Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study

Autores
Roberti, Javier Eugenio; Mazzoni, Agustina; Guglielmino, Marina; Silva, Cecilia; Mazzaresi, Yanina; Falaschi, Andrea; Hirschhorn, Lisa R.; Parker, John J.; Garcia Elorrio, Ezequiel
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: In low‐ and middle‐income countries, primary healthcare (PHC) faces significant challenges in delivering effective care for chronic conditions, exacerbated by fragmented systems, resource limitations, and inequitable access. In Argentina, despite national strategies for non‐communicable diseases, implementation varies due to decentralised governance, leading to gaps in care. Here, we describe the codesign process of a contextually relevant intervention to strengthen diabetes care in Mendoza's PHC system. Methods: Using a qualitative case study approach, we conducted co‐design workshops (11/2024 – 02/2025) involving patients, healthcare providers, and policymakers. Activities included user journey mapping, world café, and prioritisation exercises guided by the Implementation Research Logic Model and Normalisation Process Theory. We collected data from activities and were analysed using reflexive thematic analysis. Results: Participants (n = 38) identified systemic barriers, including insufficient resources, poor coordination, and patient access challenges. Emotional engagement and creative exercises, such as role‐playing, fostered collaboration and innovative problem‐solving. The codesigned package emphasised multidimensional strategies, stakeholder collaboration, and systemic improvements tailored to local needs. Some of the proposed strategies included community asset mapping and social prescribing, protected appointment slots, digitalising patient records. Conclusion: This study shows that a structured codesign process, informed by theory and previous research, can support the development of a context‐specific intervention to improve diabetes care in PHC. The workshops enabled the identification of feasible implementation strategies that reflected diverse stakeholder perspectives. While the effectiveness of the intervention will be tested in future phases, the co‐design approach was feasible and well‐received in this setting, offering insights for similar efforts in other contexts. Patient or Public Contribution: Patients, family caregivers, and primary healthcare users actively participated in the co‐ design process, contributing to the identification of challenges in diabetes care and the development of context‐specific solutions. Their lived experiences informed the previous studies that were used for the codesign process, the design and prioritisation of strategies through structured activities. Participants also reviewed the proposed components and provided feedback that helped shape the final intervention package.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Silva, Cecilia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Mazzaresi, Yanina. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; Argentina
Fil: Falaschi, Andrea. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; Argentina
Fil: Hirschhorn, Lisa R.. Northwestern University; Estados Unidos
Fil: Parker, John J.. Northwestern University; Estados Unidos
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Materia
PRIMARY CARE
CO-PRODUCTION
IMPLEMENTATION
DIABETES
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/289247
Acceder
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network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case StudyRoberti, Javier EugenioMazzoni, AgustinaGuglielmino, MarinaSilva, CeciliaMazzaresi, YaninaFalaschi, AndreaHirschhorn, Lisa R.Parker, John J.Garcia Elorrio, EzequielPRIMARY CARECO-PRODUCTIONIMPLEMENTATIONDIABETEShttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: In low‐ and middle‐income countries, primary healthcare (PHC) faces significant challenges in delivering effective care for chronic conditions, exacerbated by fragmented systems, resource limitations, and inequitable access. In Argentina, despite national strategies for non‐communicable diseases, implementation varies due to decentralised governance, leading to gaps in care. Here, we describe the codesign process of a contextually relevant intervention to strengthen diabetes care in Mendoza's PHC system. Methods: Using a qualitative case study approach, we conducted co‐design workshops (11/2024 – 02/2025) involving patients, healthcare providers, and policymakers. Activities included user journey mapping, world café, and prioritisation exercises guided by the Implementation Research Logic Model and Normalisation Process Theory. We collected data from activities and were analysed using reflexive thematic analysis. Results: Participants (n = 38) identified systemic barriers, including insufficient resources, poor coordination, and patient access challenges. Emotional engagement and creative exercises, such as role‐playing, fostered collaboration and innovative problem‐solving. The codesigned package emphasised multidimensional strategies, stakeholder collaboration, and systemic improvements tailored to local needs. Some of the