needs of individuals affected by HD and therefore may lead to high adoption and retention rates. As a result, the app provides low-threshold access to reliable information and specialized care for HD in Europe. A description of the Huntington Support App as well as implications for further development of the app's prototype are provided.

Co-design knowledge mobilization tools for universal accessibility in municipalities.

Modern research teams are re-evaluating conventional methods with the aim of improving the usefulness of knowledge for users, focusing on the role of knowledge users in shaping innovation. In disability field, encouraging participatory research inherently involves diverse perspectives and inclusion, which aligns with the principles of universal accessibility. By actively involving individuals with various backgrounds, abilities, and needs in the research process, we can better understand and address the challenges faced in adopting universal accessibility. This approach ensures that solutions are more comprehensive, inclusive, and effectively cater to the needs of all individuals, fostering a more equitable and accessible environment for everyone. Despite municipal organizations mandating universal accessibility action plans, they lack tools for efficient implementation. The aim of this study was to develop knowledge mobilization tools tailored to a specific municipal context in Quebec, Canada, to facilitate the implementation of universal accessibility measures by municipal employees. The co-design process employed in this study was organized into four distinct stages, following the Morales model: (1) Exploration (2) Co-Design (3) Validation (4) Development. Stages one and two highlighted the employees' lack of awareness about universal accessibility issues and their need to have more information and resources about how universal accessibility is encountered in their work. A steering committee co-designed three video vignettes about universal accessibility, the city's action plan and measures included in it. The co-design approach used in this study allowed us to observe the non-linear nature of partnership research with an organization as complex as a municipality. Our study shows significant advantages of collaboration between the municipal sector and research.

Design and implementation of deep learning-based object detection and tracking system

Many human tracking methods by deep learning rely on powerful computing resources. For embedded platforms with limited resources, efficient use of resources is a priority. In this paper, we design an object detection and tracking system based on deep learning methods. We propose an efficient system with software and hardware design. We apply the framework of Vitis AI and its Deep Learning Processing Unit using a hardware/software co-design approach. This approach capitalizes on a higher-level acceleration design framework, where the convolutional models can be updated more flexibly and rapidly. This design approach not only provides a fast design flow but also has good performance in terms of throughput. We facilitate the design and accelerate the object detection model YOLO v3 to achieve higher throughput and energy efficiency. Our tracking method achieves a 1.27x improvement in processing speed with the addition of a single-object tracker. Our proposed human tracking methods can achieve better performance than the others in precision with the same test sequences.

An exploration of agency enactment in e-portfolio learning co-design

Although research has always related e-portfolios to self-regulated learning, recently agency, which includes individual, relational, and contextual domains, has also been highlighted. Likewise, agency has been explored in technological environments that support collaborative and co-design learning processes. This study, investigating the enactment of student agency within e-portfolio learning co-design in secondary education, focuses on how students perceive their agency within a co-design e-portfolio learning framework, which was coined as the Co-PIRS model in previous stages of research. Among the findings, it can be argued that students report a greater awareness of agency, characterized by competence beliefs (individual domain) in the showcase phase of e-portfolios, peer learning (relational domain), and the opportunities to make choices (contextual domain) in the implementation phase. The study also reveals students' positive attitudes towards reflection, which suggests the suitability of structuring collaboration in the co-design approach. These insights serve as a foundation for implementing e-portfolio co-design frameworks to empower students’ agency and provide educators with guidance.

