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Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina

A Qualitative Case Study

Bibliographic Data

ID19509023
AuthorsJavier Roberti (0000-0002-4285-5061, CIESP‐ CONICET Buenos Aires Argentina, corresponding author), Agustina Mazzoni (0000-0003-3328-2705, Institute of Clinical Effectiveness and Health Policy Buenos Aires Argentina), Marina Guglielmino (0009-0003-9060-0949, Institute of Clinical Effectiveness and Health Policy Buenos Aires Argentina), Cecilia Silva (0000-0003-2868-1840, Institute of Clinical Effectiveness and Health Policy Buenos Aires Argentina), Yanina Mazzaresi (0009-0008-4720-5392, Ministry of Health of Mendoza Mendoza Argentina), Andrea Falaschi (0000-0002-9477-2110, Ministry of Health of Mendoza Mendoza Argentina), Lisa R Hirschhorn (0000-0002-4355-7437, Feinberg School of Medicine Northwestern University Chicago USA), John James Parker (0000-0002-6769-5922, Feinberg School of Medicine Northwestern University Chicago USA), Ezequiel García-Elorrio (0000-0002-0422-0217, Institute of Clinical Effectiveness and Health Policy Buenos Aires Argentina), Ezequiel García‐Elorrio
Year2026
Volume29
Issue1
Pagese70536-e70536
Publication date2026-02-01
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.70536
PMID41436142
OpenAlexW7117153107
LanguageEN
References cited48

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

Diabetes mellitus · Health care · MEDLINE · Primary care · Primary health care · Qualitative research · Global Public Health Policies and Epidemiology · Health Policy Implementation Science · Mental Health and Patient Involvement

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