Co-design Principles Research Articles

Designing an Intervention to Improve Medication Safety for Nursing Home Residents Based on Experiential Knowledge Related to Patient Safety Culture at the Nursing Home Front Line: Cocreative Process Study.

Despite years of attention, avoiding medication-related harm remains a global challenge. Nursing homes provide essential health care for frail older individuals, who often experience multiple chronic diseases and polypharmacy, increasing their risk of medication errors. Evidence of effective interventions to improve medication safety in these settings is inconclusive. Focusing on patient safety culture is a potential key to intervention development as it forms the foundation for overall patient safety and is associated with medication errors. This study aims to develop an intervention to improve medication safety for nursing home residents through a cocreative process guided by integrated knowledge translation and experience-based codesign. This study used a cocreative process guided by integrated knowledge translation and experience-based co-design principles. Evidence on patient safety culture was used as an inspirational source for exploration of medication safety. Data collection involved semistructured focus groups to generate experiential knowledge (stage 1) to inform intervention design in a multidisciplinary workshop (stage 2). Research validation engaging different types of research expertise and municipal managerial representatives in finalizing the intervention design was essential. Acceptance of the final intervention for evaluation was aimed for through contextualization focused on partnership with a municipal advisory board. An abductive, rapid qualitative analytical approach to data analysis was chosen using elements from analyzing in the present, addressing the time-dependent, context-bound aspects of the cocreative process. Experiential knowledge was represented by three main themes: (1) closed systems and gaps between functions, (2) resource interpretation and untapped potential, and (3) community of medication safety and surveillance. The main themes informed the design of preliminary intervention components in a multidisciplinary workshop. An intervention design process focused on research validation in addition to contextualization resulted in the Safe Medication in Nursing Home Residents (SAME) intervention covering (1) campaign material visualizing key roles and responsibilities regarding medication for nursing home residents and (2) "Medication safety reflexive spaces" focused on social and health care assistants. The cocreative process successfully resulted in the multifaceted SAME intervention, grounded in lived experiences shared by some of the most important (but often underrepresented in research) stakeholders: frontline health care professionals and representatives of nursing home residents. This study brought attention toward closed systems related to functions in medication management and surveillance, not only informing the SAME intervention design but as opportunities for further exploration in future research. Evaluation of the intervention is an important next step. Overall, this study represents an important contribution to the complex field of medication safety. RR2-10.2196/43538.

ParaVerse: co-design of a parachute rehearsal and training virtual-reality enhanced simulator for the Australian Defence Force: combining a generative co-design framework and an agile approach to development

While co-design methods are crucial for developing digital educational interventions that are user-centred, contextually relevant, inclusive, and effective in meeting the diverse needs of learners and educators, little attention has been paid to the potential value of co-design processes for digital application development in the Defence context. This research gauged the efficacy of combining a generative co-design framework making use of agile and iterative co-design principles in an applied research and development project. The project produced an immersive virtual reality based digital solution in collaboration with the Australian Defence Force Special Operations Command (SOCOMD) Army. Specifically, the ParaVerse project sought to develop a solution considering the advanced Tactics, Techniques and Procedures (TTPs) relevant to special operations soldiers for advanced parachute training. A Defence advisory group consisting of a series of subject matter experts was formulated to consult with the research and development team over the course of the co-design process. End-user testing with 35 SOCOMD personnel demonstrated the value of the ParaVerse application for SOCOMD personnel, speaking to the success of the leveraged generative co-design model. End-users rated ParaVerse as having greater capacity to influence education and training practices for SOCOMD and Defence generally in comparison to a pre-existing virtual parachute simulator. ParaVerse was also rated higher for satisfaction and useability and was associated with fewer instances of motion sickness. The Generative Co-Design Framework leveraged for this research provides one roadmap on how to integrate end-users in innovation design, particularly for projects working across the nexus of Defence and academia.

Building an Ethical and Trustworthy Biomedical AI Ecosystem for the Translational and Clinical Integration of Foundation Models.

