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Product co-design which connects the firm and consumers to achieve value co-creation is widely applied in the service-oriented manufacturing system (SOMS) to improve service quality. One of the key challenges in practice is to understand how the product co-design affects the performance of SOMS under different business models. This study considers a SOMS in which the firm optimises its product co-design effort and consumers decide whether to participate in product co-design under the selling and leasing models. The results show that the firm can always benefit from implementing the product co-design, even though consumers do not participate in product co-design under some specific circumstances. However, it does not always hold for consumers. Interestingly, we find that the free rider effect occurs when the participation cost is high. We further elaborate on the firm's business model selection strategy, introducing a threshold-based policy designed to assist the firm in making decisions when confronted with varying residual values and participation costs. Lastly, our findings indicate a lack of clear-cut pros and cons between the two business models in terms of the firm's product co-design efforts and consumer surplus. [ABSTRACT FROM AUTHOR]

BACKGROUND: Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient-care team relationships and providing information to enable care tailored to individual needs and values. OBJECTIVE: This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting. METHODS: We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data. RESULTS: In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner-IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium. CONCLUSIONS: This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting.

Student Assistants (SAs) are generally regarded as support to the instructor's teaching agency in a course. This case study assesses SAs taking on the more autonomous role of mentor-participants in student teams during an advanced bachelor's co-design course, advancing our understanding of distributing leadership within such open-ended educational contexts. We use semi-structured interviews and grounded theory analysis to understand how students, teachers and SAs experienced and responded to this shift in SA role. We conceptualize that SAs combined the qualities of both the instructor in creating and holding space for learning based on their personal experiences (i.e., mentoring) and the student in being a pro-active learner and contributor themselves (i.e., participant). Herein they acted as models for students, redistributing the traditional hierarchy of teaching (with a fixed object and subject of teaching) across course participants (i.e., instructors, SAs and students) and into more nuanced roles (i.e., teaching, coaching, mentoring and facilitating). Taking on this role as SA allowed students to take charge while being closely and safely supported. Moreover, this arrangement nurtured a sense of community: students reported experiencing an atmosphere of trust, informality and closeness. Instructors took a more distant role in this constellation, taking responsibility for formal assessment. We conclude that this rearrangement of roles facilitated students' personal leadership and development, authentic undergraduate research and challenge-based learning - and outline course design choices that likely contributed to this. [ABSTRACT FROM AUTHOR]

Background: The pronounced changes in reproductive hormones, such as oestradiol and progesterone, that occur during the menopause transition can contribute to increased risk of eating disorder onset or exacerbate a pre-existing eating disorder. Despite this heightened risk, there is a lack of available education and support that takes into consideration the unique challenges of experiencing an eating disorder during the menopause transition. This research aimed to qualitatively explore the perspectives of people with a lived experience of an eating disorder during the menopause transition, and to co-design a support option that addressed their unmet needs. Methods: A Double Diamond co-design process was followed involving four phases: discover, define, develop, and deliver. Seventeen women in Australia with a lived experience of an eating disorder during the menopause transition participated in online workshops across the four phases to identify their unmet health educational needs in experiencing an eating disorder during this transition, develop potential solutions and ultimately deliver a prototype solution in the final phase. All online workshops were recorded, transcribed verbatim and analysed using qualitative thematic analysis. The findings from the previous phase informed the next leading to the prototype creation. Results: Qualitative thematic analysis identified six major themes across the four phases; lack of awareness of the intersection of menopause and eating disorders, lack of education, limited and stigmatising services, learning from lived experience, resource impact and resource development. Conclusions: Findings from this study provided preliminary acceptability of a novel online resource to address the unmet educational needs of people experiencing an eating disorder during the menopause transition. Overall positive feedback on the potential for the resource to improve knowledge and empower treatment-seeking was provided by women with lived experience. Plain English summary: Menopause is the end of reproductive functioning usually marked by the permanent ending of menstrual periods. In the few years leading up to menopause, known as the menopause transition, there can be an increased risk of eating disorder onset or exacerbation of a pre-existing eating disorder. However, there is a lack of available education and support that takes into consideration the unique challenges of experiencing an eating disorder during the menopause transition. As such, this study designed and developed an online educational resource together with and specifically for people experiencing an eating disorder during the menopause transition through a comprehensive series of online workshops. We found that the women in our study were unaware and confused regarding the intersection of eating disorders and menopause. They provided positive feedback on the online educational resource at the end of the study which they reported improved their knowledge and made them feel more confident to seek further support from health professionals. [ABSTRACT FROM AUTHOR]

We describe a participatory art/research project envisioning alternative infrastructures enabling food as a Universal Basic Service in the context of food poverty and the cost of living crisis. The four-year process involving people who have received food aid as well as food activists was co-produced with the National Food Service, a mutual aid group trialling new models for a more just food system. Modelling our creative research on this group’s careful engagement to build communal structures based on a “solidarity not charity” model of mutual care, we devised a process of infrastructural co-design and creative visioning for more just urban food futures. We reflect on the interplay of physical and social infrastructures and the role of food in care and mutual aid settings. [ABSTRACT FROM AUTHOR]

A co-design process involving autistic children can provide a substantial benefit and optimal utilization of technologies to an off-the-shelf design-based one. Having a voice and making a contribution plays a major role in the co-design process. Yet autistic children exhibit varying communication and social skill and some of them may be minimally verbal or non-verbal. For these reasons, harmonizing the techniques of the co-design process with autistic children with varying characteristics requires detailed and careful consideration. To understand the techniques of the co-design process that accommodates all categories of autistic children, a systematic review of a co-design process involving autistic children was conducted, using six large databases (Scopus, ACM Digital Library, ScienceDirect, IEEE Xplore, SpringerLink, and Google Scholar). The search result includes 2482 papers of which only 82 met the inclusion criteria. The result of the data extraction analysis collection is classified according to techniques for accommodating autistic children of varying characteristics, the challenges encountered, and methods of minimizing those challenges. The review identifies four prominent themes within co-design research for autism: advances in co-design objectives and outcomes, participant recruitment determinants, core co-design methods, and the management of co-design challenges. Highlighting the need for inclusivity and equitable support, the study proposes recommendations for better integration of diverse communication abilities and multiple diagnoses in the co-design process, underlining the importance of adaptive technologies and methods to accommodate the needs of all children. [ABSTRACT FROM AUTHOR]

The world is now recognised by many scholars as digitally networked, and it is known that children use technologies for play, learning, and development in their everyday lives. This implies that caregivers and educators need to address these experiences to optimise their response to children’s developmental needs. This has proven challenging as digital technologies are often regarded as hindering more traditional ‘hands-on’ forms of play and as a ‘problem’ that needs regulating. This paper therefore reports on examples from three separate studies of co-design research conducted with children, families, and educators for understanding children’s digital life-worlds for play and learning. By examining these three examples, our aim was to identify common elements of co-design evident in research with children and their adults directed towards addressing the problem of adult hesitancy regarding technology use by children in their play and learning. Five main findings were identified as central to the conduct of co-design research with children and their adults regarding children’s experiences with digital technologies. These were: Mode of action, Collaboration, Creativity, Agency, and Data. The findings are discussed in relation to research with children facilitating a cultural role in informing practice rather than a technical role. [ABSTRACT FROM AUTHOR]

