Co-design
What is co-design?
Experience-based, or participatory co-design, is being used increasingly in health research. It refers to the process where patients, healthcare professionals and, in the case of HEAL-D, community leaders, work in partnership with researchers to develop healthcare programmes.
The process involves gathering experiences and insights from stakeholder groups, through in-depth interviewing, observations and group discussions. Then working together to design a programme or service which each group has played a role in developing and shaping. This process helps ensure the programmes that are developed are valuable to patients and practical to implement.
In co-designing HEAL-D, our aim was to ensure we developed a programme that was sensitive to the needs of people of African and Caribbean heritage living with type 2 diabetes, as well as healthcare professionals and NHS services.
We conducted our co-design in three phases:
Phase I: a formative research phase in which we used focus groups and semi-structured interviews to explore the relevance, acceptability and feasibility of cultural tailoring methods that have been used in other culturally tailored and/or targeted health promotion interventions for populations of African ancestry, whilst also identifying other issues and priorities that might be relevant to the design and context of HEAL-D. We gathered insights from adults of African or Caribbean heritage living with type 2 diabetes, healthcare professionals and community figureheads/leaders, such as faith leaders and community activists.
Phase II: interactive co-development workshops (2 x half-day workshops, held in community venues) were conducted to gain stakeholder involvement in developing the details of the intervention, including the setting, media channels, structure and delivery. We used scenarios to understand important themes that arose from the formative research e.g. educator credentials, location. We also sought feedback on existing educational/support materials to explore issues such as language/phrasing, and pitch.
Phase III: the HEAL-D programme materials were developed through an iterative process, seeking stakeholder input and feedback to identify refinements.
Co-design publications:
- Goff LM, Moore AP, Harding S, Rivas C. Development of Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), a culturally-tailored diabetes self-management education and support programme for black-British adults: a participatory research approach. Diabetic Medicine. 2021;00:e14594.
- Goff LM, Moore AP, Harding S, Rivas C. Providing culturally sensitive diabetes self-management education and support for Black African and Caribbean communities: a qualitative exploration of the challenges experienced by healthcare practitioners in inner London. BMJ Open Diab Res Care. 2020. 8, 2, e001818.
- Moore AP, Rivas CA, Stanton-Fay S, Harding S, Goff LM. Designing the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) self-management and support programme for UK African and Caribbean communities: a culturally tailored, complex intervention under-pinned by behaviour change theory. BMC Public Health. 2019. Aug 20;19(1):1146.
HEAL-D co-development was funded by a National Institute for Health Research (NIHR) Career Development Fellowship (Louise M. Goff, CDF-2015-08-006), and support from the NIHR Applied Research Collaboration (ARC), South London.