Foundation Models (FMs) are gaining increasing attention in the biomedical artificial intelligence (AI) ecosystem due to their ability to represent and contextualize multimodal biomedical data. These capabilities make FMs a valuable tool for a variety of tasks, including biomedical reasoning, hypothesis generation, and interpreting complex imaging data. In this review paper, we address the unique challenges associated with establishing an ethical and trustworthy biomedical AI ecosystem, with a particular focus on the development of FMs and their downstream applications. We explore strategies that can be implemented throughout the biomedical AI pipeline to effectively tackle these challenges, ensuring that these FMs are translated responsibly into clinical and translational settings. Additionally, we emphasize the importance of key stewardship and co-design principles that not only ensure robust regulation but also guarantee that the interests of all stakeholders-especially those involved in or affected by these clinical and translational applications-are adequately represented. We aim to empower the biomedical AI community to harness these models responsibly and effectively. As we navigate this exciting frontier, our collective commitment to ethical stewardship, co-design, and responsible translation will be instrumental in ensuring that the evolution of FMs truly enhances patient care and medical decision-making, ultimately leading to a more equitable and trustworthy biomedical AI ecosystem.

Applying Experienced-Based Co-Design principles to improve digital health demand management processes in a large metropolitan multi-hospital health system

ObjectiveThis study describes the application of Experienced-Based Co-Design (EBCD) principles with an embedded implementation technology framework for improving digital health and informatics demand management processes in a multi-hospital healthcare system. The study identified barriers and enablers within the existing demand management system, proposed interventions to address these challenges and engaged in collaborative co-design with stakeholders. MethodsA multi-method qualitative approach aligning with EBCD principles was used. Framework mapping (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) was applied to barriers and enablers associated with baseline practices. Reflexive thematic mapping and process charts were used to inform stakeholder priorities and co-design. Prototyping was iterative using feedback for continuous improvement with ongoing monitoring. ResultsFragmentation of information was a technological barrier, decentralized processes and service duplication were organizational barriers, and opportunities to improve clarity of governance policies were identified. Solutions were co-generated and prioritised by stakeholders. The co-design and prototyping phase followed an iterative approach which generated two interventions. For centralizing intake and management, a new workflow process was devised. For improving project portfolio visibility and developing a weighted scoring criterion, a single tool to track projects across the lifecycle and a scoring model based on prioritization techniques were created. ConclusionA novel application of an EBCD approach was used to improve demand management processes in a digital health and informatics service context in a large health system. It highlights the value and agility of EBCD to generate flexible and modular solutions for this digital health context and compares favorably to analogous approaches. Public interest summaryIn today's fast-paced digital age, it is vital for hospitals to manage health information innovation efficiently. This study used an Experienced-Based Co-Design design (EBCD) approach to improve how a multi-hospital health system handles and prioritizes digital health projects. We listened to stakeholders, identified challenges, including fragmented information and unclear processes, then co-created solutions. The EBCD produced an implementable streamlined method for managing digital health project requests, including prioritizing and tracking projects from start to finish. This outcome of the exemplar EBCD process is likely to ensure that the most critical health projects are prioritized. For the public, this means better, faster, and more efficient digital health services in the future.

Utilising co-design to develop a lived experience informed personal safety tool within a mental health community rehabilitation setting.

