Short answer
When employing co-design, establish a clear definition, select or adapt a structured framework (like a 4-5 stage process), and explicitly define the roles and expected contributions of all participants, including plans for prototype development and testing.
- Field
- User-Centred Design
- Source
- Journal of Public Health (2025)
- Method
- Systematic Review
- Sample
- 55 articles
- Evidence
- Moderate effect
A systematic review of co-design in public health reveals a common tendency to employ structured, multi-stage processes, though the depth of participant engagement and prototype testing can vary significantly. This user-centred design research insight is drawn from a 2025 study published in Journal of Public Health. Using Systematic review with 55 articles, researchers explored how this design variable affects real-world outcomes. The key design takeaway: When employing co-design, establish a clear definition, select or adapt a structured framework (like a 4-5 stage process), and explicitly define the roles and expected contributions of all participants, including plans for prototype development and testing.
Co-design frameworks in public health show a trend towards 4-5 stage processes with varied participant involvement.
A systematic review of co-design in public health reveals a common tendency to employ structured, multi-stage processes, though the depth of participant engagement and prototype testing can vary significantly.
Journal of Public Health · 2025
Key Findings
- 01A significant surge in publications on co-design in public health occurred in 2023.
- 02Most studies originated from Oceania, particularly Australia.
- 03While 44% of studies lacked a clear definition of co-design, 56% emphasized its collaborative and inclusive nature.
- 04Over half (64%) of the studies utilized specific frameworks, often involving a 4-5 stage process.
- 05Participant roles ranged from informants to active co-designers, with a notable proportion of studies not progressing to prototype development and testing.
Application
Design takeaway
When employing co-design, establish a clear definition, select or adapt a structured framework (like a 4-5 stage process), and explicitly define the roles and expected contributions of all participants, including plans for prototype development and testing.
How to apply
When initiating a co-design project, begin by defining what co-design means for your specific context and project goals. Then, select or develop a process framework that outlines clear stages and participant roles, ensuring that opportunities for user feedback and iteration, including prototype testing, are integrated.
Project actions
- 01Clearly define your co-design approach and terminology at the start of your design project.
- 02Consider using a structured, multi-stage process for your co-design activities.
- 03Ensure that participant roles are well-defined and that there are opportunities for testing and iteration.
Method & Evidence
Variables
Strengths & Limitations
Strengths
- +Comprehensive systematic review methodology.
- +Focus on a specific, relevant application domain (public health).
Limitations
The review is specific to public health, so its direct applicability to other fields might be limited. The quality of reporting in the original studies varied, which could affect the completeness of the synthesis.
Reliability & validity
The reliability of the review's findings is supported by its systematic methodology and adherence to PRISMA guidelines. Validity is enhanced by synthesizing a broad range of peer-reviewed literature, though the reliance on reported information in the primary studies introduces potential for reporting bias.
Think critically
Given the inconsistencies in co-design definitions and application, how can designers ensure genuine user empowerment and avoid tokenistic participation in collaborative design processes?
Design Principles
"Co-design processes should be clearly defined, systematically applied using structured frameworks, and transparently reported to maximize user involvement and innovation effectiveness."
Understanding these prevalent co-design structures and their variations is crucial for designers aiming to implement user-centered approaches. It highlights the need for clear definitions and consistent reporting to build robust co-design methodologies and ensure effective user involvement in design projects.
What This Means for Your Design
This study looked at how people work together to design things in public health. It found that many projects use a step-by-step process, but they don't always agree on what 'co-design' means or how much people should be involved, and sometimes they don't even build and test prototypes.
How to use in your project
- 1.Reference this study when discussing the theoretical underpinnings or practical application of co-design in your design project's methodology section.
- 2.Use the findings to justify your choice of co-design framework or to highlight the importance of clear definitions and participant roles in your research.
Add to My Project
Quick Cite
Paragraph starter
This systematic review by Vargas et al. (2025) highlights that co-design in public health research often employs structured, multi-stage processes (typically 4-5 stages), yet lacks consistent definitions and clear reporting on participant involvement and prototype testing. This variability underscores the importance of establishing explicit co-design frameworks and transparently documenting user engagement in design projects to ensure effectiveness and facilitate theory building.
Source
Journal of Public Health
Exploring co-design: a systematic review of concepts, processes, models, and frameworks used in public health research
journal · 2025
View sourceQuestions About This Research
- What does the research say about co-design frameworks in public health show a trend towards 4-5 stage processes with varied participant involvement?
- When employing co-design, establish a clear definition, select or adapt a structured framework (like a 4-5 stage process), and explicitly define the roles and expected contributions of all participants, including plans for prototype development and testing. Evidence: Journal of Public Health (2025).
- Why does "Co-design frameworks in public health show a trend towards 4-5 stage processes with varied participant involvement." matter for design?
- Understanding these prevalent co-design structures and their variations is crucial for designers aiming to implement user-centered approaches. It highlights the need for clear definitions and consistent reporting to build robust co-design methodologies and ensure effective user involvement in design projects.
- How can designers apply this research?
- When employing co-design, establish a clear definition, select or adapt a structured framework (like a 4-5 stage process), and explicitly define the roles and expected contributions of all participants, including plans for prototype development and testing.
- What were the main findings?
- A significant surge in publications on co-design in public health occurred in 2023.. Most studies originated from Oceania, particularly Australia.. While 44% of studies lacked a clear definition of co-design, 56% emphasized its collaborative and inclusive nature.. Over half (64%) of the studies utilized specific frameworks, often involving a 4-5 stage process.
- What research method was used?
- Systematic Review with 55 articles.
- How strong is the evidence?
- Evidence strength is rated Moderate effect, based on a 2025 journal from Journal of Public Health.
- What should I do differently in my next project?
- When initiating a co-design project, begin by defining what co-design means for your specific context and project goals. Then, select or develop a process framework that outlines clear stages and participant roles, ensuring that opportunities for user feedback and iteration, including prototype testing, are integrated.
- What are the limitations?
- The review focused on public health research, and findings may not directly translate to other design domains. The reporting of co-design elements was also variable, potentially limiting the depth of analysis.