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.