Impactful co-design: Adult decision-makers' perspectives on actualising children's ideas for health-promoting neighbourhoods in Aotearoa New Zealand

Our study sought to understand adult decision -makers' views on what was important for actualising children's ideas using co -design, towards creating health -promoting local environments. Ten adult decision -makers, experienced in co -design with children aged 5-13 years in Aotearoa New Zealand, participated in individual interviews. We generated three themes ( Empowering children within co -design ; Being intentional about children ' s influence ; Curating who is involved ) using reflexive thematic analysis. Our themes informed a novel framework of 'impactful co -design' accompanied by a practical checklist for adult decision -makers (practitioners, policymakers, and researchers). Study findings affirm co -designing local neighbourhoods as an inherently social and technical endeavour, advocate for greater consideration of inclusivity and cultural context, and highlight the need for co -design with children to include safety, empowerment, and evaluation. We position impactful codesign as one useful process to enact children's meaningful participation.