Background: This longitudinal case study describes the efforts and impacts of community-controlled service organisations on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands in Central Australia to tackle food security since the 1980s, with a focus on the last decade, particularly during a year of concerted action from mid-2018. Methods: The co-designed study comprised an interrupted time series with controls. Availability, affordability, accessibility and sales of foods in the community retail stores on the APY Lands were monitored regularly from 2014 to mid-2022, including by local research teams. Store nutrition policy was updated early 2018. For a year from mid-2018, of the eight communities with stores: (i) two were the focus for concerted intervention, including support from a locally based project officer to help implement the policy and action 105 community requests for nutrition activities (ii) three received usual support to implement the policy; and (iii) three were subject to 'business as usual'. From mid-2019, all communities/stores received usual service, from 2020 with some restrictions related to the COVID-19 pandemic. Results were compared over time, across different community/store groups and with controls. Results: In the 12 months from mid-2018, all food security metrics improved most in the two focus communities. Impacts were less marked in the communities without additional support to implement the revised nutrition policy, and even less apparent, although more varied, in the other three communities/stores. Dietary intake improved only in the two focus communities. In all communities from early 2020 most gains eroded due to impacts of the COVID-19 pandemic and other external stressors. Food security metrics, including price of healthy food, appeared more resilient in the focus communities, although diet quality worsened. At all times assessed, healthy diets were unaffordable for welfare-dependant households. Conclusions: This co-designed study demonstrates the effectiveness of community-led approaches, confirming that it is possible to improve food security and diet in remote Aboriginal communities. However, sustained action and monitoring, dedicated resources and employment of local people are critical for success. Results also highlight that low incomes are a major barrier to food security. [ABSTRACT FROM AUTHOR]

AbstractTheoretical understandings of micropolitics and ablism provided a framework to analyze power relations and their impacts in a participatory design process. Micropolitics allowed a focus on small scale interactions and relational processes that impact outcomes of participation, and revealed the importance of problem framing and coalition building. We also found resistance to ablism through micropolitical strategies including: the sharing of experiential narratives; the use of expressive communication styles; and the development of alliances. These helped challenge norms of ablism in the deliberative process. Suggested practices for planners and facilitators who want to intervene in status quo ablest practices are identified. [ABSTRACT FROM AUTHOR]

Aims: To co‐create strategies and identify opportunities to integrate eating disorder content within dietetics curricula at one Australian university with stakeholders using a design thinking approach. Methods: A pragmatic mixed‐methods, participatory design approach was used. An online survey explored the learning needs of dietetic students and recent graduates regarding eating disorders. Following the survey, a one‐day design thinking retreat was held with stakeholders who were identified from the research team's professional networks. Eating disorder dietitians, learning experts, dietetic students, graduates, and those with lived experience were asked to identify strategies to enhance students' confidence and competence to provide care for people living with eating disorders. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using inductive coding and reflexive thematic analysis. Results: Sixty‐four students (n = 55, 86%) and recent graduates (n = 9, 14%) completed the online survey (26% response). Seventeen stakeholders attended the retreat. Four themes were identified: (1) changing perceptions of eating disorder care from specialist to 'core business'; (2) desiring and advocating for a national change to dietetics curricula; (3) importance of lived experience at the centre of curriculum design and delivery; and (4) collaborating to co‐design and deliver eating disorder content at university. Conclusion: Raising awareness, upskilling students and educators, enhanced collaboration between universities and stakeholders, and the inclusion of lived experience were key to preparing students to provide care to people seeking support for eating disorders. Further research is needed to assess the impact these strategies have on dietetic students' confidence and competence. [ABSTRACT FROM AUTHOR]

Assistive technology has great potential to help individuals living with chronic health conditions, however devices often fail to align with the unique requirements of users. These results in device abandonment and missed opportunities to benefit people. This exploratory study aims to evaluate the short and longer-term satisfaction, psychological benefit, use and resources involved in co-designed customised assistive devices within a current healthcare service. Individuals with chronic health conditions identified daily living challenges. Eleven individuals completed the trial and were involved throughout the design process. Outcome measures evaluated the impact of the devices provided, healthcare utilisation, help required, and resources used. Nineteen custom assistive devices were produced for twenty-four challenges in daily living identified. At 3-months, eighteen devices were still being used. Daily challenges had become easier for individuals to complete and required less help from informal carers. Individuals were satisfied with the devices and service provided. Improvements in competence, adaptability and self-esteem were sustained long-term. The average clinician's time required to produce a device was 5 h 55 min, with an average cost of £203.79. People with chronic conditions were able to benefit from the co-design process resulting in satisfaction and long-term utilisation of the device, and positive psycho-social benefits. The costs associated with embedding this approach in a healthcare service were calculated. Scaling up the co-design process reduced the associated costs per device compared to previous work. Further work is required to evaluate co-designing across larger samples and explore opportunities to further improve the cost-efficiency. IMPLICATIONS FOR REHABILITATION: By involving users in the design process, healthcare professionals can create devices that better meet users' expectations, preferences and functional needs, thereby increasing overall usability, satisfaction and utilisation long-term of the devices. Incorporating the individual's perspective and needs into the design process enabled users to better understand the solutions that could be produced and thus encouraged users to identify other challenges in daily living they faced where an assistive device could assist them. Through being provided with devices to support them with specific challenges they faced, individuals were able to perform more tasks independently, reducing the need for help from family members and informal carers for the associated tasks. Re-evaluating the solutions generated with other previous research may help identify common design solutions and features to enable further scaling-up of this co-design approach [ABSTRACT FROM AUTHOR]

AMReX is a software framework for the development of block-structured mesh applications with adaptive mesh refinement (AMR). AMReX was initially developed and supported by the AMReX Co-Design Center as part of the U.S. DOE Exascale Computing Project (ECP), and is continuing to grow post-ECP. In addition to adding new functionality and performance improvements to the core AMReX framework, we have also developed a Python binding, pyAMReX, that provides a bridge between AMReX-based application codes and the data science ecosystem. pyAMReX provides zero-copy application GPU data access for AI/ML, in situ analysis and application coupling, and enables rapid, massively parallel prototyping. In this paper we review the overall functionality of AMReX and pyAMReX, focusing on new developments, new functionality, and optimizations of key operations. We also summarize capabilities of ECP projects that used AMReX and provide an overview of new, non-ECP applications. [ABSTRACT FROM AUTHOR]

Purpose: Rebuilding a strong sense of meaning and purpose following trauma is a vital contributor to post-traumatic growth and adapting well to a spinal cord injury. This project aimed to develop an intervention that used the concept of post-traumatic growth to foster a stronger sense of meaning and purpose in people with a spinal cord injury. Methods: Using participatory action research methodology, the intervention was designed in an iterative process with health professionals and people with lived experience of spinal cord injury. We developed a ten-week online group program and delivered two pilot programs to 13 participants. We used their feedback to further refine the program before finalisation. Results: A participatory action research approach resulted in a positive intervention well received by participants and consumer organisations. Feedback suggests the intervention shows promise for improvements in functional and psychosocial outcomes and has long-term viability. Conclusions: The project successfully developed and delivered a novel program that uses the concept of post-traumatic growth to foster a stronger sense of meaning and purpose. Further implementation of the program with larger numbers will allow for evaluation of the program's effectiveness. IMPLICATIONS FOR REHABILITATION: Group-based intervention programs based on principles of post-traumatic growth can help people with spinal cord injury explore meaning and purpose. Co-design, development and implementation of interventions help to ensure such programs appeal to consumers, meet their needs, and are sustainable. Interventions can be delivered effectively online. [ABSTRACT FROM AUTHOR]