Mental health personal safety tools aim to promote a recovery focus and empower an individualised approach to consumer care. These clinical tools are predominantly utilised in acute mental health settings with a person during or straight after a crisis. There is currently a gap in the literature regarding the preparation of personal safety tools in non-acute mental health settings. This descriptive article discusses the learnings and outcomes from a co-designed project that aimed to develop a personal safety tool suitable for a community mental health rehabilitation setting. Seven people with lived experience engaging within a mental health community-based rehabilitation service were recruited through convenience sampling to participate in the co-design project. A focus group approach was utilised during four group meetings to develop a personal safety tool template. Experiences and ideas about safety planning were transcribed during meetings and thematic analysis extracted key themes. Five steps underpinned the co-design process that included identifying the need, establishing the co-design group, planning, design and development, and review and closure. Consumer involvement commenced at step two of the co-design process. The completed personal safety tool was designed with consumer input and review. The personal safety tool consisted of nine intervention components. Four key themes emerged from focus group meetings that informed the content of the tool: (i) ensuring the personal safety tool is individualised and meaningful, (ii) promoting exploration of personal strengths and interests, (iii) enabling opportunities to learn self-management skills, and (iv) treating the personal safety tool as a dynamic and adaptable tool. Findings suggest that a personal safety tool targeted to a mental health community-based rehabilitation setting should have an individualised and preventative focus to mental health care. Embedding co-design principles can support opportunities for meaningful consumer engagement and establishing consumer and clinician partnerships.

A Tandem Photovoltaic-Electrochemical Photothermal Process for CO2 Conversion to Butene

Decarbonizing the chemicals industry requires net carbon negative technologies capable of displacing current greenhouse gas emitting processes. In particular, the generation of valuable monomers, such as butene, are currently produced by significant greenhouse gas emitting processes, including ethylene oligomerization and crude oil refining, which require high temperatures and pressures. Integrated, tandem solar fuels devices for the conversion of CO2 to ethylene, using solar-driven CO2 reduction (CO2R), combined with a photothermal reactor for ethylene oligomerization, offers a potential path to producing clean butene from CO2, using solar energy as the only driving force. A key challenge for the successful operation of a tandem photo-driven electrochemical-photothermal system is the co-design of the two processes, which are typically optimized under different operating conditions. Specifically, photo-driven electrochemical CO2R (pCO2R) reactors operate under ambient temperature and pressure conditions while thermally-driven ethylene oligomerization reactors prefer elevated temperatures (80-140 °C) and pressures (30-150 atm) to promote high activity as well as pure ethylene in the inlet stream. Operation of the tandem process under solar-driven conditions imposes additional constraints on the maximum power output of the pCO2R reactor and the maximum temperature which can be obtained in the photothermal reactor. Herein, we present an unassisted solar-driven tandem system coupling pCO2R with photothermal ethylene oligomerization for the conversion of CO2 to butene in a single pass. This work presents a critical advancement in the development of solar fuels technologies for larger hydrocarbon generation and identifies the co-design principles which must be considered for implementation of tandem, solar-driven electrochemical-thermal processes.

Towards building networks of solidarity: A co-designed training model for non-professional interpreters and translators in regional Australia

Despite ongoing efforts by different levels of government, barriers still exist for diverse communities in Australia when it comes to accessing culturally and linguistically appropriate social services. These barriers have detrimental effects on the sense of belonging and social inclusion of migrants, as highlighted by recent events such as the COVID-19 pandemic and natural disasters. In rural and regional areas, where access to resources and support can already be limited, these issues are particularly pronounced during crisis situations. Non-professional interpreters and translators have played a crucial role in facilitating effective communication in these circumstances, as they are often trusted members of their communities and understand their needs. However, relying on volunteers to provide multilingual communication in times of crisis is neither equitable nor sustainable. In response to this issue, the IMPARO pilot project has been implemented in the regional hub of Shepparton, Victoria, with the aim of providing training and professional development opportunities for non-certified community interpreters and translators. This project utilises principles of co-design and participatory initiatives to foster relationships and associations that promote inclusive practices and solidarity. Using action research and digital platforms, the project ensures equitable access to resources for its participants, who not only strive for professional certification and improved employability but also recognise the value of building intercultural networks of solidarity as a solid foundation to promote sustainable forms of knowledge sharing among diverse communities.

Empowering and Building the Capabilities of Mid-Level Health Service Managers to Lead and Support the Health Workforce-A Study Protocol.