proposed strategies included community asset mapping and social prescribing, protected appointment slots, digitalising patient records. Conclusion: This study shows that a structured codesign process, informed by theory and previous research, can support the development of a context‐specific intervention to improve diabetes care in PHC. The workshops enabled the identification of feasible implementation strategies that reflected diverse stakeholder perspectives. While the effectiveness of the intervention will be tested in future phases, the co‐design approach was feasible and well‐received in this setting, offering insights for similar efforts in other contexts. Patient or Public Contribution: Patients, family caregivers, and primary healthcare users actively participated in the co‐ design process, contributing to the identification of challenges in diabetes care and the development of context‐specific solutions. Their lived experiences informed the previous studies that were used for the codesign process, the design and prioritisation of strategies through structured activities. Participants also reviewed the proposed components and provided feedback that helped shape the final intervention package.Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Silva, Cecilia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mazzaresi, Yanina. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; ArgentinaFil: Falaschi, Andrea. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; ArgentinaFil: Hirschhorn, Lisa R.. Northwestern University; Estados UnidosFil: Parker, John J.. Northwestern University; Estados UnidosFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaWiley Blackwell Publishing, Inc2025-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/289247Roberti, Javier Eugenio; Mazzoni, Agustina; Guglielmino, Marina; Silva, Cecilia; Mazzaresi, Yanina; et al.; Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study; Wiley Blackwell Publishing, Inc; Health Expectations; 29; 1; 12-2025; 1-131369-6513CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/hex.70536info:eu-repo/semantics/altIdentifier/doi/10.1111/hex.70536info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:32:24Zoai:ri.conicet.gov.ar:11336/289247instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:32:24.62CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
title Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
spellingShingle Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
Roberti, Javier Eugenio
PRIMARY CARE
CO-PRODUCTION
IMPLEMENTATION
DIABETES
title_short Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
title_full Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
title_fullStr Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
title_full_unstemmed Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
title_sort Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study
dc.creator.none.fl_str_mv Roberti, Javier Eugenio
Mazzoni, Agustina
Guglielmino, Marina
Silva, Cecilia
Mazzaresi, Yanina
Falaschi, Andrea
Hirschhorn, Lisa R.
Parker, John J.
Garcia Elorrio, Ezequiel
author Roberti, Javier Eugenio
author_facet Roberti, Javier Eugenio
Mazzoni, Agustina
Guglielmino, Marina
Silva, Cecilia
Mazzaresi, Yanina
Falaschi, Andrea
Hirschhorn, Lisa R.
Parker, John J.
Garcia Elorrio, Ezequiel
author_role author
author2 Mazzoni, Agustina
Guglielmino, Marina
Silva, Cecilia
Mazzaresi, Yanina
Falaschi, Andrea
Hirschhorn, Lisa R.
Parker, John J.
Garcia Elorrio, Ezequiel
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv PRIMARY CARE
CO-PRODUCTION
IMPLEMENTATION
DIABETES
topic PRIMARY CARE
CO-PRODUCTION
IMPLEMENTATION
DIABETES
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: In low‐ and middle‐income countries, primary healthcare (PHC) faces significant challenges in delivering effective care for chronic conditions, exacerbated by fragmented systems, resource limitations, and inequitable access. In Argentina, despite national strategies for non‐communicable diseases, implementation varies due to decentralised governance, leading to gaps in care. Here, we describe the codesign process of a contextually relevant intervention to strengthen diabetes care in Mendoza's PHC system. Methods: Using a qualitative case study approach, we conducted co‐design workshops (11/2024 – 02/2025) involving patients, healthcare providers, and policymakers. Activities included user journey mapping, world café, and prioritisation exercises guided by the Implementation Research Logic Model and Normalisation Process Theory. We collected data from activities and were analysed using reflexive thematic analysis. Results: Participants (n = 38) identified systemic barriers, including insufficient resources, poor coordination, and patient access challenges. Emotional engagement and creative exercises, such as role‐playing, fostered collaboration and innovative problem‐solving. The codesigned package emphasised multidimensional strategies, stakeholder collaboration, and systemic improvements tailored to local needs. Some of the proposed strategies included community asset mapping and social prescribing, protected appointment slots, digitalising patient