Laying the Foundations for Co‐Design: A Micro‐Community Engagement Approach to Patient and Public Involvement in Rural Health Research

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BACKGROUND: Rural communities face barriers to accessing, sharing and trusting health information, which can limit the relevance and impact of health education initiatives. Early engagement to understand local communication networks is critical for designing effective, community-grounded co-design processes. OBJECTIVE: To explore, with community members, how health information is accessed, shared and trusted within rural towns to inform a subsequent co-design process. DESIGN: Formative participatory engagement study using qualitative methods, including participatory mapping, semi-structured interviews and field notes conducted within existing community awareness events. SETTING: Seven rural towns in South Australia (SA) and Victoria (VIC), across Modified Monash Model (MMM) categories: 3 (Horsham, Mount Gambier), 4 (Ararat, Hamilton, Naracoorte and Stawell) and 5 (Millicent). PARTICIPANTS: Adults who attended the events, local healthcare professionals (HCPs) and/or community interest-holders. INTERVENTION: Patient and public involvement and engagement (PPIE), hereafter referred to as community engagement, comprised participatory mapping activities, informal 'stall-side' discussions and semi-structured interviews conducted during community awareness events. The maps, interview transcripts and field notes generated through these activities constituted the study data. MAIN OUTCOME MEASURES: Engagement activities generated three forms of data: participant-generated map locations, interview audio-recordings with consenting participants and researcher field notes. RESULTS: A total of 205 members of the public and interest-holders and 59 HCPs participated; 300 community connection and information-seeking points were identified through 282 stickers placed on town maps. Interviews were completed by 35 participants. Formal information-seeking and communication networks varied across communities but included sporting clubs; HCPs and health services; council amenities and venues, and community clubs and associations. Informal networks included special interest groups, eateries, hotels/pubs and community events. Interview data provided additional context about how these networks operate and which populations they most effectively reach. DISCUSSION AND CONCLUSIONS: Future co-design and public messaging efforts should reflect both shared regional pathways and locally specific communication networks, incorporating region-wide and community-specific engagement strategies to support meaningful community participation.

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