For generations a burden of misplaced shame has sat with victim-survivors of children's institutionalisation. Experiences and memories of family separation, cultural obliteration, mistreatment, hunger, unpaid labour, curtailed educational and professional opportunities, and abuse had come to silently define and destroy the lifelong living experience of childhood incarceration. Meanwhile, institutions and the communities they are part of have been able to effectively ignore the legacies of their own trespasses, through 'top-down', celebratory approaches to history and heritage. In recent decades, renewed emphasis on survivor voices and agency has culminated in a range of Commonwealth and state-based reports, Inquiries and Commissions, driven by abundant survivor testimonies and truth-telling. The sense of shame and guilt over these parts of our collective histories has now re-centred on the perpetrators and enablers of abuse and mistreatment. Using interpretive heritage and historical lens this article outlines a theoretical conception of 'integrated' approaches to history and heritage, using real-life examples from contemporary urban development and institutional heritage in the regional Australian city of Ballarat. The authors examine changing contemporary representations of institutional Care, neglect and abuse, arguing that shifting cultural and social power is reflected in the urban landscape and cultural fabric of the associated institutions. [ABSTRACT FROM AUTHOR]

The design of a manufacturing supply network (MSN) requires the consideration of decisions made by different groups at multiple levels and their interactions that include potential conflicts. Decisions are typically made based on information from computational simulations that are abstractions of reality and, therefore, embody uncertainty. This necessitates focusing on design space exploration to identify robust satisficing solution sets that are relatively insensitive to uncertainty. Current frameworks that support robust satisficing design space exploration are limited by their capability to support the efficient exploration of multilevel design spaces simultaneously. In this paper, we present the Framework for Robust Multilevel Co-Design Exploration (FRoMCoDE), a decision support framework that allows designers to (i) model decision problems across multiple levels and their interactions, (ii) consider uncertainties in the decision problems, and (iii) visualize and systematically carry out simultaneous exploration of multilevel design spaces, termed co-design exploration. In FRoMCoDE, we combine the coupled-compromise Decision Support Problem construct, where a combination of the Preemptive and Archimedean formulations is used, with robust design constructs and interpretable-Self-Organizing Maps (iSOM)-based visualization to facilitate robust co-design. We use a steel MSN problem with decisions made at two levels to test the framework. Using the problem, we demonstrate FRoMCoDE's efficacy in supporting designers in (i) modeling multilevel decision problems and their interactions, considering the uncertainties, and (ii) the efficient co-design exploration of multilevel design spaces. FRoMCoDE is generic and supports designers in the robust co-design exploration of multilevel systems. [ABSTRACT FROM AUTHOR]

The primary aim of this systematic review is to investigate the inclusion of autistic individuals in the design process of immersive technologies. This study follows the preferred reporting items for systematic reviews and meta-analyses standards for systematic literature reviews. To ensure the research questions and subsequent stages of the review incorporate pertinent parameters, the problem, interest, context framework has also been employed. Findings highlight that, while early proponents of immersive technology emphasized the importance of user involvement in design of new technology, immaturity of the technology often limited the implementation of direct user input to the design process. Nonetheless, analysis of the literature published between 2002–2022 identified 20 studies in which substantial influence of autistic individuals and stakeholders was found in the design process of immersive technologies. The roles of autistic individuals varied from active co-designers and co-creators to essential contributors in refining prototypes and providing critical feedback, ensuring the final products align with their needs and preferences. Results underscore the need to align research and design of immersive technologies more closely with the priorities and preferences of autistic individuals. Further is needed regarding actively involving autistic individuals in the design and implementation of immersive technology applications. On this basis, we maintain that more inclusive and effective deployment of immersive technologies is needed in order to ensure that resultant technologies are fit for purpose and address the actual needs of the autistic community. [ABSTRACT FROM AUTHOR]

Background/Objectives: School-based nutrition education interventions can support the development of children's food literacy and healthy eating habits. The Foodbot Factory serious game was developed to support school nutrition education based on Canada's Food Guide and Ontario curriculum. The objective of this research was to refine the Foodbot Factory intervention to include curriculum-based lesson plans that had a high-level of acceptability by stakeholders to support implementation by teachers in classrooms. Methods: A co-design approach was used to engage teacher and dietitian stakeholders in developing five lesson plans for the intervention, who contributed to creating the intervention content in three stages. The stages included reviewing and providing feedback on the initial draft of the lesson plans, participating in facilitated discussion rounds to come to a consensus on the changes required, and completing a final review of the intervention's acceptability. Qualitative data included notes on the lesson plans and recordings from meetings that were analyzed thematically. Results: During the first co-design stage, major revisions were suggested for two-fifths of the lessons by stakeholders. Further stakeholder suggestions were discussed and integrated into the intervention from facilitated discussions, improving the lesson plan content and intervention feasibility. All stakeholders agreed that the final version of the intervention was acceptable and would support classroom nutrition education. Five lesson plans were created and compiled into a unit plan, containing additional teaching resources, to support nutrition education with Foodbot Factory. Conclusions: The co-design process greatly improved the Foodbot Factory intervention and its feasibility for classroom implementation. Including diverse stakeholder perspectives led to unique and different insights to improve the intervention. [ABSTRACT FROM AUTHOR]

Addressing work environment design methods has become increasingly important due to pandemic-induced changes in the ways and locations of work. This research addresses work environment design through a theory-informed workplace design framework to study the co-design process, the impact of spatial atmosphere on workplace experience and satisfaction, and infrequently studied spaces, i.e. meeting rooms and breakout areas. This case study is based on co-design methods, a workplace design intervention study and its evaluation. Comprehensive design is addressed through analytical dimensions of design, i.e. instrumental, symbolic, aesthetic and perceived dimensions of atmosphere and affordances. Furthermore, the spatial experience is explored through need-supply fit theory and workplace satisfaction. The pre-design results showed that employees have distinct design preferences based on perceived and analytical dimensions for technical, hybrid and creative meetings and individual work and recovery events. The workspace interventions were designed using the design information gathered from the co-design process; the changes implemented in intervention spaces increased employee satisfaction towards them. The study's methodology contributes to establishing a theory-informed workplace design framework supporting user-centred workplace design and evaluation and indicates a role for spatial atmosphere in need-supply fit formation. [ABSTRACT FROM AUTHOR]

This study applies a participatory design approach including the design, development, implementation, and evaluation of a participative website in media literacy for Iranian teachers. In the design cycle, we utilized collaboration with Iranian teachers formulating basic inceptive design in three workshops identifying needs and requirements in media literacy. The development process was through paper-based prototyping of design components of the website by participants embodying particular design guidelines and ideated design concepts for the website. In the implementation step, the website was launched based on guidelines and prototypes taken from participants in the workshops. The website was evaluated by teachers based on four factors including being educational, facilitating networking, being engaging, and user-friendly. The result of this research informs researchers about the benefit of a participatory design approach to design a platform in media literacy for teachers. We argue that the process of applying participatory design and the design components prototyped by teachers for designing a website in media literacy can be a guide for researchers and all other agents who are active in media literacy education. [ABSTRACT FROM AUTHOR]

Background and aim: Immigrant women in many high-income countries including Sweden, report unmet need of sexual and reproductive health and rights, and face worse pregnancy outcomes and higher risk of unintended pregnancies. Postpartum contraceptive services are often inadequate to meet their needs. Co-design has shown to reduce health inequities, yet little is known about using this method for postpartum contraceptive service development and even less in collaborating with immigrant populations. The aim of this paper is to describe the co-design process and the strategies that were developed to help develop tailored and acceptable postpartum contraceptive services for immigrant women in Sweden. Methods: The paper describes a co-design process that took place during 2022–2023, including the cyclical digital consultations with Arabic and Somali speaking immigrant women, midwives and researchers, as well as the outputs from the process. The theoretical framework for the co-design process was the ‘Double Diamond’ Design Process Model. Data analysis included qualitative content analysis. Results: The co-design process led to the joint development of intervention materials and strategies to improve postpartum contraceptive services. Specifically, the process revealed ideas on how to improve contraceptive counseling within three pre-identified areas of change: improve physical access to contraceptive services; improved communication strategies using visual aids and information charts; and empowerment strategies that focus on reflective practice without assumptions about what a group of women might expect. We found that participants contributed actively to the process with ideas and suggestions, and that the co-design process facilitated positive reflections on ongoing counseling practices. Conclusion: The co-design process resulted in the successful and participative development of innovative tools and activities to improve contraceptive counseling services. This approach is original because it involves both immigrant women, often left behind, and midwives delivering the services. Whilst this interplay allowed for careful refinement of services and tools by using an iterative process, it also facilitated reflective midwifery practice. [ABSTRACT FROM AUTHOR]