(1) Background: Mid-level managers in healthcare are central to improving safety and quality of care. Their ability in demonstrating leadership and management competency in their roles and supporting frontline managers and frontline staff has a direct effect on staff retention and turn-over. Yet, investment in their professional development and support for mid-level managers is often neither adequate nor effective, and high rates of staff turnover are evident. This study, set in northern Queensland, Australia, takes a strength-based approach to explore the role and strengths of mid-level managers and organisations' existing mechanisms in supporting managers. With broad involvement and contribution from managers at different management level and frontline staff, the project will identify strategies to address the challenges mid-level managers face while building on their capabilities. (2) Methods: Using co-design principles, a situation analysis approach will guide a mixed-methods, multiphase design. Qualitative data will be collected using transcripts of focus groups and quantitative data will be collected by surveys that include validated scales. (3) Results: Thematic analysis of the transcripts will be guided by the framework of Braun and Clarke. Quantitative data will employ descriptive and inferential analysis, including chi-squared, t-tests, and univariate analyses of variance. (4) Conclusions: This study will generate evidence to guide two partner organisations, and other similar organisations, to develop strategies to improve support for mid-level managers and build their capabilities to support and lead frontline managers and staff. Competent mid-level managers are critical to high-quality patient care and improve the outcomes of the population they serve.

Identifying strategies and related principles supporting a co-design approach in an assistive device service delivery and research platform.

Possibilities Project Plus (PPPlus) is a free assistive device (AD) marketplace and research platform for persons with disabilities. The overall aim of PPPlus is to increase access to ADs through an integration of service, research and education. To maximize positive outcomes and reflect community needs a co-design approach informed by guiding principles of Integrated Knowledge Translation (IKT) was adopted, with examination of methods related to Experience Based Co-design. The integrated nature of PPPlus benefits from the use of specific engagement strategies that align with IKT principles to meet project objectives. The extent to which partnership and engagement strategies are specified in the rehabilitation research literature vary greatly and studies that provide information on specific strategies used to operationalize principles are limited. The objective of this manuscript is to provide a description of the co-design approach and the specific strategies that strive to achieve meaningful user engagement. By reflecting on these processes we also report on limitations and strategies for improvement. The co-design approach is highlighted through specific project activities including a representative governance structure, ongoing environmental scan and iterative Health Equity Impact Assessments (HEIA). The inherent engagement strategies that align with IKT and co-design principles are described. The most impactful engagement strategies included early engagement of partners throughout all phases, ensuring project relevance across partners through alignment of objectives with complementary aims, using HEIAs to promote equitable outcomes from diverse stakeholders, the representative governance structure beyond individuals with disabilities and caregivers, and the use of experiences and stories to inform development. This examination of specific strategies related to co-design focused on partnership engagement and informed targets for enhancement of the PPPlus initiative. These include being more intentional in developing a more rigorous process for evaluation that includes an assessment of strategies and their impact-especially as related to partner engagement. In addition, ongoing and enhanced efforts will focus on developing knowledge products that bring to life the most salient experience-based user stories emerging from the environmental scan with these being used to drive distinct co-creation events as well as serve other knowledge mobilization purposes (i.e., supporting policy change).

Development and Evaluation of a Framework for Authentic Online Co-Design: Partnership-Focussed Principles-Driven Online Co-Design.

