EngAGE4Change: Co-creating outdoor community spaces with care home residents and community-dwelling older adults to improve movement behaviour and reduce social isolation - A Health CASCADE study protocol

Objectives: To present and structure the use of co-creation as an overarching approach to position older adults—particularly care home residents and community-dwellers—and other key stakeholders as active decision-makers in an urban design and spatial planning project aimed at creating inclusive outdoor spaces. Study design: A multi-step, context-based, iterative protocol using co-creation for designing public spaces with older adults. Methods: A structured co-creation process engaged 20 older adults (both care home residents and community-dwellers), along with 3 family members, 2 health professionals, 2 caregivers, 1 researcher, and 2 urban designers. The process included three phases: (1) exploratory stage for context assessment, (2) planning through a needs assessment, and (3) a co-creation core for public space ideation and prototyping. AR and VR technologies were used to support spatial visualization and immersive prototyping. A mixed-methods evaluation assessed the co-creation process, including participant engagement and outcomes. Results: As a protocol paper, no empirical results are reported. However, the structure of the co-creation process, participant roles, and evaluation framework are detailed to guide implementation and inspiration for planning future projects using co-creation for urban design and healthy ageing. Conclusions: This protocol offers a transferable model for integrating co-creation into urban design and planning with older adults. It supports inclusive design and adds to the growing evidence on participatory methods for addressing complex urban health challenges.