AbstractDespite the ubiquity of menstruation, the area is under-researched and stigmatized. The burden of ‘managing’ periods lies with the people who menstruate (PWM). Some etiquettes and cultures ask that periods disappear/are hidden from the public sphere, however despite this, PWM continue to experience symptoms within these public spaces (pain, nausea, discomfort etc.). This paper describes a design research study in two parts: Cycles is a design project that firstly uncovers what it means to menstruate in ‘public’ and secondly explores how we can collaboratively generate conceptual solutions to contribute towards a positive future for menstrual health and well-being. Through a series of participatory and inclusive design research methods, based on storytelling the diverse experiences of a group of PWM were gathered. Subsequent analysis of the data identified a number of shared and individual stories that were re-enacted in an urban context (using Limerick City as a test bed). This research served to highlight that whilst everyone’s story with their period is individual, there is a collective lack of infrastructural, product and social support for PWM. Cycles surfaced a requirement for inclusive and equitable solutions that support PWM at the point of need whilst also raising awareness and building understanding and sympathy. [ABSTRACT FROM AUTHOR]

This article explores the role of local vernacular socio-spatial practices in co-design and placemaking in Calderon, a peripheral urban parish in Quito, Ecuador. Using a case-study method and transformative paradigm theory, the research employs a mixed-methods approach for data collection and analysis. The focus is on ‘Minga’, a collaborative community effort manifested in two forms: ‘community mingas’ organised autonomously by communities, and ‘megamingas’ coordinated by public institutions. Community mingas enhance residents’ sense of belonging and pride, empowering them in shaping public spaces through a bottom-up approach. In contrast, megamingas exhibit top-down organisation with limited community engagement, raising concerns about social impacts. The study underscores mingas’ potential for social cohesion, cultural expression, and sustainable development in urban design. It emphasises the nuanced understanding needed for fostering active participation and addresses challenges such as sustaining community ownership. Despite yielding immediate benefits in public space enhancement, sustaining long-term engagement is crucial. The study concludes that mingas offer a valuable avenue for residents to actively contribute to public space improvement, fostering shared responsibility and long-term sustainable development in low-income neighbourhoods. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors face many barriers to physical activity (PA). Solving physical inactivity after stroke requires a "systems-based" approach. We aimed to develop a complex intervention targeted at improving PA after stroke in Singapore using behaviour change theory and a co-design approach involving multiple stakeholders. Methods: We carried out the intervention development in three phases: i. preparation phase, ii. co-design phase, and iii. intervention refinement phase. During the preparation phase, we conducted surveys (n = 38 stroke survivors, 71 physiotherapists and 35 exercise professionals) and interviews (n = 19 stroke survivors) to understand the factors influencing PA after stroke. The co-design phase consisted of two-co-design workshops held in August 2022 and were attended by 13 stroke survivors and 4 caregivers. Relevant domains of the Theoretical Domains Framework (TDF) and items in the Template for Intervention Description and Replication (TIDieR) checklist guided the discussion topics in the first co-design workshop. Solution prototypes such as exercise videos, arm and leg straps and information resources were shown in the second co-design workshop to gather feedback. In the intervention refinement phase, eight healthcare professionals from various sectors participated in two virtual Zoom meetings in August 2023, and used the Acceptability, Practicability, Effectiveness, Affordability, Spillover effects and Equity (APEASE) grid to rate the active ingredients in the complex intervention by considering the current healthcare landscape in terms of resources and manpower. Results: Stroke survivors and caregivers want a personalised PA program, stroke-specific PA opportunities and information resources, medical clearance, advice and help from healthcare professionals skilled in stroke care, face-to-face sessions at preferred exercise spaces, and access to adaptive equipment. A complex intervention consisting of 21 behaviour change techniques, 6 intervention functions and 8 options was developed. Conclusions: Using behaviour change theory and a co-design approach involving multiple stakeholders, a complex intervention was developed to target physical inactivity after stroke. The intervention titled MOTIVATE is currently being tested in a type 1 hybrid effectiveness-implementation trial. [ABSTRACT FROM AUTHOR]

Agroecology, as a holistic approach to sustainable food systems, is gaining momentum globally as a key approach to addressing current challenges in agricultural and food production. In sub-Saharan Africa, despite numerous efforts to address declining soil productivity, water scarcity, and increasing pest pressure through agroecological soil, water, and integrated pest management (IPM) practices, the adoption of such practices remains low. As part of the CGIAR Agroecology Initiative, we conducted a collaborative rapid innovation assessment of existing soil, water, and pest management practices in two Agroecological Living Landscapes (ALLs) in Makueni and Kiambu counties, Kenya. The assessment also included an evaluation of the performance of these practices and identified farmer preferences. Using a multi-stage approach, we applied stratified random sampling to identify 80 farmers for farm assessments and in-depth interviews. A total of 31 practices were identified, of which 26 were further evaluated. The evaluation revealed a heterogeneous set of socio-economic and biophysical contextual factors influencing practice performance. Respondents identified 19 strengths, and 13 challenges associated with the practices, highlighting opportunities for innovation to improve or adapt performance. Farmers also expressed preferences for future adoption of 31 practices, 77% of which were listed in one of the three focus areas, namely soil management, water management, or IPM. The other 33% were associated with multiple functions and were listed under two or three of the focus areas. The results of the collaborative assessment informed a broader co-design cycle that included participatory prioritization and selection of innovative practices, experimental design, and monitoring protocols. This collaborative and systematic approach was taken because innovative practices often fail to be adopted due to a lack of co-design and inclusion of local perspectives in innovation design, and a disconnect between science and practice. Our study highlights the importance of integrating stakeholder input and transdisciplinary technical expertise in the co-design and implementation of agroecological innovations. It also emphasizes the importance of using a structured methodology to understand farmers' options, context, and preferences while co-designing locally relevant agroecological practices, which promotes holistic and inclusive adoption, successful implementation and long-term sustainability of agroecological practices. [ABSTRACT FROM AUTHOR]

Background: HIV prevalence among female sex workers (FSW) is significantly higher than among women in the general population. Studies have shown that FSW engage in unprotected sex which provides higher compensation when they face emergency situations. We co-created a savings intervention – Jitegemee (rely on yourself) – with FSW to encourage them to save part of their earnings to withdraw in emergency situations in order to reduce risk. Methods: We undertook a five-phase intervention development process between February 2021 and July 2023: 1) qualitative interviews with FSW to identify essential intervention features; 2) pilot trial to assess intervention feasibility; 3) literature review of studies on economic empowerment of FSW; 4) scoring of key components of Phases 1–3 on a scale of 1–5 (1 = definitely exclude, 5 = definitely include), for inclusion in the intervention package; 5) workshops with FSW and other key stakeholders to co-design the intervention. Results: In phase 1, nearly all participants (99%) found the intervention acceptable to them and 95% believed it would be acceptable to other FSW. Participants suggested inclusion of financial literacy (75%), savings groups (38%) and goal-setting (24%). In the feasibility assessment, 41% saved, of whom 46% withdrew some savings. Condom use was higher among FSW who withdrew their savings compared to those who did not (χ2 7.52; p = 0.006). In Phase 3, we identified 14 intervention components. In phase 4, all suggested intervention components scored 4.5 on average. In phase 5, we held 3 workshops with FSW to co-design the intervention, which included instructions for how to save and make withdrawals, financial literacy training, and formation of savings groups. Conclusions: A savings intervention for and by FSW was highly acceptable and feasible. Involving end-users in the design process is likely to result in greater economic security among FSW and lower engagement in higher risk transactional sex. [ABSTRACT FROM AUTHOR]