Co-design in health research involves patient and public involvement and engagement (PPIE) in intervention or service design. Traditionally, co-design is undertaken in-person; however, exploring online delivery is warranted. PPIE in co-design must be considered carefully, and assumptions that in-person approaches will transition automatically to an online environment should be avoided. Currently, there are a lack of evidence-informed approaches to facilitating co-design online. This study aimed to develop and evaluate a framework for authentically adapting health research co-design into an online environment. The initial framework was developed through a literature review, synthesis of in-person co-design principles, and alignment of online strategies. The framework was then applied to a co-design project with 10 participants across relevant PPIE groups (end-users [n = 4], clinicians [n = 2], coaches [n = 2] and clinician-researchers [n = 2]). Participants' experiences of the online co-design process were evaluated via a mixed-methods design using surveys and semi-structured interviews. Evaluation data were analysed using descriptive statistics and reflexive thematic analysis to inform a revised framework. The developed framework, Partnership-focussed Principles-driven Online co-Design (P-POD) was used to design eight 90 min online co-design workshops. Evaluation data involved 46 survey responses, and eight participants were interviewed on project completion. Survey data indicated that the process was satisfying, engaging and adhered to the P-POD framework. Themes derived from interview data describe a respectful and collaborative online culture, valuing of diverse perspectives and space for healthy debate, how power was perceived as being shared but not equal and multiple definitions of success within and beyond the process. A final, refined P-POD framework is presented. With evaluation of the initial P-POD framework showing evidence of adherence to co-design principles, positive participant experiences and goal achievement for both the project and the participants, the refined P-POD framework may be used and evaluated within future intervention or service design. This study involved the participants (end-users, clinicians and service providers) in the co-design process described, interpretation of the results through member-checking interview responses, assisting in development of the final framework and as co-authors for this manuscript.

Improving healthcare transition for young people with cancer: factors fundamental to the quality improvement journey.

Young people receiving cancer treatment in the South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network usually receive care across two or more NHS trusts, meaning transition into adult services can be challenging. To develop a planned, co-ordinated approach to transition across the network that meets National Institute for Health and Care Excellence guidance recommendations for transition and the cancer service specifications. A 2-year, nurse-led quality improvement (QI) project, using the principles of experience-based co-design. The QI project resulted in the development of six key principles of practice; refining and testing of a benchmarking tool; initiatives to facilitate first transition conversations; and the launch of an information hub. Robust QI processes, cross-network collaboration and wide stakeholder involvement required significant resource, but enabled deeper understanding of existing pathways and processes, facilitated the establishment of meaningful objectives, and enabled the testing of interventions to ensure the project outcomes met the needs of all stakeholders.

Development of an electronic health record-integrated patient-reported outcome-based shared decision-making dashboard in oncology.

Patient-reported outcomes (PROs) describe a patient's unique experiences with disease or treatment, yet effective use of this information during clinical encounters remains challenging. This project sought to build a PRO based dashboard within the electronic health record (EHR), prioritizing interpretability and utility of PROs for clinical decision-making. Codesign principles were used to define the goal, features, and visualization of the data elements on the dashboard. Codesign sessions occurred between February 2019 and May 2020 and involved a diverse group of stakeholders. Pilot evaluation of dashboard usability was performed with patients and clinicians not involved in the codesign process through qualitative interviews and the Systems Usability Scale. The dashboard was placed into a single tab in the EHR and included select PROM scores, clinical data elements, and goals of care questions. Real-time data analytics and enhanced visualization of data was necessary for the dashboard to provide meaningful feedback to clinicians and patients for decision-making during clinic visits. During soft launch, the dashboard demonstrated "good" usability in patients and clinicians at 3 and 6 months (mean total SUS score >70). The current dashboard had good usability and made PRO scores more clinically understandable to patients and clinicians. This paper highlights the development, necessary data elements, and workflow considerations to implement this dashboard at an academic cancer center. As the use of PROs in clinical care is increasing, patient- and clinician-centered tools are needed to ensure that this information is used in meaningful ways.

Developing a Modular Survey App Using Co-design Principles

The objective of our project was to develop a smartphone app for administering shorter (“modular”) surveys. Given the paucity of research on this topic, we decided to use “co-design” techniques to generate design solutions. To implement these techniques, we recruited respondents in the survey target population to work in small groups and provide design ideas for the app. In this article, we present their input and examine whether we were successful in engaging them to contribute useful ideas. Although participation levels were uneven across the different groups, we found no evidence that group engagement was low overall or declined over the course of the sessions. In addition, the groups generated a diverse set of ideas, some of which informed the final app design. These findings underscore the feasibility of applying co-design principles to survey research, though further investigation is needed with different samples and design topics.

