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Addressing sustainability challenges entails collaborating between people with different backgrounds, knowledge, and experiences to co-create change strategies. In this work, we share how a group of livestock producers, non-profit organization members, scientists, and government officials became a partnership aimed at promoting sustainable cattle ranching in Mexico. We identified three key ingredients for fostering meaningful partnerships: i) promoting horizontality among participants; ii) reframing participation beyond sectoral roles; and iii) co-creating a common actionable world. Nurturing these conditions at the onset of a co-design project phase is essential for catalysing the transformative potential of initiatives seeking transformative change towards sustainability.
Technical Summary
Literature concerning sustainability-related endeavours seeking transformative change increasingly acknowledges the importance of creating more meaningful interactions within transdisciplinary partnerships. Yet, further research is needed to understand what these interactions entail and which enabling conditions can create partnerships required to catalyse transformative change. Framed in the initial co-design phase of a Social-ecological Innovation Laboratory aimed at fostering change towards sustainable cattle ranching, and based on notions of safe-enough and public spaces, in this article we elaborate on certain enabling conditions for creating meaningful partnerships. We describe how participants collectively articulated an actionable shared world, represented by a network of changes, and positioned themselves as relational agents co-designing the strategies to enact the desired changes from within, not from outside. From this experience, we discuss the conditions identified as enablers for facilitating meaningful transdisciplinary partnerships: i) promoting horizontality among participants, ii) reframing participants’ sector-specific identities into genuine and relational subjects, and iii) co-constructing and institutionalizing a shared actionable world. Our findings emphasize the relevance of a co-design phase centred on nurturing the quality of social interactions through context-specific conditions. We posit that such enabling conditions are essential for accumulating the transformative potential of initiatives seeking to catalyse significant change towards sustainability.
Social Media Summary
Nurturing meaningful relationships in a shared world for co-designing transformative change.
Coordinated, multicomponent care models improve outcomes in early psychosis in high-income settings, but how coordinated care can be adapted for rural, pluralistic, low-resource systems remains poorly understood. We aimed to co-design a locally feasible coordinated care model for people with severe mental illness (SMI) in rural Uganda and identify feasible delivery agents, role divisions, engagement with pluralistic care pathways, and anticipated implementation barriers. We conducted three iterative co-design workshops with 18 participants across parallel churchand mosque-based series in Buyende District, Uganda. Participants included biomedical and mental health workers, Village Health Team members, religious leaders, traditional healers, local leaders, people with lived experience of SMI, and caregivers. Transcripts were translated and analyzed using the Framework Method. Four themes emerged. Participants described sequential help-seeking across a pluralistic care landscape with directional referral asymmetries. They proposed distributing psychosocial support and medication follow-up across a tiered workforce, with relational trust as a key feasibility condition. Reintegration was framed through administrative endorsement and community economic institutions. Family psychoeducation was viewed as foundational and deliverable through task-shifting and peer caregivermentorship. Participants articulated a coordinated care model preserving core functions while redesigning delivery around a community-extended, task-shared workforce.
Mental health problems have long-lasting impacts and often begin in adolescence, yet young people face multiple barriers to accessing care and support, including a fragmented system, limited awareness of services and stigma. Afloat was developed to guide users to suitable support.
Aims
This study aimed to (a) co-develop a mobile app to support young people’s access to mental healthcare and support; and (b) evaluate its acceptability, potential impact on service use, mental health outcomes and economic implications.
Method
Afloat was co-developed with young people to provide information on available support, and included personal stories from peers and links to care resources. A pilot evaluation involved 105 participants aged 16–25 years from London, UK. Participants completed surveys at baseline and 3 months to assess changes in mental health, service use, stigma and self-identification of mental health issues. App usage was monitored through analytics. A budget-impact analysis estimated financial implications of Afloat implementation.
Results
Participants reported high acceptability and satisfaction. After 3 months, there was an increase in the likelihood of help-seeking and a reduction in mental health symptoms. The increase in actual service use was significant only among those with mild-to-moderate symptoms. Budget-impact analysis indicated potentially increased costs from additional service use.
Conclusions
Afloat shows preliminary promise as a tool associated with increased help-seeking and improved mental health. Long-term benefits of timely intervention may offset short-term costs from increased service use, although this requires formal evaluation. Further research is required to assess long-term outcomes and economic implications.