Participatory Design (PD) is a commonly used method in Western cultures with roots in Scandinavia. After the COVID-19 pandemic, many PD practitioners have transitioned to an online space, where researchers and participants from different geographical locations can co-design together. Yet, we do not fully understand how different cultures collide, mix and blend in the online co-design space. By understanding how one's culture influences the participation of a child, researchers can better structure sessions to elicit diverse input. This study examines a case study of researchers and participants from South Korea and the United States co-designing together. Close analysis of video recordings, analytic memos, and parent/child interview data demonstrates the ways in which children participated in design sessions. Facilitators paid special attention to various cultural sensitivities. Applying the theory of cultural awareness from public health literature, we offer implications on how scholars who are not fully embedded in the culture where co-design happens can understand other cultural norms and in response, create spaces in which co-design can occur successfully despite different cultural norms. Our findings show how different parts of the ecological systems from ideology, education systems, and ethnicity all influence children's participation in sessions. [ABSTRACT FROM AUTHOR]

While existing literature describing the use of co-design has focused on its application within individual-level or group-level health interventions, the use of co-design to plan and support the implementation of mental health and substance use health stepped care (MHSUH) models and other MHSUH system transformation initiatives is more limited. In this commentary, the authors describe the Populating the Model Series, a co-design-based, system-level planning intervention specifically developed for sites implementing the Stepped Care 2.0 (SC2.0) model of care. The use of co-design, which is a core component of the SC2.0 model, distributes risk through engagement across the community, broadens the system of care to include and acknowledge informal and formal options, creates person-centricity, and incorporates access points and care modalities that are tailored to the intervention site's context. Seven steps are identified within the Populating the Model Series including assessing intervention site readiness, understanding site context, planning and adjusting engagement of key groups for co-design, learning through workshop sessions and co-design, validation with key groups, understanding findings, and application of findings. This guidance provides an actionable process framework for the application of co-design in the planning and implementation of SC2.0 and other stepped care models. [ABSTRACT FROM AUTHOR]

(1) Background: Public transport has a vital role to play in creating sustainable, accessible societies. Accessible and inclusive, door-to-door public transport systems with low barriers to use benefit everyone, increasing the mobility of citizens and improving independence. As the industry strives towards multi-modal and Mobility as a Service (MaaS) concepts, there is a need to delve deep into the needs and perceptions of transport user's door-to-door journeys to find ways to improve. Accordingly, in order to increase the sustainability of MaaS, improving accessibility and understanding service user perceptions are of utmost importance. However, there is a scarcity of research within national transport services to determine unmet user needs to increase the accessibility and autonomy of door-to-door journeys. This research aims to investigate if it is possible to improve the door-to-door journey experience for public transport travellers, increasing the accessibility and the perception of autonomy via technology, and by doing so, providing a more sustainable alternative to road transport. It focuses on understanding service users of Ireland's National Rail service, Irish Rail, to create key improvements in interactive systems. (2) Methods: The study applies a user-centred mixed-methods methodology using surveys (N = 316) and co-design workshops (four workshops N = 15). The research collected deep insights into the mindsets and needs of service users, showing the potential to improve this door-to-the-door customer journey. Key improvements for interactive systems were outlined. Experience maps were designed, leading to a Conceptual Design for a travel assistant to aid the service user throughout the door-to-door journey. (3) Results: Travellers' autonomy and the sense of freedom they experience can be improved, mainly if their needs across the complete door-to-door customer journey are supported. Highlighted areas for action include information, accessibility, personal security, ticketing, comfort, facilities, and anxiety. (4) Conclusions: This research reiterates the need for national transport and MaaS providers to prioritise service users' perspectives when developing sustainable services. Co-designing is recommended as a means of achieving this. [ABSTRACT FROM AUTHOR]

ABSTRACT Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co‐designed and systems‐level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems‐based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co‐design and person‐centred care. This study assessed the acceptability of GMB as a method for co‐design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems‐level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co‐design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence‐based, person‐centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co‐designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field. [ABSTRACT FROM AUTHOR]

Background: Interprofessional education is crucial for healthcare students to develop collaborative skills and provide effective patient care. However, opportunities for interprofessional learning are often limited in healthcare curricula. The present study aimed to engage students from different health professions in co-designing an educational resource on delirium recognition and management through an interprofessional lens and explore their experiences of this process. Methods: Two co-design workshops were conducted with students from medicine, nursing, pharmacy, and occupational therapy programmes at two universities across the island of Ireland. Focus groups were held following these workshops to explore students' experiences of the co-design process. The workshops involved a range of activities, including theme generation, scenario development, resource creation (podcasts, simulations), and focus group discussions. Data from focus groups were analysed thematically. Results: A total of 19 students participated across the two workshops. Three themes were identified: (1) Relationship development, where students identified the benefits of co-creating the resource and valued the flexibility, collaboration, and social aspects of the co-design approach; (2) Interprofessional collaboration, which challenged students' assumptions about other disciplines, fostered teamwork and communication, and highlighted the need for early and continuous interprofessional learning; (3) Professional growth, with students reporting increased confidence in managing delirium, working with other professions, and engaging in novel experiences like podcasting and simulation. Conclusions: The co-design process facilitated interprofessional collaboration, peer learning, and personal growth among healthcare students. Students appreciated the opportunity to co-create an educational resource while developing interprofessional skills. The study demonstrates the potential of co-design as a methodology for enhancing interprofessional education and promoting effective teamwork in healthcare. [ABSTRACT FROM AUTHOR]

Objectives: Analyse reported processes of co-design and co-production in the context of health and social care to explore the underlying mechanisms that enable inclusive and reciprocal engagement. Search strategy: Peer review research was obtained from a prior scoping review searching eight databases consisting of all methodologies relevant to co-design or co-production in the context of health and social care services and involving service-users. Methods of selection: Articles were included for synthesis if they reported a process of dialogue, with mutuality, insight and clarification in their engagement process. Ninety-three peer-review articles informed our programme theory development. Analysis: Data relating to co-design and co-production processes were extracted and analysed through inductive, abductive, and deductive analysis leading to the development of an initial programme theory. Main results: This realist synthesis finds that co-design and co-production can occur at different times, in part or all of the research and participatory process. There is an over reliance on the term 'co-design' or 'co-production' to convey complex engagement or participatory processes. We identified six mechanisms (intention, assets, dialogue, documentation, interpretation and understanding). Interaction between these six identified mechanisms in context, even if only brief, is important for supporting meaningful engagement, alignment and agreement within a co-design or co-production process. Implications for practice: The initial programme theory presented in this article provides clarity by identifying essential mechanisms which can guide the design and implementation of a range of participatory approaches. Rather than relying on a single label to convey complex participatory methods or processes, the values and principles of co-design or co-production, in combination with this programme theory, could be applied to guide implementation and reporting of specific activities within a range of research or participatory methods. Patient and public contribution: The initial programme theory was presented and piloted in a series of collaborative workshops between May 2023 and March 2024 with patient and public contributors, health professionals and researchers. This engagement process is currently underway to refine the programme theory and it is anticipated that this next phase will be completed in September 2024. Plain English summary: The aim of this review was to understand what needs to happen for meaningful engagement to take place by exploring how co-design and co-production in health and social care has been reported in published research. Ninety-three research articles were selected as these reported engagement processes with exchanges of mutual insight. Articles which only stated that engagement took place, without reporting details, were excluded. Any information relating to co-design and co-production processes were then extracted and analysed. The findings from this review were that co-design and co-production can occur at different times, in part or all of the research and engagement process. We identified that interaction between six key elements (intention, assets, dialogue, documentation, interpretation and understanding) in context, even if only brief, are important for meaningful engagement to occur within a co-design or co-production process. We also found that there is an over reliance on the term 'co-design' or 'co-production' to convey complex processes for engagement. Rather than relying on a single word to convey such complex methods or processes, the values and principles of co-design or co-production, in combination with the key elements identified, could be applied to guide implementation, and reporting of specific activities within a range of research methods. [ABSTRACT FROM AUTHOR]