Cultural and co-designed principles for developing a Māori kaumātua housing village to address health and social wellbeing

BackgroundThe current study is a case study of a Māori (Indigenous people of New Zealand) organisation and their developmental processes in creating a kaumātua (older people) housing village for health and social wellbeing. This study identifies how a set of established co-design and culturally-centred principles were enacted when creating and developing the village.MethodA mixed-method concurrent design was used in creating the case with interviews (n = 4), focus groups (N = 4 with 16 total participants) and survey questionnaires (n = 56) involving kaumātua and organisation members.ResultsSurvey results illustrate that suitable and affordable housing are associated with self-rated health, loneliness, and life satisfaction. The primary purpose of the housing village was to enable kaumātua to be connected to the marae (community meeting house) as part of a larger vision of developing intergenerational housing around the marae to enhance wellbeing. Further, key themes around visioning, collaborative team and funding, leadership, fit-for-purpose design, and tenancy management were grounded in cultural elements using te ao Māori (Māori worldview).ConclusionThis case study illustrates several co-design and culturally-centred principles from a previously developed toolkit that supported the project. This case study demonstrates how one community enacted these principles to provide the ground for developing a housing project that meets the health and social wellbeing of kaumātua.

The effects of co-designed physical activity interventions in older adults: A systematic review and meta-analysis.

Physical activity (PA) declines with age despite the knowledge that physical inactivity is a leading cause of disease, death, and disability worldwide. To better tailor PA interventions to older adults, researchers are turning to the collaborative principles of co-design. The purpose of this systematic review was to compare the effectiveness of co-designed PA interventions and standard care for increasing PA and other health outcomes (i.e., physical function, quality of life, mental health, functional independence, attendance and attrition rates) in older adults. A search was conducted in MEDLINE, AgeLine, CINAHL, Embase, and SPORTDiscus. Records were screened by independent pairs of reviewers. Primary research studies conducted among community-dwelling older adults (age 60+) comparing co-designed PA interventions to standard care were considered for inclusion. Controls included wait-list control, usual care, sham interventions, PA interventions without the use of co-design, and no intervention. A random effects meta-analysis was conducted, and the standardized mean difference (SMD) was used to report effect estimates. Quality of evidence was rated using GRADE. Of 16,191 studies screened, eight (N = 16,733) were included in this review. Most studies reported results favouring the effect of co-design on physical activity; however, only two studies (N = 433) could be pooled for meta-analysis resulting in a SMD of 0.28, (95% CI = -0.13 to 0.69; p = 0.19; I2 = 56%) immediately post-intervention. The GRADE quality of evidence was very low. The quantitative analysis of three studies reported improved physical function. This review did not demonstrate that co-designed PA interventions are more effective than standard care for increasing PA in older adults; however, evidence was limited and of very low quality. Further well-designed trials are warranted to better understand the impacts of co-designed PA interventions and how to best implement them into practice. PROSPERO registration number: CRD42022314217.

Codesign principles for the effective development of digital heritage extended reality systems for health interventions in rural communities

ABSTRACT We present a methodological, theoretical, and technological outline of codesign principles for the effective development of digital heritage extended reality systems for health and care. The paper is based on two large-scale research projects involving ageing in rural and coastal communities, focused on the codesign of extended reality systems to stimulate new forms of access to local heritage sites with potential impact on health outcomes. Our approach stems from a multi-disciplinary collaboration between health, digital design, and heritage specialists, and suggests ways to reconcile diverging forms of knowledge production, such as our ‘researcher in residence’ methodology and the place-based complexities of codesigning such systems. Based on an analysis of fieldwork data and our own fieldwork experiences, the paper presents a roadmap for the codesign of digital heritage extended reality systems for health interventions that meet the needs of stakeholders and organisational implementation requirements, providing a useful tool in supporting the health and social care system for our ageing population.

