Participatory Design Activities Research Articles

Development of a Lightweight Powered Wheelchair for Persons with Physical Disabilities Using a Participatory Action Design

Development of a Lightweight Powered Wheelchair for Persons with Physical Disabilities Using a Participatory Action Design

Extended Learning beyond Physical Schools in Rural Contexts in Uganda; a Case of Kyotera District

The period of Covid -19 pandemic unlocked many lessons and opened up the need to benchmark various interventions in the social setup, more so, the means to manage social services like education. Education is a right enshrined in article 26 (1) of the 1948 United Nations Human rights Declaration, and the Constitution of the Republic of Uganda (1995), particularly articles 30, 34(2) and objective XVIII. Uganda’s Vision 2040 asserts that, the education curriculum, examination and instruction methods should always be revised to suit the proposed changes in the education system as well as being responsive to the global demands. The COVID-19 lockdown which took almost two years, introduced non-formal learning through use of internet, radios and televisions but these did not favor rural settings. In Uganda, 55.2 percent of households have radios, 7.2 percent own televisions while 19 percent can access internet with ease. Basing on participatory action design laid on the social learning framework the assumption is that data becomes information only when filtered through a theory of reality that common data is set on the policy environment, yielding diverse political strategies and holding distinct practical programs for implementation if interpreted through different value filters. This intriguing reality led us to visit 25 out of 30 Local Council (LC) one (1) Chairpersons in Kyotera and Kasaali Town Councils and found that each received one copy of learning materials which could be accessed through photocopying yet 10 percent of the beneficiaries could comply. To address the challenge and using these materials, we organized a total of 168 audio lessons for primary one to six; and senior one to three classes which we recorded and saved on memory sticks. We drew a timetable of three hours a day throughout a week and louder speakers were mounted in 11 most rural villages in Kyotera District to deliver lessons. Through interviews conducted on visit of at least one home from a village and from political leaders, testimonies showed that learning took place. Head teachers interviewed [4] also confirmed the same We concluded that through recorded audio lessons, content can well be delivered at any time. We recommend that; Governments, institutions, teachers and other facilitators, should adopt the model to extend learning to beyond classrooms with audio lessons for future use in learning and revisions. This can be through transmission of lessons on simple memory sticks and discs. Stakeholders at all levels of education should be encouraged to appreciate existence of pre- developed lessons and lectures which Amy not require internet connection by teachers -Government Organizations should use the model and fund extension of learning in rural villages in order to affirmatively have all learners supplement on learning obtained from classrooms

Participatory design of augmented reality games for word learning in autistic children: the parental perspective

The use of participatory design (PD) to inform the design of games and learning technology seems to be appropriate for marginalized groups of people, including children with autism. However, specific traits of the autism phenotype can create a barrier in facilitating participation of autistic children during PD activities, especially when their verbal abilities are limited. Involving parents in PD projects can help address challenges related to the communication abilities of the children. We have facilitated the design augmented reality (AR) games by including four autistic children and 9 parents. We analyzed qualitative data using an inductive approach using affinity diagrams and thematic analysis. We present insights from the parents on the use of AR technology and how it can be incorporated at home to enhance word learning activities. We report on (1) a set of five games based on learning by repetition, learning by classification and learning by association; (2) novel insights and knowledge about learning strategies and (3) tools to support autistic children in learning new words. We conclude our study by discussing the relevance of involving parents of autistic children in PD activities, offering design implications.

Design Tensions in Online Freelancing Platforms: Using Speculative Participatory Design to Support Freelancers' Relationships with Clients

This paper explores the design challenges that arise in supporting online freelancers to navigate relationships with clients. Prior studies have shown that current platform designs can lead to worker precarity in freelancer-client relationships, such as power imbalances, information asymmetry, and labor abuse. To envision alternative designs that empower workers in managing their relationships with clients, we engaged 22 Upwork freelancers in participatory speculative design activities. Through this co-design process, we identified design tensions that constrain design options as a result of conflicting values and priorities that could only be balanced and compromised rather than completely resolved. Six design tensions were identified in the context of designing for four different phases of freelancing. We observed three patterns in these tensions: 1) the freelancers' need for client involvement in their tasks and career growth, which conflicted with their skepticism that clients had sufficient incentives to be involved; 2) that there was often no viable balancing option for some tensions, but they could be addressed through changes in the platform's incentive structure; and 3) some tensions occurred not only between freelancers and clients, but also within the freelancer community. We present three approaches for addressing these design tensions and discuss how this research can support more equitable and healthy freelancer-client relationships.

