Abstract
BACKGROUND: The rising prevalence of non-communicable diseases, especially hypertension, presents a significant public health concern. Early detection and effective health promotion of hypertension remain challenging for healthcare providers. A co-design approach was used to engage stakeholders and consumers in exploring and developing a culturally appropriate intervention. This study aimed to co-design evidence-based resources with local key stakeholders, focusing on hypertension prevention for individuals with varying levels of literacy and addressing barriers to behaviour change in a rural Thai community. METHODS: This study was guided by the Optimising Health Literacy and Access (Ophelia) framework, specifically steps 3 to 5, to codesign a hypertension prevention programme. Participants were recruited through purposive sampling, based on recommendations from the health service advisory group. A total of 13 individuals - comprising consumers, healthcare providers, and community leaders - were invited to participate in a codesign workshop. Data were analysed using descriptive and content analysis. RESULTS: Thirteen workshop participants generated action ideas using Problem-Tree Analysis and the Rose, Thorn, Bud technique. These ideas were then prioritised using an Impact-Effort Matrix to determine feasible next steps. Interventions identified in the "quick wins" (do now) quadrant were selected for further development. The final health literacy interventions included: (1) a community-based educational project on hypertension; (2) a blood pressure monitoring system for individuals with prehypertension; and (3) public relations activities to raise community awareness. CONCLUSION: Co-design approaches underpinned by the Ophelia framework enable the development of tailored, culturally appropriate health literacy interventions that improve health outcomes and access to services by addressing the diverse, real-world needs of rural communities. PATIENT OR PUBLIC CONTRIBUTION: The co-design process involved engaging community leaders, health care providers, individuals with hypertension or prehypertension, and their family members throughout the research process.