The care-less academy? Making space for parents and carers in higher education

Within Higher Education (HE) research there is increasing interest in the links between student identity, experience, and wellbeing, particularly in relation to minority student groups. One such group is Students with Caring Responsibilities (SCRs), consisting of both students who are carers and/or parents (including those students who undertake the role of carer and parent), who it has been suggested have been actively constructed as 'other' in academia (Moreau, 2016) such that their experiences and needs are not well understood. Indeed, HE has been described as a 'care-less' environment, characterised by competitive individualism within which students are assumed to be unencumbered by the responsibilities of care (Lynch, 2010; Moreau, 2016). This article details findings from a rapid evidence review and online survey of a UK research project titled Who Cares? funded by SMaRteN (the Student Mental Health Research Network). The project explored the challenges faced by SCRs with a focus on their wellbeing and was shaped by principles of co-design and collaboration and, resisting a deficit model approach, also highlights the strengths which SCRs bring to their studies and their institution. For universities to become truly inclusive, these strengths should be recognised, and ways found to empower SCRs to reshape the university into a 'care-full', not 'care-less', institution.

Experiences of participants in the co-design of a community-based health service for people with high healthcare service use

BackgroundIncorporating perspectives of health consumers, healthcare workers, policy makers and stakeholders through co-design is essential to design services that are fit for purpose. However, the experiences of co-design participants are poorly understood. The aim of this study is to explore the experiences and perceptions of people involved in the co-design of a new service for people with high healthcare service utilisation.MethodsA methodology informed by the principles of grounded theory was used in this qualitative study to evaluate the experiences and perceptions of co-design participants. Participants were healthcare professionals, health managers and leaders and health consumers involved in the co-design of the new service in Tasmania, Australia. Semi-structured interviews were conducted, and data were iteratively and concurrently collected and analysed using constant comparative analysis. Audio/audio-visual recordings of interviews were transcribed verbatim. Transcripts, memos, and an audit trail were coded for experiences and perspectives of participants.ResultsThere were thirteen participants (5 health professionals, 6 health managers and leaders, and 2 health consumers). Codes were collapsed into six sub-themes and six themes. Themes were bureaucracy hinders co-design, importance of consumers and diversity, importance of a common purpose, relationships are integral, participants expectations inform their co-design experience and learning from co-design.ConclusionMost participants reported positive aspects such as having a common purpose, valuing relationships, and having a personal motivation for participating in co-design. However, there were factors which hindered the adaptation of co-design principles and the co-design process. Our research highlights that bureaucracy can hinder co-design, that including people with lived experience is essential and the need to consider various types of diversity when assembling co-design teams. Future co-design projects could use these findings to improve the co-design experience for participants, and ultimately the outcome for communities.

Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol

IntroductionPremature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of...

Practice Recommendations or Not? The LoGeT Model as Empirical Approach to Generate Localized, Generalized, and Transferable Evidence

In educational research, there is the general trade-off that empirical evidence should be generalizable to be applicable across contexts; at the same time, empirical evidence should be as specific as possible to be localizable in subject-specific educational interventions to successfully transfer the empirical evidence to educational practice. This trade-off is further increased by the fact that the diverse instructional contexts, such as school or student characteristics constrain the applicability of empirical evidence. Several approaches have been proposed to address this issue, however, emphasized the different problems (i.e., localization, generalization, transferability) rather in an isolated manner. To this end, in this article, we introduce a synergistic approach, the LoGeT (localize, generalize, transfer) model, which systematically integrates co-design (localization strategies) and ManyClasses principles (generalization strategies) with co-constructive transfer activities, to generate empirical evidence that may be applicable in educational practice. To illustrate the LoGeT model, we present three long-term projects, covering different granularities and durations of educational interventions across different fields of education (teacher education, adaptive teaching, non-interactive teaching) that successfully applied the LoGeT approach. Finally, we outline further directions for future iterations of the LoGeT model. We hope that the LoGeT approach may be a stimulus to guide researchers as well as practitioners alike to design generalizable and evidence-based educational interventions that are rooted in localized instructional contexts.