228 Investigating the Transitionary Process from Pediatric to Adult Care and Improving Transitional Readiness for Youth with Sickle Cell Disease (SCD) through Co-Designing an Intervention

OBJECTIVES/GOALS: The goal is to use a participatory design approach involving patients and healthcare providers to create an intervention aiming to improve the transition readiness of youth with sickle cell disease (SCD) when going from pediatric to adult care in Ontario. METHODS/STUDY POPULATION: The study employed a participatory design approach, utilizing co-design and community-consulted design practices. The co-design process involved three design sessions with 7 adult participants (3 with SCD, 3 with SCD working in healthcare, and 1 without SCD but working in healthcare) to actively involve them in designing an intervention that addressed their unmet needs. A thematic analysis of the first design session was conducted to gain insight into their experiences. The community-consulted design included three internal research team sessions to synthesize the participants' insights. Zoom was used for all sessions, and Miro as the online collaboration tool for participatory design activities, resulting in a prototype that reflected the collective input of the target users and the broader community. RESULTS/ANTICIPATED RESULTS: With the thematic analysis, one prominent theme emerged, labeled as 'Barriers to Successful Transition,' which consisted of four subthemes: 1) Lack of Education and Awareness; 2) Constraints in Healthcare Delivery, 3) Managing Multiple Transitions; and 4) Racial Bias in Healthcare. The word 'hospital' emerged as the most frequently mentioned word, following closely were the terms 'school,' 'person,' 'sickle cell disease,' and 'education.' This analysis underscores the crucial involvement of hospitals and healthcare providers in facilitating the transition of youth with SCD. Following the design sessions, the most desirable/feasible intervention was to create an accredited digital educational module for adult healthcare providers specifically focusing on youth transitioning with SCD. DISCUSSION/SIGNIFICANCE: 3,500 people in Ontario have SCD, with an average age of 24 years, where one-third are aged 14 or younger. Youth with SCD face unique challenges, so effective communication and comprehensive care coordination are needed from healthcare providers. The digital module will increase awareness and ultimately improve transition readiness.

When participatory design meets data-driven decision making: A literature review and the way forward

This study explores the impacts of participatory design (PD) on data-driven decision-making (DDDM) in organisations. Despite the extensive examination of PD and DDDM individually, there is a dearth of research in understanding their integration and their impact on decision-making processes in organisations. This research aims to fill this gap by investigating the potential impacts, challenges, benefits, and critical success factors associated with the incorporation of PD activities into DDDM. The study employs a systematic literature review methodology to provide a comprehensive understanding of the topic. The paper provides a research agenda for future researchers as well as discussing best practices for organizations seeking to optimise their data driven decision-making processes in a participatory manner. The research also discussed the ethical implications of data-driven decision-making. Ultimately, this research advances our understanding of how PD and DDDM can be effectively combined to achieve better decision-making outcomes.

“People are now working together for a common good”: The effect on social capital of participatory design for community-level sanitation infrastructure in urban informal settlements

Communities with higher levels of social capital perform better than communities with lower social capital in community-level water and sanitation interventions and have better health outcomes. Although research recommends bolstering social capital to improve intervention outcomes, few studies provide empirical evidence on the effect of intervention activities on social capital. This study aimed to evaluate the effect of participatory design and community engagement activities on social capital among urban informal settlements in Suva, Fiji and Makassar, Indonesia enrolled in the Revitalizing Informal Settlements and their Environments trial using the Short Adapted Social Capital Assessment Tool. We performed confirmatory factor analyses (CFA) to test tool performance and built structural equation models to assess intervention effect on CFA-informed, sub-scale scores for cognitive and structural social capital. Qualitative in-depth interviews in Fiji and Indonesia and focus group discussions in Fiji provided nuanced understanding of intervention effects on social capital from residents’ perspectives. Results confirmed the hypothesized two-factor solution but revealed differences by country and by gender in Indonesia. The intervention appeared positively related to cognitive social capital among men and women in Indonesia and negatively related to cognitive and structural social capital among men and women in Fiji. While effect sizes were small and cluster-adjustment for a small number of settlements yielded non-significant effects, trends were consistent across models and bivariate analyses and were corroborated by qualitative findings. Several contextual factors may explain these results, including timing and duration of intervention activities and influence of COVID-19. Qualitative data suggested that the relationship between participatory design and social capital may be bidirectional, helping to explain why certain settlements appeared to be better equipped to benefit from intervention activities. Practitioners and program designers should carefully consider the social pre-conditions of communities in which they intend to work to optimize program outcomes and avoid unintended consequences.

