An Age-Adapted Co-Design Methodology for Community Health Research Involving Older Adults With Type 2 Diabetes

Abstract

Introduction: Co-design is increasingly used in health and social care research, but its application with older adults in community settings may raise methodological challenges. Age-adapted co-design methods are needed to support meaningful participation. Methods: This study developed and examined an age-adapted co-design methodology in a community setting involving older adults with Type 2 diabetes mellitus (T2DM). A qualitative approach was adopted, which included exploratory interviews, design probes, clarification interviews, a co-design workshop and evaluation interviews. A total of 24 participants were involved across the study, including older adults with T2DM, community workers, healthcare professionals and extended reality (XR) designers. The methodology was examined in terms of acceptability, appropriateness and feasibility. Results: The methodology was generally found to be acceptable, appropriate and feasible. Participants described the interviews, design probes and workshop activities as manageable and low-burden, particularly when tasks drew on everyday life. Visual materials such as stickers, icons, images and videos, together with simple prompts and reduced writing demands, supported understanding of the research activities, expression and positive emotional engagement. The study also identified challenges related to unfamiliar co-design concepts, the interpretation of some visual tools, workshop duration and practical implementation constraints such as staffing, space, funding, health conditions and time availability. Participant feedback and researcher reflection informed iterative refinements to the materials, workshop preparation, communication strategies and activity format during the study. Conclusion: This study demonstrates the value of an age-adapted, multi-stage co-design methodology for engaging older adults in community health research. The findings highlight the importance of grounding co-design in lived experience, using age-friendly materials and refining methods iteratively. Patient or Public Contribution: Older adults with T2DM, community workers, healthcare professionals and XR designers contributed to this study. Their experiences and feedback informed the refinement of the research materials, co-design activities and methodological process.