Greenspace & Us: Exploring co-design approaches to increase engagement with nature by girls and young women

Nature connection through engagement with greenspaces plays an important role in promoting well-being. In England, certain groups, such as girls and young women from disadvantaged backgrounds, have limited access to high-quality greenspaces and face other barriers to engaging with nature. In Oxfordshire, the County Council has committed to improving access to greenspace and nature for all. In 2022, a group consisting of twenty girls and young women (aged 10–16) from East Oxford not-for- profit organisations, academic institutions and public bodies came together to start an initiative called ‘Greenspace & Us’. The girls and young women participated in six three- hour workshops in February to March 2022. Using the COM-B (Capability, Opportunity, Motivation, Behaviour) approach, we explored the enablers and barriers to girls and young women in Oxford engaging more with nature, which included: increasing equity of access; introducing meaningful co-production; taking safety concerns seriously; making nature normal; promoting the right to play; and increasing the ability to connect with greenspaces.The outputs of this process were synthesised into the ‘Greenspace & Us Manifesto’, which was crafted collectively. Furthermore, these insights were used to design inclusive park furniture, which was later installed in a local park in East Oxford. In this practice-based article, we outline the methods, outcomes as well as the strengths and weaknesses of the engagement, co-design and co-production approaches we used in Greenspace & Us. We hope the insights from our project will support more inclusive and equitable design of greenspaces for all.

Electro-thermal co-design of a variable pole toroidal induction motor

The United States Department of Energy targets an 88 % reduction in motor and power electronics volume by the year 2025 while minimizing or eliminating magnet usage. Induction machines are a magnet-free alternative with advantages such as low cost, high reliability, and capability of withstanding high short-term overload. To meet these societal goals, we develop an induction machine that uses an electro-thermal co-designed converter-integrated thermal management approach. The machine utilizes toroidal windings in the stator, and an 18-phase power converter to achieve 40 kW/L power density. An optimized jacket design was developed to enable the effective thermal management of the stator and integrated power electronics. The toroidal winding configuration provides advantages for thermal performance over conventional distributed windings due to an increased winding copper surface area without reducing slot-fill factor, thereby allowing for a higher stator density. The improved thermal performance of the toroidal winding design was verified using three-dimensional conjugate computational fluid dynamic simulations. A reduced-order transient model was then developed to generate torque-speed-temperature plots at various load conditions. The transient thermal analysis was extended to verify safe operation of the motor during a typical drive cycle for the desired application. The thermal design models developed in this work are robust and scalable to other motor sizes providing a framework for co-designing and developing thermal management systems for electric motors.

Tailoring communication practices to support effective delivery of telehealth in general practice

BackgroundThe unprecedented increase in telehealth use due to COVID-19 has changed general practitioners’ (GP) and patients’ engagement in healthcare. There is limited specific advice for effective communication when using telehealth. Examining telehealth use in practice in conjunction with perspectives on telehealth as they relate to communication allows opportunities to produce evidence-based guidance for optimal use of telehealth, while also offering practitioners the opportunity to reflect on elements of their communicative practice common to both styles of consultation. The objective of this research was to develop evidence-based resources to support effective, person-centred communication when GPs and patients use telehealth. This included examination of interactional practices of recorded telehealth consultations, exploration of GP and patient perspectives relating to telehealth, and identifying priorities for guidance informed by these analyses as well as participant co-design.MethodsThis study involved recording telehealth consultations (n = 42), conducting patient surveys (n = 153), and interviewing patients (n = 9) and GPs (n = 15). These were examined using interaction analytic methods, quantitative analysis, and thematic analyses, to create a robust, integrated picture of telehealth practice and perspectives. The process of research translation involved a co-design approach, engaging with providers, patients, and policy makers to facilitate development of evidence-based principles that focus on supporting effective communication when using telehealth.ResultsThree key themes relating to communication in telehealth were identified across the different analyses. These were relationship building, conversational flow, and safety netting. The draft best practice principles drawn from these themes were modified based on co-design feedback into five Best Practice Principles for Communication between GPs and Patients using Telehealth.ConclusionsEffective communication is supported through relationship building and attention to conversational flow in telehealth consultations, which in turn allows for safety netting to occur. In telehealth, GPs and patients recognise that not being co-present changes the consultation and use both intuitive and strategic interactional adjustments to support their exchange. The mixed-method examination of experiences through both a detailed analysis of telehealth consultations in practice and comparative exploration of GP and patient perspectives enabled the identification of principles that can support effective communication when using telehealth. Co-design helped ensure these principles are ready for implementation into practice.