Key mechanisms of a gender and socially inclusive community engagement and participatory design approach in the RISE program in Makassar, Indonesia and Suva, Fiji

Globally, more than one billion people live in urban informal settlements and experience suboptimal access to safe water, sanitation and hygiene (WASH). Participatory approaches are increasingly being promoted in WASH interventions, but the key elements of these approaches are not well-defined. The Revitalising Informal Settlements and their Environments (RISE) program launched in 2017 uses a participatory approach to co-design water-sensitive infrastructure with residents of 24 urban informal settlements in Makassar, Indonesia and Suva, Fiji. Our objective was to identify key mechanisms of a gender and socially inclusive participatory approach for engaging diverse people in RISE. We conducted and analysed semi-structured in-depth interviews (IDIs) with 49 RISE program staff; IDIs with 29 residents from RISE settlements in Indonesia and Fiji; and 6 focus group discussions (FGDs) with RISE residents in Fiji in 2020–2021, after participatory design activities were complete. Resident participants were purposively selected for representation of women and men; high and low participation in RISE; and different levels of disability/impairment. The question guides were informed by the Consolidated Framework for Implementation Research (CFIR), which defines 39 constructs (grouped into five domains) that describe an intervention. The IDI and FGD transcripts were analysed thematically with deductive codes based on the CFIR. For each of the five CFIR domains, the construct that was most relevant to mechanisms for the engagement of diverse people was used for the final analysis. The findings identified several key mechanisms for engaging diverse residents in programs like RISE. Four of these are recommended for future implementation and scale-ups of RISE and similar programs: engaging with residents at the household level (and potentially the individual level); incorporating flexibility and adaptability throughout the program; having a diverse team; and maintaining regular contact and positive rapport between the staff and participants.

Sustainable Health and Wellness: Effectiveness of a Drama Therapy Program to Improve the Wellbeing of People Affected by Mental Health Decline

An increasing number of health professionals advocate for psychosocial attention as a vital part of treating mental health illnesses and not only a pharmacological intervention. Drama therapy offers a space where patients can improve socially, physically, and mentally, thus reaching a complete state of wellbeing. So, we aimed to design and evaluate a drama therapy program to develop assertiveness, quality of life, and social interaction in patients suffering from mental health decline. The study was performed under a participatory action design and a critical focus using a case study methodology that required a pretest–posttest and tracking of activities during the whole process. The results suggest that there was a rise in social interactions, an improvement in the quality of life and, significantly, assertiveness, perception of dependency, and isolation. The program improves the assertiveness of the participants and helps a person to feel less isolated and more independent. We conclude that the creation works help them to know themselves and favors their improvement.

Participatory Action Design and Engineering of Powered Personal Transfer System for Wheelchair Users: Initial Design and Assessment.

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users' perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers.

Connecting citizens through participatory design activities: Lessons from Kuala Lumpur, Malaysia

Construction of affordable housing in Malaysia has been one of the national objectives set by its government, ensuring low-income families have access to adequate housing. This paper discusses the perceptions and the needs of residents for the development of single-family housing units for low-income families in Kuala Lumpur, Malaysia based on the outcomes from participatory design activities in the city. As part of these activities, a series of six focus groups and participatory design workshops were conducted in Kuala Lumpur. The findings from these interactive sessions are to be used in the development of proposals for new housing in the city built for low-income families, advocating for consideration of the views of the residents in the design process.

Developing a Digital Medication Adherence Intervention for and With Patients With Asthma and Low Health Literacy: Protocol for a Participatory Design Approach.

