JMIR Publications

ABSTRACT

Background:

People with intellectual disabilities experience a disproportionate burden of preventable health conditions, often linked to low levels of physical activity and poor dietary habits. Although digital health interventions hold considerable promise for addressing these challenges, many existing solutions remain difficult to use for this population due to limited accessibility. Co-design is increasingly advocated to develop digital health solutions that better align with users’ needs, yet there is limited empirical guidance for co-design processes with people with intellectual disabilities.

Objective:

This study aimed to explore experiences of a co-design process for a digital intervention for health promotion with people with intellectual disabilities.

Methods:

A qualitative study design was used, based on five retrospective reflection meetings focusing on a co-design process for a digital intervention for health promotion. These involved a multidisciplinary design team, who had been involved in the co-design process, including researchers, user experience designers, support worker, and co-researcher with lived experience of intellectual disability. Transcribed data from the reflection meetings were analyzed inductively and interpreted in relation to established co-design frameworks.

Results:

The findings reflect participants’ experiences of the co-design process and point to a number of factors that appeared to support participation and collaboration. These included an extensive preparatory phase focused on recruitment and relationship building, the importance of working concretely and visually already during pre design, and the role of convivial relational practices in supporting confidence, voice, and collaboration. Time demands were mainly related to the iterative and participatory nature of co-design rather than to intellectual disability per se. Ethical considerations related to compensation were also highlighted, particularly in relation to recognizing co researchers’ contributions on equal terms.

Conclusions:

The findings suggest that enabling meaningful co-design with people with intellectual disabilities requires flexible interpretation of existing co-design frameworks, sustained attention to relational collaboration throughout the process while recognizing the ongoing importance of collaboration with support workers, and adaptation of methods rather than a need for development of entirely new ones. Supporting a sense of collaboration and conviviality over time, alongside addressing ethical issues of compensation for co-researchers’ work, may be critical for producing digital interventions for health promotion that are both usable and inclusive.