Design is transitioning modalities, from participation to deep engagement, creating active citizen(s). Authors define, communicate, and navigate post-participatory sustainable design, (interviewing 50+ project leaders), catalysing sustainable activities. Engaging Design, enables creative individuals, communities & collective action(s) to craft/design synergies: motivated by mutual respect, designing ‘with’ not for, shifts understandings’ of public engagement, transcending disciplines, providing sustainable value. Analysis and insights, yield recipes to cultivate sustainable active citizen(s).
Collaborative design futuring has gained attention as an inclusive approach for envisioning future societies where external stimuli play a crucial role in stimulating imagination. Building on literature on design stimuli, psychological distance, and co-design, we propose and evaluate a five-layer framework through a multiple-case analysis of fifteen workshops and exhibitions. Through comparative analysis of different workshops, we explored how stimulus characteristics, such as modality, richness, and scenario, influence participant engagement and perceived psychological distance.
To bridge capability gaps between designers and artisans that hinder fashion and textile business collaboration and social innovation effects, this study explores how capability-based co-design fosters sustainable partnerships. Based on 20 case studies in China’s textile sector, it connects craft values, product features, and capability-based interactions. The model links this approach to make co-design practical amid skill gaps and enhance social innovation. It offers actionable strategies for balancing co-design methods in skill asymmetric partnerships in cultural and creative industries.
This study explores how AI workflows and prompt engineering reshape storytelling in design education. Students utilized tools such as ChatGPT, Midjourney, Runway, and Meta Glasses to reframe existing projects through iterative scripting, image generation, and reflection. Analysis of 88 visual projects and over 80 videos showed a shift from static documentation to multimodal narratives. Findings suggest AI enhances communication fluency, engagement, and reflective practice through adaptive, platform-native storytelling.
This paper presents a pedagogical tool for the co-design of systemic and resilient Nature-based Solutions for carbon removal. Tested with nine participants, it significantly improved understanding of NbS dynamics. Wilcoxon tests showed higher scores for all thinking skills derived from Bloom’s taxonomy (p < 0.05), with notable gains for higher-order skills. Participants reported that the tool was intuitive and engaging, fostering collaborative learning. Results confirm its educational value and potential to engage creative and resilient NbS design.
Co-creation with end-users is a well-known process. While this approach has been widely adopted in B2C, B2B companies have been slower to adopt it due to complex decision-making structures. This case study is based on co-creation sessions with end-users to respond to the needs of B2B industries. The study highlighted the importance of co-creation with end-users in B2B industries to understand real-life use scenarios, and finally to propose a final product that meets their expectations.
This study investigates how structured co-design approaches foster team mental models (TMMs) sharedness in interdisciplinary design teams engaged in information visualization projects. Interdisciplinary collaboration faces challenges including communication barriers, diverse domains and complex informational environments that hinder shared understanding and cohesion. Drawing from literature on team mental models, team cognition and co-design practices, the study formulates four research questions related to specific interventions, integrative activities, evocative artifacts, framing guides and guided reflexivity. An exploratory mixed-methods approach involved two design teams through brainsketching workshops, with one experiencing structured co-design interventions and an unfacilitated group without interventions. Data analysis integrated qualitative verbal protocol coding with quantitative transition matrices to capture sequential interaction patterns. Chi-square analysis revealed distinct behavioral patterns, with the intervention group exhibiting richer communicative sequences. Findings reveal that integrative activities enhanced early team integration and supported divergent thinking. Evocative artifacts facilitated semantic alignment and novel idea development, while framing guides helped establish adaptive decision-making. Guided reflexivity encouraged procedural strategies around complex problem spaces. The unfacilitated group experienced difficulties, particularly in task framing and reflection processes. This research contributes a procedural framework mapping verbal activity types to team cognition stages, offering approaches for fostering TMMs in interdisciplinary design contexts.
People with schizophrenia spectrum disorders (SSD) experience high rates of type 2 diabetes (T2D), mainly due to antipsychotic medication side-effects and lifestyle factors (e.g. suboptimal nutrition and physical inactivity). Digital technologies may reduce T2D risk by complementing face-to-face and pharmacological treatments, through the provision of flexible and personalised psychoeducation and behavioural prompts tailored to end-users.
Aims
This study tested the preliminary efficacy of the Schizophrenia and diabetes Mobile-Assisted Remote Trainer (SMART), a co-designed text message-facilitated intervention, designed to reduce the risk and/or improve self-management of T2D, along with its acceptability and feasibility.
Method
Using an uncontrolled pre–post design, 29 out-patients of an endocrinology mental health clinic and two community-based rehabilitation mental health facilities used SMART for 12 weeks. The primary outcome was patient activation, measured using the Patient Activation Measure. Secondary outcomes were combined objective cardiometabolic and self-reported health and mental health indicators. Pre–post changes were analysed with a linear mixed model, accounting for within-participant variation.
