A Two-Phase Asynchronous–Synchronous Online Co-Design Method for Facilitating Multistakeholder Participation in Healthcare Technology

Abstract

Multistakeholder co-design is widely used in healthcare technology development to surface diverse viewpoints and support alignment across stakeholder groups. However, healthcare co-design faces persistent challenges: providers’ fragmented schedules limit sustained participation, provider-receiver authority asymmetries can shape whose input is taken up, and receivers from vulnerable or stigmatized groups may hesitate to engage in visible real-time discussion. We propose a low-cost, two-phase asynchronous-synchronous online co-design method designed to reduce these participation barriers. The method separates (1) asynchronous perspective articulation, which enables stakeholders to contribute at their own pace, from (2) synchronous perspective exchange, which relies on limited real-time interaction to clarify tensions and negotiate trade-offs. A researcher-mediated transition connects the phases by translating distributed inputs into de-attributed, negotiable discussion prompts. We illustrate the approach through a chatbot co-design case for pre-exposure prophylaxis (PrEP) care involving PrEP navigators and clients, using widely available tools (Google Sites, Sheets, and Meet). The case shows how asynchronous engagement surfaces divergent expectations about the chatbot’s scope and communication style, and structured prompts support focused negotiation in dyadic sessions. We conclude by discussing how the method mitigates authority effects when synchronous exchange remains essential, and how the structure can be iterated across cycles as new questions emerge.

Keywords: Multistakeholder Co-design, Online Workshops, Healthcare Technology, Structured Facilitation

DOI: 10.54941/ahfe1007420