Conducting Co-Design with Older People in a Digital Setting: Methodological Reflections and Recommendations

Introduction: Co-design has been identified as a participatory method to create person-centred integrated healthcare services that align with older people's values and lived experiences. Description: Existing guidelines on conducting co-design primarily focus on inperson methods with limited guidance on using digital methods to collect data. This gap in knowledge is particularly pertinent when co-designing with older people who can experience challenges with digital literacy and accessibility. This article uses the exemplar of a pilot site within a European co-design research project, aiming to create digital health technology to support integrated care, to describe the steps and considerations required when collaborating with older people in an online environment. Focus groups and one-to-one interviews were conducted utilising digital mediums of teleconferencing and telephone calls to engage and collaborate with older people. Discussion: Several preparatory steps are required to effectively bridge the digital divide and conduct co-design with older people including engaging gatekeepers, relationship and trust-building, assessing digital literacy levels, education and providing technological support. Conclusion: This article highlights the steps and considerations that researchers should be aware of when embarking on co-designing with older people in a digital setting. The authors describe their methods that promotes inclusivity and the empowerment of older people as equal collaborators in the research process. The co-design approach and recommendations can be applied to various research settings and wider areas of integrated care with this population.