Codesigning youth diversion programmes with community-led organisations: a case study

Background:We explore the feasibility of applying methods of participatory codesign to collaborative service development with community-led youth diversion programmes. Collaborative partnerships can support wealth redistribution and community mobilisation, a goal of governments aiming to implement equity-focused policy. There is little systematic exploration of methods aiming to structure the relationship between government and community-led programmes as part of youth criminal-legal diversion efforts. Methods:We use case study methodology to assess the feasibility and impact of a curriculum codesign approach between a university research team and two community-led organisations providing diversion services through a county juvenile court. The codesign method was informed by participatory design and use of research evidence frameworks. Findings:The analysis focuses on the feasibility of the approach from the perspective of the university research team and community organisations as well as how well the approach successfully navigated critical components of participatory process, including shared power, deference to community vision and values, and a valued end product. We conclude that the approach was generally feasible as a quality improvement strategy and well-received by the community-led organisations. Discussion and conclusions:Codesign is a promising strategy for reconciling public administration and health equity goals. The approach used in this case study adds to a small literature on methods of using codesign as a quality improvement process with applications for government contracting and monitoring, programme development and capacity-building.

Development of an animal health testing tool to reduce antimicrobial use on farms: perceptions, implications, and needs of Irish dairy farmers and farm veterinarians

BackgroundThe threat of antimicrobial resistance is triggering the need for behavioural change towards antimicrobial use on Irish farms. Newly introduced veterinary medicine regulations are mandating the restricted and more prudent use of antimicrobials in the animal health sector. The need to reduce antimicrobials has placed a greater emphasis on the importance of animal health testing, however, issues with current testing practices are affecting diagnosis and subsequent drug usage. There is potential for digital technologies to address these issues and reduce antimicrobial use on farms, however, for these tools to be successful, they would need to be developed in collaboration with future end users.ResultsUsing qualitative approaches (focus groups), this study engages with dairy farmers and farm veterinary practitioners to detail current challenges with animal health diagnosis and to explore the initial development of a rapid, on-farm animal health testing tool to address these challenges. Issues with timing and testing, the role of knowledge and experience, and veterinarian availability all affect the ability of farmers and veterinarians to diagnose animal health issues on farm. These issues are having negative implications including the increased and unnecessary use of antimicrobials. An on-farm testing tool would help mitigate these effects by allowing veterinarians to achieve rapid diagnosis, facilitating the timely and targeted treatment of animal illnesses, helping to reduce overall antimicrobial use on farms. However, engagement with end users has highlighted that if a tool like this is not developed correctly, it could have unintended negative consequences such as misdiagnosis, increased antimicrobial use, challenges to farmer-veterinarian relationships, and data misuse. This study outlines initial end user needs and requirements for a testing tool but suggests that in order to successfully design and develop this tool, co-design approaches such as Design Thinking should be applied; to mitigate future negative impacts, and to ensure a testing tool like this is designed specifically to address Irish dairy farmers and farm veterinarians’ values and needs, ensuring responsible and successful uptake and use.ConclusionsDigital tools can be effective in reducing antimicrobial use on farms, however, to be successful, these tools should be designed in a user centred way.

Meaningful consumer involvement in cancer care: a systematic review on co-design methods and processes.

Although the benefits of consumer involvement in research and health care initiatives are known, there is a need to optimize this for all people with cancer. This systematic review aimed to synthesize and evaluate the application of co-design in the oncology literature and develop recommendations to guide the application of optimal co-design processes and reporting in oncology research, practice, and policy. A systematic review of co-design studies in adults with cancer was conducted, searching MEDLINE, CINAHL, Embase, and PsycINFO databases and included studies focused on 2 concepts, co-design and oncology. A total of 5652 titles and abstracts were screened, resulting in 66 eligible publications reporting on 51 unique studies. Four frameworks were applied to describe the co-design initiatives. Most co-design initiatives were designed for use in an outpatient setting (n = 38; 74%) and were predominantly digital resources (n = 14; 27%) or apps (n = 12; 23%). Most studies (n = 25; 49%) used a co-production approach to consumer engagement. Although some studies presented strong co-design methodology, most (n = 36; 70%) did not report the co-design approach, and 14% used no framework. Reporting was poor for the participant level of involvement, the frequency, and time commitment of co-design sessions. Consumer participation level was predominantly collaborate (n = 25; 49%). There are opportunities to improve the application of co-design in oncology research. This review has generated recommendations to guide 1) methodology and frameworks, 2) recruitment and engagement of co-design participants, and 3) evaluation of the co-design process. These recommendations can help drive appropriate, meaningful, and equitable co-design, leading to better cancer research and care.