AbstractHealing gardens are green spaces that support the interaction of humans and elements of nature to improve well-being and quality of life. However, little is known about healing garden use and outcomes in African countries. This study aimed to design a healing garden intervention and measure its impact on psychosocial factors and quality of life of residents and care staff within two residential aged care facilities in Lagos, Nigeria. Each facility’s staff completed the psychosocial measurement tools by proxy for participants between ages 60 and 99, with or without dementia, at baseline and three months following interaction with the garden and completed the garden use observational survey to determine the effect on and use of the garden by care staff and residents. Results revealed an improvement in the quality of life and experiences of agitation but no beneficial change in depression among residents with and without dementia. Further, care staff reported a positive benefit of the garden on their work-life experience and the residents’ well-being. This study provides the base for future research on assessing the impact of healing gardens on persons living with dementia in Africa. [ABSTRACT FROM AUTHOR]

The educational design research movement asserts that the use of new tools or innovative devices is a powerful vector for the professional development of teachers, to the benefit of pupils' learning. It recommends that these tools be designed using a participatory approach that translates the knowledge gained from research into resources for action. The design-in-use approach shares the same presupposition. As part of our thesis work, we adopted this approach to co-design a teaching aid. With the help of a student in training practice and engineering, we studied the effects of this participatory approach on the professional development of the sixteen co-designing teachers. This study enabled us to identify and categorize the professional contributions perceived by the practitioners. This work encouraged reflection on the "meta" processes used by teacher-designers to self-evaluate their professional development. [ABSTRACT FROM AUTHOR]

Introduction: There is growing recognition that healthcare inequalities faced by people with intellectual disabilities extend to their experiences at the end of life, resulting in calls for more inclusive research to help address these inequities. Our study aimed to address this through the co‐design of a toolkit for supporting end‐of‐life care planning with people with intellectual disabilities. To inform the co‐design process, we undertook an evidence review to identify existing tools, resources and approaches that were already being used in practice. Methods: Our evidence review comprised three components: (i) a rapid scoping review of the academic literature, (ii) a desk‐based search of the grey literature and (iii) an online survey to capture unpublished resources that were distributed to services, professionals, third‐sector organisations and family members. A longlist of existing materials was appraised using an adapted version of the AGREE II instrument, resulting in a shortlist that was shared with the co‐design team. Results: The evidence review played a critical role in the co‐design of a new toolkit of end‐of‐life care resources for people with intellectual disabilities. However, AGREE II proved to be limited for our purposes. Conclusions: The survey was particularly useful in helping us identify resources, tools and approaches in current use. We identified evidence review processes that served to support co‐design team activities and elements that were more problematic. We argue that evidence review practices might be enhanced to better aid co‐design activities in health and care research, particularly for studies involving people with intellectual disabilities. Patient or Public Contribution: This article reflects on an evidence review that was conducted as part of The Victoria and Stuart Project. People with intellectual disabilities were deeply involved at every stage of project design, delivery and dissemination. The project employed people with intellectual disabilities as members of the core research team. People with intellectual disabilities and family carers were members of the project co‐design team and the project Advisory Group. The evidence review process itself was led by academic members of the research team with contributions from colleagues with intellectual disabilities via the Advisory Group and core research team. The findings from the evidence review were used by the co‐design team to inform the development of an end‐of‐life care planning toolkit for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Introduction: Health services rely upon carers to provide care for loved ones with cancer, yet many carers often feel ill‐prepared for this role. Despite a multitude of programmes to support carer mental health, programmes that help carers feel better equipped to support a person with cancer are lacking. This study aimed to address this need by adapting an evidence‐based intervention to be suitable for carers of people with cancer. Methods: This study used an exploratory, qualitative design consisting of experienced‐based co‐design and an in‐depth stakeholder engagement strategy. An existing evidence‐based programme to promote resilience in the context of providing care was adapted for relevance to carers for people with cancer via two co‐design workshops with carers and healthcare professionals (n = 8). The resulting prototype programme was refined based on stakeholder consultations with staff and consumer members of cancer and carer support organisations across Australia (n = 16). Transcripts of the workshops, meetings and written feedback from carers were thematically analysed. Results: Major programme developments were guided by three themes that emerged from the co‐design workshops: 'creating value for carers', 'multiple contributors to carer distress' and 'the need for flexible implementation'. Analysis of the stakeholder consultation data showed that the themes of 'diversity in carer journeys' and 'creating impact for carers' were key to further tailoring the programme for applicability to practice. An adapted programme called 'iCanSupport' resulted from the process, with key adaptations being more relevant case study scenarios for carers and greater flexibility in accessing and engaging with the intervention to accommodate a range of carer circumstances. Conclusion: Programmes to build skills for becoming a carer for someone with cancer are absent, yet they are desired by carers. Using co‐design provided a user‐centric approach to adapt an existing evidence‐based programme. Programme evaluation is required to determine the effectiveness of the co‐designed approach in improving carer preparedness among a range of cohorts. Patient or Public Contribution: Carers and consumers with lived experience and others involved in supporting consumers made valuable contributions to co‐designing and refining the programme in addition to providing ongoing guidance in the unfolding analysis and reporting of this research. [ABSTRACT FROM AUTHOR]

Background: There is wide variation in premature mortality rates in adults with severe mental illness (SMI) across London, with Tower Hamlets (a highly deprived and ethnically diverse area) scoring the highest. Objective: To identify examples of best practice and co‐design recommendations for improving physical health checks and follow‐up care amongst people with SMI in Tower Hamlets. Methods: Data were collected through online questionnaires (using SMI physical health best practice checklists), one‐on‐one interviews (n = 7) and focus groups (n = 3) with general practices, secondary mental health services, commissioners and leads of community services and public health programmes, experts by experience and community, voluntary and social enterprise organisations in Tower Hamlets. Data were analysed using deductive and inductive thematic analysis. Results: Twenty‐two participants representing 15 general practices (out of 32), secondary mental health services, commissioners and public health leads completed the online questionnaires. Twenty‐one participants took part in interviews and focus groups. Examples of best practice included cleaning and validating the SMI register regularly by general practices, knowing the number of patients who had been offered and/or received physical health checks, having clear pathways to community and specialist care services, using various communication methods and having a key performance indicator (KPI) for tailored smoking cessation services for people with SMI. Recommendations included adopting evidence‐informed frameworks for risk stratification and utilising the wider primary care workforce with specific training to follow up on results, offer interventions and support navigating pathways and taking up follow‐up care. Incentivising schemes were needed to deliver additional physical health check components such as oral health, cancer screening, Covid‐19 vaccination and sexual health checks. Including KPIs in other community services' specifications with reference to SMI people was warranted. Further engagement with experts by experience and staff training were needed. Conclusion: The present initiative identified best practice examples and co‐designed recommendations for improving physical health checks and follow‐up care in deprived and ethnically diverse people with SMI. Patient or Public Contribution: This initiative was supported by three experts with experience, and two community organisations, who were involved in data curation and interpretation, development of recommendations and/or dissemination activities including writing this manuscript. [ABSTRACT FROM AUTHOR]

