Digital health co-design: Perspectives from participating stakeholders on creating the Compass app

Abstract Background Co-design is increasingly heralded as an appealing and effective method for engaging diverse stakeholders in public health research. However, it is not clear how co-design can best be implemented in research projects and what the constraints and enablers of its use are. Methods In this study, we evaluate the use of co-design in the design of a digital health prevention intervention, titled ‘Compass’. The co-design process is evaluated according to Normalisation Process Theory and investigated how co-design was implemented in a public health research setting. In-depth interviews were conducted with 12 stakeholders who were heavily involved in the co-design process. Results Co-design of a digital health intervention was widely perceived to be beneficial by those involved. Key advantages include that it empowered diverse stakeholders to have a voice in the digital health design process, that the use of design thinking led to the disassembly of power imbalance that typically characterise traditional patient - professional relationships, and it generated new ideas for the intervention design that wouldn’t otherwise have eventuated. Challenges include the substantial effort required to initiate and execute a co-design process including coordination of the various activities and diverse stakeholder group. High-quality project management was identified as a critical factor in the success of the co-design process. Conclusion Co-design is a substantial yet worthwhile undertaking that can add significant value to the development of digital health interventions including increasing the relevance of such outputs and empowering diverse stakeholders in the process.