Identifying research priorities and essential elements of palliative care services for people facing malignant brain tumors: A participatory co-design approach.

Primary malignant brain tumors (ie, brain cancer) impact the quality of life (QoL) for patients and care partners in disease-specific ways involving cognition and communication. Palliative care (PC) addresses patient/care partner QoL, but it is not known how PC may address the unique needs of brain cancer patients. The purpose of this project was to identify brain cancer PC research priorities using participatory co-design methods. Participatory co-design included the formation of a longitudinal, collaborative advisory group, engagement frameworks, design-thinking processes, and social media-based engagement over a 1-year period. Community-identified brain cancer QoL needs and research priorities were mapped to proposed "essential elements" of brain cancer PC services. We engaged an estimated 500 patients, care partners, healthcare professionals, and others with an interest in QoL and PC services for people with malignant brain tumors. Research priorities included testing the early introduction of PC services designed to address the unique QoL needs of brain cancer patients and care partners. Essential elements of brain cancer PC include: (1) addressing brain cancer patients' unique range of QoL needs and concerns, which change over time, (2) tailoring existing services and approaches to patient needs and concerns, (3) enhancing the involvement of interprofessional care team members, and (4) optimizing timing for PC services. This was the first participatory research effort exploring brain cancer patient and care partner QoL needs and PC services. The brain tumor community calls for research testing PC service models for patients that incorporate the "essential elements" of palliative care.

Perceptions of patients towards oral health care in a spinal cord injury rehabilitation unit: A qualitative study.

Individuals with spinal cord injuries (SCIs) are at an increased risk of poor oral health compared to the general population. However, little is known about the related barriers and facilitators experienced by these individuals within the hospital setting. Understand the oral health knowledge, attitudes and practices of people with SCIs, barriers and facilitators to managing their oral health, and recommendations to improve oral care at acute/rehabilitation hospital settings. Semi-structured interviews were conducted with 11 participants, from a major metropolitan hospital in Sydney, Australia. The interviews were thematically analysed. Three themes were constructed. Participants believed that the onus was on them to manage their oral health. Individuals also had limited knowledge of its importance to general health, and placed a lower priority on oral health compared to other aspects of health. All participants identified a combination of factors, such as cost, time, resources and prior negative experiences, that contributed to the neglect of their oral care. Participants also discussed the need of support from the multidisciplinary team and family/carers to facilitate oral care and identified various appropriate oral health education formats. This study highlighted some areas where oral health knowledge among people with SCIs could be improved. It also identified the need for oral health training for the multidisciplinary team, as well as carers, to better integrate oral care during rehabilitation in the hospital. The development of oral health interventions would need to utilise a co-design approach to best support clients and their carers to facilitate oral care self-management.

Optimizing support before and after Cardiac Resynchronization Therapy implantation in co-creation with patients with heart failure, informal caregivers and healthcare professionals.