Results
Significant improvements (p < 0.05) were detected in patient activation, confidence in diabetes self-management and general health management, health literacy and mental health recovery. High levels of acceptability and feasibility were confirmed, with recruitment, retention and adherence rates of 67.4, 92.9 and 93.0%, respectively.
Conclusions
SMART is a world-first digital intervention aimed at improving metabolic health in individuals with SSD. This study provides evidence of its preliminary efficacy in self-management of metabolic health while confirming its high acceptability and feasibility, supporting expansion towards a sufficiently powered controlled trial to assess its clinical effectiveness.
We aimed to improve the shared decision-making process for those offered antipsychotic medicines by co-designing a suite of accurate and accessible medicines information video resources.
Methods:
We adopted the four core activities of the Double Diamond Design Thinking Model – Discover, Define, Develop, and Deliver. We first explored the full range of stakeholder needs including pharmacists, psychiatrists, nurses, and most importantly experts-by-experience, in relation to existing antipsychotic medicines information resources. Using a validated tool, we assessed the understandability and actionability of the manufacturer’s patient information leaflets and digital resources accessed following an internet search. Using this information, we refined our insights into a clear problem statement and solution.
Results:
We identified gaps in readability, understandability, and actionability with existing antipsychotic medicines information resources. Consequently, we developed prototype information resources that we iteratively reviewed and validated along with our expert panel of key stakeholders. We uploaded our six antipsychotic medicines information videos to our digital platform where they can be freely accessed by those participating in shared decision-making.
Conclusions:
Our antipsychotic medicines information videos address an unmet need in the shared decision-making process. Using a human-centred and innovative approach, we prioritised input from key stakeholders to provide clear, accurate, and accessible information to support informed choices in psychosis recovery.
Antimicrobial stewardship (AMS) is essential for mitigating antimicrobial resistance (AMR) in animal health, but implementing national initiatives is challenging due to diverse influencing factors and the need for context-specific approaches. An Animal AMS Practice Group, comprising individuals with lived experience overseeing AMS in various animal health contexts, was engaged and through an experience-based co-design approach created a comprehensive AMS Framework that captures progress and supports tangible improvements in AMS practices in each context. The Framework supported a cross-sectoral pilot assessment that helped users identify progress, areas for improvement and contextualise antimicrobial usage and AMR data, while also motivating further AMS efforts. Despite common barriers to the sharing of sensitive data, participants willingly shared AMS results for comparison and publication. The process demonstrated that co-design coupled with peer learning and expert support is essential to creating AMS tools that are relatable to users. Several participants incorporated the Framework into routine practice, with some using it to drive sector-level AMS action. The resulting Framework offers an adaptable, scalable entry point for AMS efforts and a platform for setting meaningful improvement goals. It supports broader opportunities for national-level AMS assessments and strategy development.
Archaeologists often proclaim that they have much to contribute to the ‘global challenges’ of the twenty-first century, yet they find little space at the policymaking table. In this debate article, the authors argue that archaeologists seeking practical relevance must start with a critical, expanded understanding of the contemporary, including how communities, stakeholders and complex policy structures operate to navigate unfolding socioecological crises. They propose a reversed historical directionality grounded in transdisciplinary research design that integrates contemporary challenges and community-defined priorities from the outset to foster a dynamic, future-facing dialogue that more readily informs pathways to tangible impact.
Over the course of seven years, the Tata center recruited and trained more than 200 graduate students from 18 different MIT departments to design and implement energy solutions that are practical and reliable in the developing world. Their work produced 45 patents, 12 commercial licenses, and over a dozen startups. This chapter demonstrates the method for implementing similar programs, with a focus on energy-related research projects. The program leaders describe their project as “CPR for Engineers,” with a three-axis model focusing on developing Compassion, Practice, and Research.
This Element explores the transformative impact of integrating service design principles into public management and administration, championing a user-centred approach and co-design methodology. By reviewing existing literature, the authors define the scope and applications of service design within public administration and present three empirical studies to evaluate its implementation in public services. These studies reveal a trend towards embracing co-design and digital technologies, advancing a citizen-centred strategy for public service design. This approach prioritizes value creation and responsiveness, highlighting the importance of involving users and providers in the development of services that meet changing needs and promote inclusion. Combining theoretical insights with practical solutions, the Element offers a comprehensive framework for public management research. It highlights the need for ongoing engagement and integration of user experiences, presenting an effective strategy to navigate the complexities of public service design. This title is also available as Open Access on Cambridge Core.
