JMIR Publications

ABSTRACT

The author/s of ‘Adolescent co-creation in digital health: From passive subjects to active stakeholders’ highlight the importance of actively involving adolescents in research about adolescent health. Our codesign with adolescents, outlined in “Developing an educational resource aimed at improving adolescent digital health literacy: Using co-design as research methodology”, was characterised as a ‘pivotal intervention’ because we prioritised the youth voice in its design process. The role played by adolescents in our research was central to our development of a digital educational resource that would help adolescents improve their digital health literacy. We valued the involvement of a diverse group of adolescents as research partners in the co-design to ensure the resource was engaging and aligned with the educational needs of a broad range of adolescents. Thus, our adolescent research partners’ insights and recommended designs were an integral part of the educational resource, which was created for use on hand-held devices, based around quizzes and serious games, featuring short videos and still images that are typical of social media platforms that are popular with adolescents. Our adolescent research partners who re-joined us for beta testing were pleasantly surprised to see that the educational resource was developed based on their design ideas, and pleased to have been involved and heard in the project. This highlighted the valuable combination of inputs from these diverse adolescent research partners with the equally diverse research team members, all of whom brought unique perspectives to the design. In separate, follow-up evaluation, we found the educational resource was effective at improving the digital health literacy of another group of adolescents, who felt the content was engaging and met their age group’s educational needs. Social-cognitive theory’s self-efficacy (confidence in one’s abilities) was foundational in our co-design approach and the educational resource.(1) To enhance users’ self-efficacy and learning, through co-design we ensured the resource was appropriate to adolescents’ attitudes and behaviour and embedded in their social context. A participatory research approach is crucial when conducting research in adolescent health with adolescents.(2) There is increasing recognition of adolescence as an important life phase, involving multiple physical and psychosocial changes that influence health behaviour and health outcomes into adulthood.(3) Nevertheless, adolescents are not a homogenous group: adolescence ranges in age from 10-25 and involves broad differences in sociodemographic background, interests, abilities and gender and sexual identities. When conducting participatory research with adolescents, it is important to collaborate with a group that includes members from all subpopulations of interest who have a stake in the project’s outcomes.(4) For participatory research to be maximally effective, adolescents should be involved in the actual research design. This has implications for research planning, with time required for recruiting adolescents to the research team and research training. Acknowledgement and remuneration is required in appreciation of adolescents’ lived experience expertise and time dedicate to research training and design. Adolescents’ contributions also need to be in ethics applications to human research ethics committees. When seeking research funding, budgetary provisions need to be available for this preparatory phase of participatory research.(5)