records. Conclusion: This study shows that a structured codesign process, informed by theory and previous research, can support the development of a context‐specific intervention to improve diabetes care in PHC. The workshops enabled the identification of feasible implementation strategies that reflected diverse stakeholder perspectives. While the effectiveness of the intervention will be tested in future phases, the co‐design approach was feasible and well‐received in this setting, offering insights for similar efforts in other contexts. Patient or Public Contribution: Patients, family caregivers, and primary healthcare users actively participated in the co‐ design process, contributing to the identification of challenges in diabetes care and the development of context‐specific solutions. Their lived experiences informed the previous studies that were used for the codesign process, the design and prioritisation of strategies through structured activities. Participants also reviewed the proposed components and provided feedback that helped shape the final intervention package.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Guglielmino, Marina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Silva, Cecilia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Mazzaresi, Yanina. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; Argentina
Fil: Falaschi, Andrea. Gobierno de la Provincia de Mendoza. Ministerio de Salud Desarrollo Social y Deportes.; Argentina
Fil: Hirschhorn, Lisa R.. Northwestern University; Estados Unidos
Fil: Parker, John J.. Northwestern University; Estados Unidos
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
description Background: In low‐ and middle‐income countries, primary healthcare (PHC) faces significant challenges in delivering effective care for chronic conditions, exacerbated by fragmented systems, resource limitations, and inequitable access. In Argentina, despite national strategies for non‐communicable diseases, implementation varies due to decentralised governance, leading to gaps in care. Here, we describe the codesign process of a contextually relevant intervention to strengthen diabetes care in Mendoza's PHC system. Methods: Using a qualitative case study approach, we conducted co‐design workshops (11/2024 – 02/2025) involving patients, healthcare providers, and policymakers. Activities included user journey mapping, world café, and prioritisation exercises guided by the Implementation Research Logic Model and Normalisation Process Theory. We collected data from activities and were analysed using reflexive thematic analysis. Results: Participants (n = 38) identified systemic barriers, including insufficient resources, poor coordination, and patient access challenges. Emotional engagement and creative exercises, such as role‐playing, fostered collaboration and innovative problem‐solving. The codesigned package emphasised multidimensional strategies, stakeholder collaboration, and systemic improvements tailored to local needs. Some of the proposed strategies included community asset mapping and social prescribing, protected appointment slots, digitalising patient records. Conclusion: This study shows that a structured codesign process, informed by theory and previous research, can support the development of a context‐specific intervention to improve diabetes care in PHC. The workshops enabled the identification of feasible implementation strategies that reflected diverse stakeholder perspectives. While the effectiveness of the intervention will be tested in future phases, the co‐design approach was feasible and well‐received in this setting, offering insights for similar efforts in other contexts. Patient or Public Contribution: Patients, family caregivers, and primary healthcare users actively participated in the co‐ design process, contributing to the identification of challenges in diabetes care and the development of context‐specific solutions. Their lived experiences informed the previous studies that were used for the codesign process, the design and prioritisation of strategies through structured activities. Participants also reviewed the proposed components and provided feedback that helped shape the final intervention package.
publishDate 2025
dc.date.none.fl_str_mv 2025-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/289247
Roberti, Javier Eugenio; Mazzoni, Agustina; Guglielmino, Marina; Silva, Cecilia; Mazzaresi, Yanina; et al.; Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study; Wiley Blackwell Publishing, Inc; Health Expectations; 29; 1; 12-2025; 1-13
1369-6513
CONICET Digital
CONICET
url http://hdl.handle.net/11336/289247
identifier_str_mv Roberti, Javier Eugenio; Mazzoni, Agustina; Guglielmino, Marina; Silva, Cecilia; Mazzaresi, Yanina; et al.; Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina: A Qualitative Case Study; Wiley Blackwell Publishing, Inc; Health Expectations; 29; 1; 12-2025; 1-13
1369-6513
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1111/hex.70536
info:eu-repo/semantics/altIdentifier/doi/10.1111/hex.70536
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.265058

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