To optimize support by healthcare professionals to enhance physical activity, HF-related symptom monitoring and management in patients with heart failure before and after cardiac resynchronization therapy (CRT) implantation in co-creation with patients, informal caregivers, and healthcare professionals. A qualitative and co-design approach was used to develop support strategies collaboratively with end-users. Seventeen semi-structured interviews were conducted to explore patients' expectations and factors influencing physical activity and symptom management. The qualitatively obtained insights informed the development of support strategies using an ideas group with patients, informal caregivers, and healthcare professionals.Four themes emerged from the interviews: 1. Expecting and hoping to regain energy and fitness; 2. Difficulties and opportunities to become more active; 3. Impact of CRT on sense of safety; and 4. Dealing with continuing bothersome symptoms. Several strategies were brainstormed, prioritized and prototyped, including optimization of CRT information, a peer contact list, expansion of the post-CRT implantation consultation to ask questions and share concerns, and a group meeting with peer patients, partners, and healthcare professionals. Patients expected and hoped to have positive effects from CRT, but not all patients experienced improvement after CRT. To improve patients' physical activity, feelings of insecurity, symptom monitoring, and thoughtful response to symptoms, support must include providing information and support to increase their knowledge and discuss experiences and physical and mental concerns.

AI-Generated Art in Art Therapy: Insights from Art Therapists Using a Mixed Methods Approach.

With the increasing integration of Artificial Intelligence (AI) into various aspects of daily life, there is a growing interest among designers and practitioners in incorporating AI into their fields. In healthcare domains like art therapy, AI is also becoming a subject of exploration. However, the use of AI in art therapy is still undergoing investigation, with its benefits and challenges being actively explored. This study aims to investigate the integration of AI into art therapy practices to comprehend its potential impact on therapeutic processes and outcomes. Specifically, the focus is on understanding the perspectives of art therapists regarding the utilization of AI-assisted tools in their practice with clients, as demonstrated through the presentation of our prototype consisting of a deck of cards with words covering various categories alongside an AI-generated image. Employing a co-design approach, ten art therapists affiliated with the American Art Therapy Association participated in this study. They engaged in individual interviews where they discussed their professional perspectives on integrating AI into their therapeutic approaches, evaluating the prototype. Qualitative analysis was conducted to derive themes and insights from these sessions. The study began in August 2023, with data collection involving 10 participants taking place in October 2023. Our qualitative findings provide a comprehensive evaluation of the impact of AI on facilitating therapeutic processes. The combination of a deck of cards and the utilization of an AI-generated tool demonstrated an enhancement in the quality and accessibility of therapy sessions. However, challenges such as credibility and privacy concerns were also identified. The integration of AI into art therapy presents promising avenues for innovation and progress within the field. By gaining insights into the perspectives and experiences of art therapists, this study contributes knowledge for both practical application and further research.

Co-designed dual-ambient energy harvester hydrogel for hydrogen production and electricity generation

In the quest to scavenge and convert environmental energy into useable green power, the development of materials that can efficiently harvest from multiple ambient energy sources remains challenging. Essentially, the reconciliation of differing material and structural requirements necessary for distinct functionalities is still a significant obstacle. In this work, a co-design approach has been taken to tailor a hydrogel capable of meeting the specific demands of two energy conversion processes; solar-induced hydrogen generation and evaporation-induced electricity generation. Specifically, Cu-doped ZnS photocatalysts integrated into a chitosan matrix, featuring internally aligned channels, not only facilitate mass transport but also significantly enhances the hydrogel’s photochemical and electrokinetic properties. Dual functionality is attainted through the harmonious combination of light absorption, charge separation, and fluid transport features within a unified material system, embodying a balance between the photophysical reactions for hydrogen production and the capillary flow essential for electricity generation through the streaming potential phenomenon. Finally, the real-world environmental demonstration achieved a hydrogen generation rate of 17.3 mmol m−2 h−1 under natural sunlight irradiation and a potential output of 192.8 mV. Overall, this study demonstrates strategies applicable to designing other ambient energy harvesters with the potential to convert disparate renewable energy sources for sustainable energy production.

