Partnership-focussed Principles-driven Online co-Design (P-POD): a mixed-methods evaluation of a novel online co-design process.

Abstract: Purpose: Co-design involves stakeholders in designing rehabilitation interventions that impact their health (end-users) or professional lives (clinicians and researchers). Partnership-focussed Principles-driven Online co-Design (P-POD) is proposed and evaluated as an authentic approach to adapting research co-design into an online environment. Materials and methods: A community-based participatory research approach scaffolded the co-design process and convergent mixed-methods evaluation. P-POD involved 10 stakeholders (parents, clinicians, coaches, and researchers) in eight 90-minute workshops to co-design a circus-based rehabilitation intervention to improve participation for preschool-aged children born preterm (premmies). P-POD was evaluated via anonymous surveys during workshops and semi-structured interviews upon completion of the process. Data were analysed using descriptive statistics and reflexive thematic analysis. Results: The resulting co-designed intervention is "CirqAll: preschool circus for premmies". Evaluation of P-POD indicated adherence to guiding principles of stakeholder involvement and co-design. Themes describe participants' experiences of the supportive online culture, room for healthy debate, power-sharing, and multiple definitions of success. Conclusions: P-POD appears to provide an authentic transition of research co-design into an online environment. P-POD was successfully used with stakeholders to produce a paediatric rehabilitation intervention, and benefits from the online approach align with, and extend on, those reported in the literature on in-person co-design approaches. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by the Physiotherapy Research Foundation #S20-013. The following funding supports the authors: FC: National Health and Medical Research Council of Australia (Centre of Research Excellence #1153176); Australian Government Research Training Program Scholarship AS: National Health and Medical Research Council of Australia (Career Development Fellowship #1159533) These funding sources had no role in study design, collection, analysis or interpretation of data, report writing or submission for publication. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study received ethical approval from The Royal Children's Hospital Human Research and Ethics Committee (Ethics approval number: HREC/15/RCHM/110). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study are available from the corresponding author, FC, upon reasonable request.