Conference Agenda

Co-design with marginalised communities in developing settings —and their experiential knowledge—often collides with expert rationalities and hierarchical logics in public health institutions, undermining power-sharing, sustained participation, and institutionalisation. This paper explores how co-design mediates these competing logics to bring structurally produced health injustices back into the formal institutional field of vision. Based on seven months of immersive fieldwork in Shenzhen, China’s largest migrant city, the paper analyses a social design case addressing rural–urban migrants’ psychological well-being in an informal settlement. It integrates community-based participatory research (CBPR) and co-design to initiate the process of returning public health concerns to the institutional domain through four stages: relational trust-building, macro-meso-micro social analysis, asset-based co-design, and public inquiry. Findings indicate that integrating multi-level empirical evidence with experiential knowledge enables a more persuasive response to the concerns of diverse stakeholders, thereby mitigating the community–institution divide within co-design for marginalised health issues.

Although co-design is widely promoted in healthcare, it is seldom true co-design. In practice, power imbalances persist, and (former) service-users’ voices rarely shape design decisions. This study examines how design processes can nevertheless surface these much-needed perspectives. Using a multiple-case study design, nine peer-reviewed healthcare design projects were selected and reformulated into analytical scenarios, enabling systematic comparison of methodological strategies. Thematic cross-case analysis explored how user perspectives were elicited, how insights informed design decisions, and where representation broke down. A key finding is that lower levels of direct involvement require more methodological steps to capture and translate users' needs adequately. The results offer a modest compass for designers designing within healthcare contexts. They might prevent situations in which co-design or participatory approaches are merely performative because they align with current trends, while the service users’ perspective is not genuinely embraced in the process.

Healthcare providers’ participation in the design process is essential for developing effective care interventions. However, engaging them through traditional design methods is challenging due to heavy workloads, unpredictable schedules, and hierarchical roles within care teams. Traditional co-design approaches, such as synchronous workshops, are often less effective in capturing clinical realities and may not fully embody participatory principles of collaboration and shared ownership. Our study addresses these challenges through a situated, self-paced co-design approach created with provider input and embedded within clinical workflows. Conducted in a pediatric cardiology clinic, fifteen providers participated over one month to refine a hybrid educational intervention for children with congenital heart disease. This approach shows how embedding co-design within clinical settings can foster provider engagement and equitable participation across roles without disrupting care. It offers a practical framework for enhancing provider involvement and improving the relevance of interventions, with potential to inform other complex, multi-stakeholder contexts.

This study explores how participatory and emotional service design can improve patient experiences and equity. Conducted in a Spanish public hospital, it involved breast and melanoma oncology patients as well as healthcare professionals, highlighting the importance of effective communication during initial consultations to help patients better cope with treatment and engage in self-care. The objective of this study is to analyse how oncology patients’ experiences change, from an emotional perspective, when a co-designed prototype is introduced in initial consultations. A comparative analysis between the initial state and post-redesign process was conducted using the EMPATHS methodology, which identifies patients’ emotional variations through service design-focused role-play sessions. Results indicate improvements in key aspects of the patient experience, information assimilation and uncertainty and stress during the process. By combining emotional design analysis with participatory methods, the study demonstrates how service design can contribute to health equity and patient-centred care.

Empowerment in chronic disease management (CDM) is often treated as an outcome delivered to patients, leaving limited attention to how empowerment is negotiated in practice. This study develops the Needs-Means-Values design empowerment framework and demonstrates how it can be materially enacted through a co-design toolkit. Drawing on literature review, interview, policy and case data, the framework conceptualises empowerment as a situated and relational process shaped by how needs, resources and values are interpreted across different actors in CDM settings. The resulting toolkit consists of four modules that support stakeholders in articulating multiple enactments of needs, exploring resource configurations and generating context-sensitive empowerment strategies.

Procedural ethics—applying for approval—alone may fail to address many issues that arise during fieldwork (ethics in the field), particularly when designers enter sensitive contexts such as healthcare. Building on our earlier contribution (DRS 2024: Embedded Ethics in Practice), we reflect on shadowing recently diagnosed cancer patients through a set of ethical considerations. Using framework analysis, we examine challenges encountered by what we term shadowers—five designers and one nurse who accompanied 14 patients throughout the service journey, from consultations to treatment. By noting the actions taken and feelings experienced as ethical issues emerged, we question how to navigate such complexities. Examining the shadowers’ narratives alongside relevant literature, we generate five themes that describe their experiences whilst proposing speculative, creative ways to address ethical challenges: On doing, not doing and harm; Toward risk-and-benefit consent forms; The researcher’s right to withdraw; Who is who?; and The before, during and after of embedded ethics.