Background: People with dementia have complex palliative care needs that are often unmet, including physical and psycho‐social needs. It is essential to empower people with dementia, family carers and professionals to better assess and manage care needs. We aimed to co‐design a palliative dementia care Framework delivered through a digital app to support holistic assessment and decision making for care in the community and care homes—the EMBED‐Care Framework. Methods: A systematic co‐design approach was adopted to develop the EMBED‐Care Framework across three stages: 1) Framework analysis to synthesise data from preceding evidence reviews, large routine clinical data and cohort studies of unmet palliative dementia care need; 2) Co‐design using iterative workshops with people with dementia, family carers and health and social care professionals to construct the components, design of the app and implementation requirements; and 3) User testing to refine the final Framework and app, and strengthen use for clinical practice and methods of evaluation. Results: The Framework was co‐designed for delivery through an app delivered by aTouchAway. It comprised five main components: 1) holistic assessment of palliative care needs using the Integrated Palliative care Outcome Scale‐Dementia (IPOS‐Dem); 2) alert system of IPOS‐Dem scores to highlight unmet needs; 3) IPOS‐Dem scores and alerts enable shared decision making between the practitioner, patient and/or carer to support priority setting and goals of care; 4) evidence‐informed clinical decision support tools automatically linked with identified needs to manage care; and 5) Training package for users incorporating face‐to‐face sessions, clinical champions who received additional face‐to‐face sessions, animated videos and manual covering the main intervention components and email and telephone support from the research team. Conclusions: This is a novel digital palliative dementia care intervention to link holistic assessment with clinical decision support tools that are practical and easy to use but address the complexity of palliative dementia care. The Framework is ready for feasibility testing and pilot studies for people with dementia residing at home or in a care home. Patient or Public Contribution: We were guided by our Patient and Public Involvement (PPI) group consisting of three people with mild dementia, including younger onset dementia, and seven family carers throughout the project. They supported the overall development of the Framework, including planning of workshops, interpreting findings and testing the framework in our PPI meetings. [ABSTRACT FROM AUTHOR]

Background In the coming years, major governance changes in the form of policy directives and regulations will catalyse major top-down change with respect to animal health on European farms in an effort to combat the OneHealth threat of antimicrobial resistance. This top-down approach must be met with bottom-up strategies to ensure target actors (namely, farmers and vets) are supported and motivated to change their practices, thus, avoiding unintended consequences of forced change. Although much behavioural research has explored the factors influencing antimicrobial practices on farms, a gap exists translating these findings into evidence-based behaviour change interventions that can be put into practice. The current study aims to fill this gap. It provides insights into identifying, understanding, and changing the behaviours of farmers and veterinarians with respect to the responsible use of antimicrobials in farming. Results Through an inter-disciplinary and multi-actor approach, the study combines scientific knowledge from the behavioural sciences and animal health sciences, coupled with tacit knowledge from a co-design, participatory approach to recommend seven behaviour change interventions that can help to support good practices amongst farmers and vets, with respect to animal health, and reduce the use of antimicrobials on farms. The behaviour change interventions include message framing; OneHealth awareness campaign; specialised communications training; onfarm visual prompts and tools; social support strategies (for both farmers and vets); and antimicrobial use monitoring. The study details each intervention with respect to their evidence base and scientific concept, grounded in behavioural science, along with stakeholder feedback on design and delivery of the interventions. Conclusions These behaviour change interventions can be taken, adapted, and put into practice by the agri-food community to support good animal health practices and responsible antimicrobial use on farms. [ABSTRACT FROM AUTHOR]

Integrative social–ecological approaches are crucial for addressing sustainability challenges in coastal and marine systems. Among these, Marine Spatial Planning (MSP) emerges as a pivotal approach for integrated management. Often, the establishment of Marine Protected Areas (MPAs) and the application of MSP occur in parallel. Given the potential synergies, there is a need to better understand and address barriers to the adoption of MSP approaches for integrative conservation mechanisms. Using São Tomé and Príncipe as a case study, we illustrate how MSP was employed as an operational framework for establishing an MPA network. Drawing on the experiences of people directly involved in this co‐design process, we reflect on the main challenges and opportunities in achieving social–ecological integration, and highlight recommendations for conservation practitioners and planners. Applying MSP was perceived to contribute substantially to multiple project goals, with some (e.g., incorporating perspectives and needs of vulnerable groups) more challenging to achieve. While MSP enhanced conceptual, disciplinary, methodological and functional integration, practical challenges in implementation hindered the extent to which each of these was achieved. Given international commitments to Blue Growth, high fisheries dependence and current patterns of change, developing effective integrative MSP approaches is essential for social–ecological resilience. [ABSTRACT FROM AUTHOR]

Extended reality (XR) such as Virtual Reality (VR) and Augmented Reality (AR) has been heralded as a particularly promising technology for autistic people. However, prior studies have centered around curing or ameliorating deficits and impairments and are typically conducted by non-disabled and non-autistic researchers. Using co-design and a variety of learning experience design methods and processes, Project PHoENIX (Participatory, Human-centered, Equitable, Neurodiverse, and Inclusive XR) speaks to the need for research that applies a social-ecological perspective to the design and evaluation of VR experiences for autistic users, with the goal of decreasing environmental barriers and promoting a more inclusive society. In this study, we describe a multi-cycle process of educational design research (EDR), consisting of iterative human-centered formative design, development, implementation, and evaluation of Project PHoENIX from Spring 2021 to Spring 2022. A framework for conducting co-design and collaborative educational design research with autistic individuals in a VR environment is provided along with design principles that support this framework. Findings from 3 meso-cycles illustrate the dual outcomes of educational design research, namely, (1) a consistently maturing intervention and (2) improving theoretical understanding. Findings underscore the feasibility of our approach, and demonstrate potential to scale. [ABSTRACT FROM AUTHOR]

This article introduces a method for conducting a fully online collaborative design workshop requiring no facilitation which we refer to as a Self-guided Collaborative Online Workshop (SCOW). The article provides three main contributions. Firstly, we present a process for the conversion of a face-to-face facilitated design workshop into a SCOW using a method we call the "playboard" which draws on concepts from CSCL literature. Secondly, we evaluate the efficacy of SCOWs using an iterative evaluation with 75 participants, including measures for participant satisfaction, subjective and objective learning outcomes, quality of the online and self-guided experience, and comparison with face-to-face workshops. Results across all measures indicate that the self-guided workshop was as successful as the in-person facilitated original. Moreover, participants reported advantages of the more scalable format including improved access to those with non-visible disabilities and in the Global South. Finally, based on our findings, we present a set of recommendations for others interested in using SCOWs as an inclusive and scalable way to support collaborative experiences. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co‐designing interventions with consumers (lived experience experts), co‐design methods and outcomes are often poorly reported. The present study aims to report on the co‐design process used to develop The Healthy Gut Diet intervention. Methods: Co‐design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co‐facilitators (including a consumer co‐facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a "behaviour diagnosis" to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. Results: A co‐designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co‐design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3‐month study period. Conclusions: Co‐design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours. Highlights: Co‐designing dietary interventions with consumers can reduce research waste, improve applicability and intervention adherence, and enable selection of behaviour change techniques.Although increasing in popularity, co‐design methods, processes and outcomes are minimally described in diet research.Co‐design for The Healthy Gut Diet for Preventing Gestational Diabetes study involved 12 consumers with a lived experience of gestational diabetes and six researchers.Three online co‐design workshops were used to explore and decide on educational formats, content and delivery for the intervention, communication methods and a "behavioural diagnosis".The result was a dietary and behaviour change intervention (The Healthy Gut Diet), which is reported using the Template for Intervention Description and Replication. [ABSTRACT FROM AUTHOR]

