Human-centred design thinking: a novel tool for co-creation in physical activity research

Rivera et al. Health Research Policy and Systems (2025) 23:149 https://doi.org/10.1186/s12961-025-01409-6 Health Research Policy and Systems Open Access COMMENT Human‑centred design thinking: a novel tool for co‑creation in physical activity research Elise Rivera1*, Vivian Romero2 and Ralph Maddison3 Abstract Despite the substantial health benefits of physical activity across the lifespan, most youth and adults are insufficiently physically active. To combat this trend, numerous policies and interventions have been developed, many of which have had modest effects. The limited effectiveness of such interventions has been linked to the lack of or minimal community involvement. Consequently, there have been calls for solutions with greater community buy-in. In particular, there has been a rise in the use of co-creation in physical activity research, where stakeholders are engaged in understanding and defining problems and designing localised and contextual solutions. While there are many benefits to co-creation (for example, collaboration and empowerment), there are also challenges, including the underreporting of co-creation approaches and methodologies used in physical activity research. We argue that human-centred design thinking can be a tool for approaching, complementing, and elevating co-creation. We discuss human-centred design thinking and offer strengths for how it can augment co-creation, such as through the Double Diamond model, toolkits and field guides, established activities, reporting guideline’s and asking different questions to spark social innovation. We also present a case study to showcase how human-centred design thinking as an approach to co-creation can look. Keywords Design thinking, Co-creation, Physical activity, Active living, Co-design Introduction Physical activity (PA) is considered a “best buy” in public health due to its considerable health benefits [1]. However, roughly 81% of youth and 28% of adults worldwide are insufficiently active [2, 3]. To combat this trend, numerous health-promoting policies and interventions have been developed and evaluated, many with limited effectiveness for improving physical activity levels [4–6]. The modest effects of previous interventions has been *Correspondence: Elise Rivera 1 Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville, South Australia 5034, Australia 2 Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 3010, Australia 3 Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20001, Geelong, Victoria 3220, Australia linked to the lack of community involvement in their development and implementation [7]. Consequently, there has been growing interest in the development of more localised solutions that include community buy-in [7, 8]. Specifically, there has been a rise in the use of co-creation in public health and PA research, where stakeholders (for example, beneficiaries) are active agents in shaping their health outcomes as opposed to passive contributors [9]. This rise is evidenced by several recent studies exploring methods, characteristics, and frameworks for co-creation in public health and PA research [7, 9–15]. Co-creation is defined as “engaging stakeholders in the process of understanding problems and designing contextually appropriate solutions” [16]. Co-creation in PA research may empower communities to generate contextspecific solutions [7], which may increase adherence and effectiveness of interventions [17]. Additional benefits © The Author(s) 2025. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Rivera et al. Health Research Policy and Systems (2025) 23:149 include collaboration, empowerment, communication, flexibility, impact, reflection and efficiency [9]. However, co-creation is not without challenges, such as poor engagement, resource and practical constraints, and limited trust and transparency [9]. Additionally, the way in which co-creation is approached and the methodologies used is not always reported, posing difficulties with replication and interpretation [9, 14]. Given these challenges, this commentary proposes a tool for approaching and complementing co-creation: human-centred design thinking (HCDT). This commentary will discuss HCDT and its related components, whilst posing several questions and offering strengths of HCDT to augment co-creation. How might we start? PA is complex and influenced by interactions with a range of individual characteristics and behaviours and economic, political, social, and physical determinants [18]. There is a need for more human-centred, innovative, and effective approaches to better frame PA problems and develop meaningful solutions [19, 20]. Given its collaborative, creative approach to problem-solving and solution generation, HCDT offers a useful tool for cocreation [21, 22]. HCDT draws on the values, motivations, and needs of communities to understand the challenges they face and develop best-fit solutions by utilising specific practices rooted in understanding the context [23, 24]. HCDT involves community engagement, iterating among distinct phases: empathise, define, ideate, prototype, and test [21]. HCDT offers certain mindsets, such as creative confidence, empathy, and learning from failure [25], as well as “designerly ways of knowing”, such as humanity, ingenuity, and imagination (that is, human-centred design thinking) [26]. Additionally, it provides a range of established practices and activities [20, 21, 27] for meaningful collaboration among communities, researchers (for example, design academics), and stakeholders from a range of disciplines (that is, human-centred design doing) [28–30]. While there are parallels between co-creation and HCDT, they are not the same. For example, co-creation emphasises partnership, where problems are solved and solutions are developed with communities through (...truncated)