Infusing co-design with ADAPT-ITT: adapting interventions with populations experiencing health disparities

Health disparities refer to preventable differences in the burden of disease, injury, and opportunities to achieve optimal health experienced by marginalized populations. Addressing these disparities requires more than traditional top-down approaches to interventions. One promising strategy is co-designing interventions directly with communities impacted by inequities. Co-design is a collaborative process where community members and researchers work together to identify needs, develop solutions, and implement tailored interventions to address inequities. However, practical guidance on rigorously co-designing interventions is critically needed. In this methodological piece, we provide a framework for integrating co-design approaches with a rigorous intervention adaptation methodology: Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT), based on the experiences of a unique, multidisciplinary investigator team working across family, healthcare, justice, and community systems. The current paper presents a novel framework to systematically embed co-design principles and ADAPT-ITT with clear guidance to support efforts among others seeking to integrate these two synergistic methods. ADAPT-ITTs eight phases are outlined with suggestions on infusing co-design principles and values to bolster the adaptation and development of salient interventions to address health disparities. Increasingly, people are realizing how important it is to include those with real-life experience (lived experience) when creating treatments, services, and programs for communities. These voices help make sure that what’s being developed actually meets the needs of the people it’s meant to help. Even though this idea is becoming more common, there has been little clear advice for researchers on how to truly involve community members in their work — in ways that go beyond just checking a box. This paper shares a practical approach for working closely with people who have lived experience, showing how they can be included in meaningful ways throughout the process of creating and testing new programs or treatments. The paper was written by researchers who focus on working with communities, along with a community partner who has helped lead many similar projects — not only in research but also in advocacy and politics. The paper is aimed towards researchers who want to use co-design methods in a way that fits well with scientific standards and also respects and values the input of community members. Having clear steps for this kind of work can help establish more community-driven research projects; ultimately, leading to better results. Most importantly, it helps make sure that the people most affected by these programs have a real voice in shaping them.