Collaborative design (co-design) is a team effort fostered through the creative involvement of all participants in co-creative collaboration (co-creation). This new approach to design as a creative social activity heightens the need to study the interpersonal aspects of creativity. Though co-creation has become widely used in recent years, few studies focus on its dynamics, which emerge from intense interactions created by the shared subjectivities of participants in an intersubjective environment. The management and enhancement of interpersonal factors can help create this shared environment by leading the process from personal to interpersonal creativity. Some of these interpersonal factors could be measured by observing the data of biosignals that are used as social cues, particularly if studied in comparison with the data of one of the partners of the social interaction, thanks to the synchrony rate between these datasets. This synchrony of biosignals related to shared behaviours can be associated with the interactive level dynamics that occur during co-creation in team of two (pairwork). This study presents the results of an experiment where biosignal synchrony results were compared to subjective feedback regarding the interactive level to understand the dynamics of the interaction. The results suggest the possibility of using the synchrony rate measured by the Damerau- Levenshtein distance (Ld) or dynamic time warping method (DTW) to approximate the dynamics of the interactive level in co-creative pairwork. This study will contribute to our understanding of the influence of the socio-cognitive process on interactions during co-creation to improve the co-creative design process.
To co-design a systems approach aimed at promoting the wide-scale adoption of whole-school approaches to food in UK primary schools to improve school food environments, food provision and dietary intake in children.
Design:
A systems framework (Action Scales Model) was used to guide the co-design of the systems approach. The process involved identifying leverage points within the UK primary school food system that, if influenced, could alter the way in which the system functions. Actions were then agreed upon to influence those leverage points.
Setting:
Co-design workshops were held online between September 2021 and February 2022.
Participants:
Members of the co-design team comprised twelve school stakeholders (headteachers, school food improvement officers, catering leads, representatives of UK school food organisations and a dietician) and a team of researchers with expertise in school food, systems thinking and intervention development. Our partnership board included decision-makers and advocates of the whole-school approach to food in England and Northern Ireland.
Results:
Identified leverage points included the priorities of headteachers, who are instrumental in instigating whole-school approach to food adoption. Direction from local and national policymakers was also identified. Actions to influence these leverage points included providing direct support to schools (through an online resource) and encouraging policymakers to monitor the adoption of the approach.
Conclusion:
The methods described here can be replicated by others to promote the adoption of whole-school approaches to food in other contexts and contribute to the growing literature on developing systems-wide approaches to promote the adoption of public health initiatives.
Safety planning is a commonly used, evidence-based intervention for suicide prevention. There is a need for continuous engagement with safety plans post-discharge, and the improvement of safety plan portability has been discussed within our mental health organisation. This has led to the development of an app, called the Hope App. This study aims to implement this app into routine practice in a Canadian psychiatric emergency department.
Aims
We aimed to describe a collaborative, theoretically driven approach to co-design implementation strategies to elicit behaviour change among emergency department clinicians; co-develop a set of tailored, theory-informed, multifaceted implementation strategies for embedding an app into a psychiatric emergency department; and describe engagement evaluation received by the co-design team.
Method
Co-design approaches and the Behaviour Change Wheel were used to develop implementation strategies with clinicians, patients and care partners. The co-design team consisted of 12 members, and we held four design sessions. Design sessions were iterative in nature and organised such that the findings of each session fed into the next session.
Results
We identified 11 implementation strategies encompassing different combinations of intervention functions and behaviour change techniques, targeting barriers and leveraging facilitators identified in our previous work.
Conclusions
The tailored implementation strategies developed in this study have the potential to fill existing gaps in integrating digital technology. A key strength of this study is its use of behaviour change theories and a collaborative approach. The strategies are designed to align with the needs and preferences of clinicians, patients and care partners.
The advent of complex socio-technical systems in modern society calls for teaching value-based participatory design in engineering curricula. Yet, no scientific literature supports teachers in this effort. This paper introduces a teaching approach called “value-based participatory design of complex socio-technical systems” and reports on its implementation. It emphasizes the importance of actively involving stakeholders and tapping into their values from the very start of the design process. Following this approach, students learn to (1) design with stakeholders, (2) identify key values and conflicts to create a value-based mission statement, (3) navigate uncertainties, (4) adopt an iterative design process, and (5) recognize that only stakeholders can define what works best. Results of an academic course based on this approach confirm its value and importance for engineering curricula.