Background: Multifactorial cancer risk prediction tools, such as CanRisk, are increasingly being incorporated into routine healthcare. Understanding risk information and communicating risk is challenging and healthcare professionals rely substantially on the outputs of risk prediction tools to communicate results. This work aimed to produce a new CanRisk report so users can directly access key information and communicate risk estimates effectively. Methods: Over a 13-month period, we led an 8-step co-design process with patients, the public, and healthcare professionals. Steps comprised 1) think aloud testing of the original CanRisk report; 2) structured feedback on the original report; 3) literature review; 4) development of a new report prototype; 5) first round of structured feedback; 6) updating the new report prototype; 7) second round of structured feedback; and 8) finalising and publishing the new CanRisk report. Results: We received 56 sets of feedback from 34 stakeholders. Overall, the original CanRisk report was not suitable for patients and the public. Building on the feedback, the new report has an overview of the information presented: section one summarises key information for individuals; sections two and three present information for healthcare professionals in different settings. New features also include explanatory text, definitions, graphs, keys and tables to support the interpretation of the information. Discussion: This co-design experience shows the value of collaboration for the successful communication of complex health information. As a result, the new CanRisk report has the potential to better support shared decision-making processes about cancer risk management across clinical settings. [ABSTRACT FROM AUTHOR]

Development and popularisation of creative technologies have resulted in changes to creative processes in the art and museum sector, and have redefined consumer and producer roles. The design practises that emerge when exhibition designers integrate new technologies to promote visitor engagement and co-creation are investigated in this article. This study delves into a novel design strategy for exhibition co-creation that acknowledges each interaction as a potential data point and involves connections between exhibition space, narrative, technology, interaction, and visitor, as well as a distinction between aware and unaware co-creation. [ABSTRACT FROM AUTHOR]

Given calls to decolonise engagement with Indigenous communities, this article explores how allied researchers can participate in self-determined learning with Indigenous Peoples. Drawing on over a decade of experience within an action-research collective in a Mapuche context, the authors suggest that allied researchers can accompany Indigenous-led co-design in a manner that not only strengthens genuine Indigenous participation but also fosters mutual and collective learning from within the co-creative processes themselves. Lake Budi, a biocultural hotspot in the Pacific coast of Northern Patagonia, Chile, is a coastal wetland habitat for hundreds of endemic and migratory species and the ancestral homeland for the Mapuche-Lafkenche (∼15,000) who, through grassroots learning, are determining practical steps towards restoring their territory and its self-governance for kvmemongen. This Mapuche concept refers broadly to enacting forms of living well together, humans and non-humans. As allied participants in a Mapuche-led codesign collective since 2013, in this paper, we focus on exploring key “moments of mutual learning” within this longer-than-usual co-design process. Each of these moments involved collective learning that required interaction and feedback loops across diverse areas of expertise, made possible over longer and flexible rhythms and periods. Tools, protocols, and methods gradually take shape in such a process through mutual learning opportunities provided by relationship building, cultural immersion, community-led protocols, decision-making, and evaluation mechanisms. This work suggests a new understanding of the involvement of allied researchers in Indigenous-led co-design as an emerging and increasingly relevant form of grassroots mutual learning toward climate resilience. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this demand driven research is to co-design an intervention for upper-secondary students that addresses issues of consent and healthy relationships. In this paper, we (university researchers, student coresearchers, school staff), present the engagement framework that has been critical to the project's development and planned implementation. Methods: An iterative co-design approach grounded in a participatory research approach is currently being adopted. Student co-researchers from three independent secondary schools on Whadjuk Nyungar Country in Boorloo/ Perth, Western Australia, have been engaged as co-researchers in the design of the intervention. Supplementary quantitative and qualitative data from students enrolled at each school site is also being collated to further inform the intervention design. Student co-researchers will provide insights on the overarching design of the intervention including: the scope of key concepts they want to learn, interpretation of supplementary data, and the development of contextually relevant educative content. Results: Retrospective and prospective components of the engagement framework are described and supported with applied examples where applicable. Preliminary results demonstrate the imperative of adopting iterative co-design, and the efficacy of our authentic engagement framework. A draft intervention has been formalized and will soon undergo piloting. The codesign process has already resulted in an intervention that differs from the initial program first conceptualized by university researchers. Conclusion: Imperative to our engagement framework is centering students as experts of their lived experience. It is anticipated that this engagement framework will provide insights around the feasibility, value, and necessity for authentic engagement of upper-secondary school students in the design of their consent and healthy relationship education. [ABSTRACT FROM AUTHOR]

Cancer is one of the main public health challenges globally. In Europe, it is also the second leading cause of mortality and incidence is likely to increase from nearly 4 million cases per year in 2020 to over 5 million new cases per year by 2040. Recognizing the urgency of tackling the entire disease pathway and supporting European Union (EU) Member States (MS), the European Commission (EC) launched two major initiatives: Europe's Beating Cancer Plan (EBCP) and the Mission on Cancer (MoC). Belgium is one of the few EU MS that has set up a dedicated structure, known as the Belgian EBCP Mirror Group (MG), to support the implementation of the EU strategy against cancer. The MG is a large national stakeholder platform coordinated by the Cancer Centre at Sciensano (Belgian Institute of Health). This Supplement between includes eight policy briefs developed by the MG on the most pressing needs to address in the Belgian cancer field. The policy briefs take into account relevant interventions at national level as well as Belgium's participation in European projects as of 2021-2023. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONIntroduction: Using computer-aided design and 3D printing within a co-design process to produce assistive technology (AT) has a positive impact in delivering customised solutions to end-users’ needs. However, to date its adoption within healthcare services has been limited. This work aims to gather clinicians’ insights to identify and analyse barriers inherent in the AT design, manufacturing, and provision processes and inform a detailed understanding of the current AT eco-system. It forms part of a long-term ambition to efficiently scale up a service for the co-design of custom AT across specialties and healthcare services.Methods: Five interactive workshops were run with 21 healthcare professionals currently involved in AT provision. Participants were recruited from two health boards in the UK. Thematic analysis was used to identify common barriers to scaling up a custom AT approach. Additionally, an eco-system map was created to determine the key stakeholders and their interactions.Results: Nineteen descriptive themes, grouped into four analytical themes, were identified related to the design of AT, access to AT, healthcare staffing and healthcare system pressures. The eco-system map identified sixteen individual stakeholders and ten different groups of significant corporate stakeholders.Discussion: The identified barriers relate to both the provision of off-the-shelf and the co-design of customised AT. Further promoting the scaling up of a co-design custom AT process requires: improving communication between stakeholders, enabling information about AT to be easily accessible, ensuring feedback is gathered and used, and creating tools that enable non-expert designers to modify custom AT designs safely and effectively.The provision of custom assistive technology (AT) needs to centre around engaging end-users from the outset to set goals, manage expectations and educate individuals on the solutions available.A digital platform needs to be developed that incorporates a user-friendly repository with clear information about off-the-shelf and custom AT solutions available.The platform should facilitate easy communication between healthcare services and the end-users of AT and enable feedback to be easily gathered and shared.The scaling up of co-design processes for the provision of custom AT within healthcare services requires training of non-expert designers in digital design and manufacturing and the creation of more user-friendly computer aided design tools.The provision of custom assistive technology (AT) needs to centre around engaging end-users from the outset to set goals, manage expectations and educate individuals on the solutions available.A digital platform needs to be developed that incorporates a user-friendly repository with clear information about off-the-shelf and custom AT solutions available.The platform should facilitate easy communication between healthcare services and the end-users of AT and enable feedback to be easily gathered and shared.The scaling up of co-design processes for the provision of custom AT within healthcare services requires training of non-expert designers in digital design and manufacturing and the creation of more user-friendly computer aided design tools. [ABSTRACT FROM AUTHOR]