Current eHealth interventions are poorly adopted by people with low health literacy (LHL) as they often fail to meet their needs, skills, and preferences. A major reason for this poor adoption is the generic, one-size-fits-all approach taken by designers of these interventions, without addressing the needs, skills, and preferences of disadvantaged groups. Participatory design approaches are effective for developing interventions that fit the needs of specific target groups; yet, very little is known about the practical implications of executing a participatory design project for and with people with LHL. This study aimed to demonstrate the application of participatory design activities specifically selected to fit the needs and skills of people with LHL and how these were manifested within an overarching eHealth design process. In addition, the study aims to present reflections and implications of these activities that could support future designers to engage people with LHL in their design processes. We used the design process of a smart asthma inhaler for people with asthma and LHL to demonstrate participatory design activities. The study was framed under 5 stages of design thinking: empathize, define, ideate, prototype, and test within 2 major iteration cycles. We integrated 3 participatory design activities deemed specifically appropriate for people with LHL: co-constructing stories, experience prototype exhibition, and video prototype evaluation. Co-constructing stories was found to deepen the understanding of the participant's motivation to use or not to use maintenance medication. This understanding informed and facilitated the subsequent development of diverse preliminary prototypes of possible interventions. Discussing these prototypes in the experience prototype exhibition helped provoke reactions, thoughts, and feelings about the interventions, and potential scenarios of use. Through the video prototype evaluation, we were able to clearly communicate the goal and functionality of the final version of our intervention and gather appropriate responses from our participants. This study demonstrates a participatory design approach for and with patients with asthma and LHL. We demonstrated that careful consideration and selection of activities can result in participants that are engaged and feel understood. This paper provides insight into the practical implications of participatory activities with people with LHL and supports and inspires future designers to engage with this disadvantaged target group.

Whom do we include and when? participatory design with vulnerable groups

ABSTRACT This article makes three contributions to participatory design (PD) research and practice with vulnerable groups: 1) a framework for understanding stakeholder engagement over the course of a PD project; 2) approaches to making user engagement and PD activities more inclusive; and 3) an analysis of how the design and power dynamics of PD projects affect vulnerable groups’ participation. A map of engagement is developed to evaluate stakeholder involvement from initial problem definition to design outcome. The map is applied to three projects aimed at increasing inclusion of vulnerable groups in the planning of public sector services. The first looks at codesign activities to support decision-making in the context of intellectual disabilities; the second looks at culturally diverse youth navigating crisis without adequate assistance from public services; and the third examines nursing students adapting to work in the health sector without accommodations for learning disabilities. Comparing the projects reveals patterns in project planning and execution, and in stakeholder relationships. The article analyses how users are defined, engaged and supported in PD; how proxies shape vulnerable groups’ involvement and PD projects as a whole; and opportunities for greater inclusion when the entire PD project is taken into account.

Integrated health system to assess and manage frailty in community dwelling: Co-design and usability evaluation.

We aimed to co-create and evaluate an integrated system to follow-up frailty in a community dwelling environment and provide a multi-modal tailored intervention. Frailty and dependency among the older population are a major challenge to the sustainability of healthcare systems. Special attention must be paid to the needs and particularities of frail older persons as a vulnerable group. To ensure the solution fits all the stakeholders' needs, we performed several participatory design activities with them, such as pluralistic usability walkthroughs, design workshops, usability tests and a pre-pilot. The participants in the activities were older people; their informal carers; and specialized and community care professionals. In total, 48 stakeholders participated. We created and evaluated an integrated system consisting of four mobile applications and a cloud server, which has been evaluated through a 6-months clinical trial, where secondary endpoints were both usability and user experience evaluation. In total, 10 older adults and 12 healthcare professionals participated in the intervention group using the technological system. Both patients and professionals have positively evaluated their applications. Both older adults and healthcare professionals have considered the resulted system easy to use and learn, consistent and secure. In general terms, they also would like to keep using it in the future.