Mobilizing exercise recommendations for people with bone metastases: An experience-based co-design approach.

e23241 Background: People with bone metastases have historically been advised to limit exercise due to potential risks, such as fractures. Although published exercise recommendations by the International Bone Metastases Exercise Working Group emphasize regular exercise may benefit people with bone metastases, adopting guidelines into clinical practice remains challenging. Our study aims to use an experience-based co-design (EBCD) approach to collaborate with knowledge users (KUs) to develop knowledge mobilization (KM) products and a dissemination plan to promote the adoption of exercise recommendations for people with bone metastases. Methods: Three KU groups participated in EBCD: patient/family partners, oncology healthcare providers (e.g., physicians, nurses, allied health), and community-based exercise professionals (e.g., physiotherapists, exercise physiologists). Through four facilitated meetings, KM products were co-created and a dissemination strategy was planned. A survey of exercise professionals was used to collect further information on professional development (PD) preferences. Results: Twenty-nine KUs from five Canadian provinces participated (n = 10 patient/family partners, n = 9 healthcare providers, and n = 10 exercise professionals). KM products prioritized for co-development were: 1) a patient education handout; 2) patient education videos; 3) a clinical communication tool; and 4) PD resources for exercise professionals and healthcare providers. Finalized KM products will be presented at the meeting. A total of 183 international exercise professionals completed the PD survey, with 80% indicating that more PD resources were needed for bone metastases, focusing on exercise safety, feasibility, and prescription considerations. The dissemination plan will involve partnerships with Canadian and international organizations. Conclusions: Collaborating with KUs through EBCD may enhance KM product development and maximize utility and acceptability compared to researcher-designed products. Our KM products, tailored to support people with bone metastases to exercise safely, may also increase healthcare providers' and exercise professionals' satisfaction by improving the quality of information they can offer patients. A fulsome evaluation is planned to assess the reach, use, and partnership indicators of the KM products and dissemination plan.

Experimental and CFD analysis of a floating offshore wind turbine under imposed motions

The rotor of a floating offshore wind turbine experiences intricate aerodynamics due to significant motion in the floating foundation, necessitating a holistic understanding through a synergistic blend of experimental and numerical methodologies. This study investigates rotor loads and the emergence of unsteady phenomena for a floating offshore wind turbine under motion. The approach compares a wind tunnel experimental campaign on a moving scale model with large-eddy simulations. Importantly, both experimental and numerical setups were co-designed simultaneously to match conditions and allow a fair comparison. The experimental setup features a 1:148 scale model of the DTU 10MW reference wind turbine on a six degrees of freedom robotic platform, tested in a wind tunnel. Numerically, the LES code YALES2, employing an actuator line approach undergoing imposed motions, is used. Harmonic motions on one degree of freedom in surge and pitch directions are explored at various frequencies. Thrust force variation aligns with quasi-steady theory for both numerical and experimental results at low frequencies. However, higher frequencies reveal the rise of unsteady phenomena in experiments. Large-eddy simulations, coupled with an actuator line approach, provide additional insights into the near- and mid-wake response to imposed motions. This co-design approach between numerical and experimental tests enhances the comprehension of aerodynamic behaviour in floating offshore wind turbines, offering valuable insights for future designs.

Empowering pharmacy professionals to enhance public health nutrition: a mixed methods study

Unhealthy dietary patterns stand as the foremost risk factor for noncommunicable disease- associated morbidity and mortality(1). As widely accessible healthcare providers, pharmacy professionals’ potential to catalyze improvements in public health nutrition is substantial, offering a means to combat the escalating epidemic of obesity and NCDs through tailored interventions, services, and education(2,3).Our study employed a mixed-methods approach to assess the role of pharmacy professionals in promoting nutrition advice and healthy dietary practices.An online questionnaire (N=200) was designed and conducted to evaluate pharmacy professionals’ nutrition knowledge, the advice given in various diet-related conditions (e.g. obesity, type 2 diabetes, cardiovascular disease risk factors, malnutrition, sustainable diets), practices in delivering diet- related guidance within their routine practice and perceived roles and future ambitions of pharmacy professionals towards nutrition counselling, yielding both quantitative and qualitative insights.Subsequently, qualitative interviews and focus group discussions (N=19) were conducted, engaging pharmacists, nutritionists and dietitians to gather insights essential for the development of a comprehensive nutrition toolkit tailored for pharmacy practice.These interviews delved deeper into the subject, with the goal of designing a nutrition toolkit that empowers pharmacists with the knowledge, tools, and resources needed to play a more active and impactful role in promoting nutrition and healthy lifestyle practices among their patients. Thematic analysis was conducted, and emerging themes and subthemes were identified.Our findings indicate that a significant portion of participants in our study are involved in providing nutrition and diet advice for various health conditions. The majority of pharmacists considered diabetes programmes having a high level of importance (84%), followed by weight management services (78%), hypertension management (86%), and healthy diet campaigns (63.5%). However, our knowledge and confidence rating questions revealed a significant gap in training and a clear need for educational materials tailored for pharmacists to enhance their ability to provide nutrition advice effectively. Key themes identified in open-text questions were referrals and collaboration, training and education needs, wider needs (changes in the public health system, materials/resources, integration and implementation of nutrition in pharmacy practice) and perceived roles as pharmacists in providing nutrition advice (patient support, feeling responsible, specialised focus areas).Qualitative findings underscore the pressing demand for nutrition training and education to deliver comprehensive services, as well as the necessity for collaborative efforts with dietitians and nutritionists to ensure effective care and the improvement of referral pathways in pharmacy practice.This research contributes to the advancement of public health nutrition by recognizing the potential role of pharmacy professionals as key players in the dissemination of nutrition knowledge and fostering healthy behaviours within the community. The results will guide us in the collaborative development of a nutrition toolkit tailored for pharmacy practice, employing a co-design approach.

A Small-Gain Co-Design Approach to Adaptive Neural Sampling Control for Uncertain Nonholonomic Systems

A Small-Gain Co-Design Approach to Adaptive Neural Sampling Control for Uncertain Nonholonomic Systems

Supporting healthy lifestyles for First Nations women and communities through co-design: lessons and early findings from remote Northern Australia.

The period before, during, and after pregnancy presents an opportunity to reduce diabetes-related risks, which in Australia disproportionately impact Aboriginal and Torres Strait Islander women. Collaboration with Aboriginal and Torres Strait Islander women/communities is essential to ensure acceptability and sustainability of lifestyle modifications. Using a novel co-design approach, we aimed to identify shared priorities and potential lifestyle strategies. We also reflected on learnings from this approach. We conducted 11 workshops and 8 interviews at two sites in Australia's Northern Territory (Central Australia and Top End), using experience-based co-design (EBCD) and incorporating principles of First Nations participatory research. Workshops/interviews explored participant' experiences and understanding of diabetes in pregnancy, contextual issues, and potential lifestyle strategies. Participants included three groups: 1) Aboriginal and Torres Strait Islander women of reproductive age (defined as aged 16-45 years); 2) Aboriginal and Torres Strait Islander community members; and 3) health/community services professionals. The study methodology sought to amplify the voices of Aboriginal women. Participants included 23 women between ages 16-45 years (9 with known lived experience of diabetes in pregnancy), 5 community members and 23 health professionals. Key findings related to identified priority issues, strategies to address priorities, and reflections on use of EBCD methodology. Priorities were largely consistent across study regions: access to healthy foods and physical activity; connection to traditional practices and culture; communication regarding diabetes and related risks; and the difficulty for women of prioritising their health among competing priorities. Strategies included implementation of a holistic women's program in Central Australia, while Top End participants expressed the desire to improve nutrition, peer support and community awareness of diabetes. EBCD provided a useful structure to explore participants' experiences and collectively determine priorities, while allowing for modifications to ensure co-design methods were contextually appropriate. Challenges included the resource-intensive nature of stakeholder engagement, and collaborating effectively with services and communities when researchers were "outsiders". A hybrid methodology using EBCD and First Nations participatory research principles enabled collaboration between Aboriginal women, communities and health services to identify shared priorities and solutions to reduce diabetes-related health risks. Genuine co-design processes support self-determination and enhance acceptability and sustainability of health strategies.