"With a hint she will remember": Collaborative Storytelling and Culture Sharing between Immigrant Grandparents and Grandchildren Via Magic Thing Designs

The timeless social activity of passing down oral stories preserves family memory, identity, values, and culture. Existing tools for family memories often take a techno-determinist approach by focusing on the mechanics of connecting families and the resulting documentation, rather than the social process of sharing stories and morals, and largely without considering the specific needs of immigrant families. For immigrant families, cultural exchange, particularly crucial across grandparent and grandchild generations, is threatened by the language and cultural barriers emerging from displacement and migration. As a result, immigrant grandparents and their young grandchildren struggle with fostering social kinship, leading to social disconnect and loss of cultural heritage. In our research, we collaborate with multi-generational and culturally-at-risk immigrant families through Participatory Design activities towards the design of reminiscence tools that support their needs focusing on language and cultural connection. We report on the designs created by families and propose design guidelines supporting cultural resilience, focusing on flexible, visual storytelling.

Participatory action design and engineering of a manual wheelchair virtual coach including in-home and community usage

Background Current clinical practice guidelines (CPG) recommend periodic pressure redistribution (PR) to alter sitting pressure and reduce the risk of developing pressure injuries (PI). Individuals who have strength and trunk stability are asked to perform PR such as wheelies, leaning laterally, and forward-leaning to minimize the duration of pressure acting on the same region of the body. Objective Our long-term objective is to build upon previous research and development to create a more effective device for improving PR training and adherence to CPG among manual wheelchair users (MWU). Through this study, we employed a participatory action design and engineering (PADE) approach in developing the hardware and user interface to increase the likelihood of eventually yielding a device effective for both MWU and clinicians. Participants Focus Groups: Ten clinicians – 6 physical therapists, 3 occupational therapists, and one registered nurse, and 10 MWU with spinal cord injuries (SCI) who reported using their wheelchairs 40–80 h per week. Five-Day Assessment: Five male MWU with SCI who had been wheelchair users for 18.5 ± 16.2 years. Four-Week Investigation: The 7 participants with SCI were 5 males and 2 females, who had been wheelchair users for 24.7 ± 17.0 years. Methods A PADE approach was used to improve upon a manual wheelchair virtual coaching system for people with SCI. The system comprises a seat support instrumented with force sensors, software algorithms to detect PR, and a smart phone app for user interface. The methods included three stages: multiple focus groups, a five-day evaluation phase with participants using their own wheelchairs in their homes and communities, and a 4-week assessment with improvements made based on the 5-day results by users with their own wheelchairs in their homes and communities. Results The focus groups yielded guidance for ergonomics, user interface, charging frequency, and key dimensions and mass. The 5-day study identified mechanical, electrical, and connectivity challenges, which were resolved before the 4-week study. The 4-week trial suggested that participants performed PR less frequently than clinically recommended and provided an indication of the types of maneuvers that they performed. Conclusion A prototype manual wheelchair virtual coaching system was developed using a PADE process. The system was able to detect and record PR in home and community environments. Following improvements identified in this study, a future version will be tested with additional users to determine whether it can improve adherence to PR guidance.

(Re)Designing Technical Documentation About COVID-19 with and for Indigenous Communities in Gainesville, Florida, Oaxaca de Juárez, Mexico, and Quetzaltenango, Guatemala

<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Background:</b></i> In this article, we document how our team of translators, interpreters, technical communicators, and health justice workers is collaborating to (re)design COVID-19-related technical documentation for and with Indigenous language speakers in Gainesville, FL, USA; Oaxaca de Juarez, Mexico; and Quetzaltenango, Guatemala. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Literature review:</b></i> Although (mis)representations of Indigenous communities have been an ongoing issue in and beyond technical communication, the COVID-19 pandemic has brought added attention to how government institutions and other agencies fail to consider the cultural values, languages, and communication practices of Indigenous communities when writing, designing, and sharing technical information. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Research questions:</b></i> 1. How can technical communicators work toward social justice in health through collaborative design with Indigenous language speakers? 2. How can technical documentation about COVID-19 be (re)designed alongside members of vulnerable communities to redress oppressive representations while increasing access and usability? <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Methodology:</b></i> Through interviews and other participatory design activities conducted with Indigenous language speakers in the US, Guatemala, and Mexico, we illustrate how Western approaches to creating technical documentation, particularly in health-related contexts such as the COVID-19 pandemic, put communities at risk by failing to localize health messaging for Indigenous audiences. We then document our work intended to collaboratively design and translate COVID-19-related technical information alongside those Indigenous language speakers to benefit Indigenous language speakers in Gainesville and other parts of North Central Florida. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Results:</b></i> Through this discussion, we highlight how technical communicators can collaborate with Indigenous language speakers to create, translate, and share multilingual technical documents that can contribute to social justice efforts by enhancing language access. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><b>Conclusion:</b></i> Through collaborations with Indigenous language speakers, translators, and interpreters, social/health justice projects in technical communication can be combined, localized, and adapted to better serve and represent the diversity of people, languages, and cultures that continue to increase in our world.

Pizza and Poop: Using Playful Probes to Investigate Community in Semi-Public Restrooms on a University Campus

This exploratory paper aims to discuss how community is fostered in semi-public restrooms on a college campus. While previous research has been undertaken in similar semi-private environments, this paper differs by simultaneously offering the researchers’ reflective insights in tandem with participants’ input on the research question. We begin by unpacking the challenges around Participatory Design (PD) activities that are undertaken in sensitive and private interior environments. Gathering perceptions of these sensitive spaces required methods that allowed for both anonymity and a communal approach through the use of provocative and evocative probes such as comment boxes and graffiti wall posters. This paper not only catalogues the findings of this research but also documents the difficulties in utilizing a participant-led approach, gaining access to sites and participants, and countering our own biases throughout the study’s construction. Through researcher accounts and participatory data analysis, the researchers offer a focused reflection on a possible new frontier for advancing PD methods in sensitive environments through playful probes. The contribution of this paper offers six lessons on the efficacy of using probes in semi-private environments, with playfulness as a primary driver of engaging participants.

Архитектурная смена: на пути к соучаствующему проектированию с подростками городской среды

The article presents the results of participatory design activities within the architectural programme “Territory of Development”, hosted by the All-Russian Children’s Centre “Smena”. 130 teenagers from different Russian cities participated in the 14-day programme to develop their territory analysis and spatial thinking skills, their understanding of the structure of their city and sense of involvement in its development. In two online focus groups, adolescents asked their peers who participated in the architectural programme and their counsellors about the results of the programme, adolescents’ attitude towards the city and any changes thereof after the programme, the project itself, adolescents’ places in the city and their opportunities to participate in the life of the city, including through design work. In parallel, a questionnaire was launched through a Google form. The architectural programme demonstrated the potential for introducing adolescents to the life of the city through the design of public spaces and small architectural forms. As a result of the programme, adolescents did not only make career choices, acquired skills in territorial analysis and spatial thinking, but also conceptualised their own participation in the life of the city. Other ways to include adolescents into the life of the city are city workshops, festivals and architectural expeditions. Urban development laboratories can also promote the ideas of participatory design, including that with children and adolescents as participants. It is crucial to include adolescents into the life of the city because it helps shape them as active individuals, instil a sense of ownership of their city’s development, incentivise the youth to stay in their city and introduce new ideas for urban development.

Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY).

To develop a cognitive behavioural therapy-based intervention for people with type 1 diabetes and disordered eating using Experience-Based Co-Design as part of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY). Fifteen people with type 1 diabetes and experience of disordered eating (33±11years old, 22±12years diabetes duration) and 25 healthcare professionals working in type 1 diabetes or eating disorders (44±9years old; 14±10years of professional experience) attended six Experience-Based Co-Design workshops from July 2019 to March 2020 to collaboratively develop intervention content. We developed a cognitive behaviour therapy intervention 'toolkit' that can be tailored for individual patient needs. Participants designed and revised toolkit materials to ensure acceptability and relevance for people with diabetes and disordered eating by engaging in guided discussion, brainstorming, and rapid testing to review toolkit prototypes in an iterative process. Workshop themes were 'Insulin titration'; 'Hypoglycaemia'; 'Coming to terms with diabetes'; 'Fear of weight gain'; 'Toolkit revision'; and 'Practical elements of STEADY therapy'. The intervention is focussed on improving diabetes self-care and embedded in a multidisciplinary healthcare approach. The intervention will be delivered in 12 sessions by a diabetes specialist nurse trained in cognitive behavioural therapy. Through an iterative co-design process, people with type 1 diabetes and healthcare professionals collaboratively developed a novel intervention toolkit that can be used with a wide range of disordered eating presentations. The intervention will be tested in the STEADY feasibility randomised controlled trial.