While youth engagement in innovative research methods is growing, it remains critically low in conventional health leadership across local and national systems. However, there is increasing recognition of the importance of involving young people in initiatives that directly affect their lives. This shift has prompted a move toward working with youth rather than for them, emphasizing their active participation in decision-making processes.

Co-creation is an iterative, bidirectional collaboration between researchers or stakeholders and the community to create knowledge, fostering broader public engagement in medical research. ^1,2 Youth co-creation ensures that programs are more relevant and inclusive and empowers young people in decision-making that shapes their lives with attention to power imbalances. However, there is limited understanding of the practical tools needed to implement various youth co-creation approaches, highlighting the necessity of developing a structured guide to facilitate this process.

The INSPIRE team, Social Entrepreneurship to Spur Health (SESH), and Social Innovation in Health Initiative (SIHI) jointly launched a youth co-creation crowdsourcing open call. Crowdsourcing is defined as having a large group solve a problem and then share their solutions with the public.³ Crowdsourcing allows for diverse perspectives and encourages the participation of those outside traditional research circles and it typically does not set strict limits on participation. The purpose of this crowdsourcing open call is to gather experiences, good practices, and practical tips on youth co-creation to inform the development of a practical guide to support stakeholders with effective insights in researching, designing, implementing, and evaluating youth-focused programs to enhance health and well-being. The crowdsourcing open call steering committee included fifteen (15) representatives from Africa, Asia, Europe, and North America. The committee represented experts in youth engagement, participatory research, and co-creation in diverse sectors such as academia, non-profits, development agencies, and startups. The steering committee members, who met every other month on Zoom, provided high-level guidance on the specifics of the open call.

The SESH website announced the open call and provided key details along with the challenge question: “How can we best design, execute, or evaluate successful youth-focused co-creation health programs or research projects?” Social media assets (infographics, short videos, and e-mails) were developed, translated, and disseminated across social media with the support of the steering committee, the organizing committee, and partner organizations.

The call was open until January 25, 2025. All submissions received were screened for eligibility and to also remove incomplete, duplicate, and bot submissions. The final 51 eligible submissions were evaluated by 14 independent expert judges using the following five criteria: 1). relevance to the call, 2). clear and concise description, 3). adaptability, 4). feasibility and scalability, and 5). promotion of equity. The steering committee shortlisted submissions with a mean score of at least 7.5/10 for a videoconference deliberation to select finalists. Four finalists were selected from Kenya, Nigeria, South Africa, and the Philippines. Below is a summary of the finalists’ submissions:

1. Youth Pulse: Empowering Resilient Minds Through Co-Creation (William Muthama | Kenya)

Youth Pulse empowered young people to become creators of mental health solutions through a dynamic three-stage engagement model. Youth-led ideation sessions using empathy tools collaborated in design sprints with platforms like Miro and Figma and later became peer mentors driving localized campaigns. Safety measures included mental health first-aid training and anonymous feedback. To tackle cultural stigma, youth co-created comic books in local dialects; to sustain engagement, gamified “Youth Co-Creation Olympics” were introduced. Outcomes included an 82% boost in mental health literacy, with 70% of youth are producing prototypes (40% adopted locally), while also igniting youth leadership and shifting public perceptions.

2. Unplugged: Youth-Driven Solutions for Digital Addiction (Mdoo Emmanuella Tormough and Joseph Asipitha Onipe | Nigeria)

The Digital Wellness Toolkit co-creation activity engaged young people in addressing digital addiction and promoting mental health by identifying key challenges, co-designing solutions, and shaping outreach strategies. Youth stayed engaged through interactive techniques like role-play, creative labs, and storytelling workshops, alongside expert mentorship and gamified tasks. Icebreakers such as the “Digital Detox Challenge” fostered open dialogue, while power imbalances were tackled by forming a youth advisory board. Flexible scheduling and stipends ensured inclusivity. Success stemmed from a youth-driven agenda, real-life impact through pilot programs, and formal recognition, which collectively inspired continued participation and empowered youth to lead change in digital wellness.

3. Youth Co-Creation for Mental Health Innovation: Empowering Young Minds (Palesa Tsotetsi | South Africa)

The Youth Co-Creation for Mental Health Innovation project empowered over 200 young people through brainstorming sessions, design sprints, and peer-led focus groups to develop mental health solutions. Activities like innovation bootcamps, hackathons, and storytelling circles encouraged empathy and creativity, supported by community mentors and gamification. Digital tools enabled inclusive participation, with rural access facilitated via community center partnerships. Outreach through schools and NGOs ensured diverse representation. A key outcome was the development and pilot of a mental health app in two schools. Trust-building, regular feedback loops, and flexible facilitation emerged as critical to fostering authentic engagement and reducing mental health stigma.

4. Co-creating Social Innovation for Sustainable Community Transformation (Jo-Ann Caberoy and Fababaer Emerson | Philippines)

The Urban Farming Co-Creation Workshop engaged youth in sustainable community transformation by promoting awareness of local food systems and activating green spaces for social connection and physical activity. Using the Living Lab Bayanihan framework, participants collaborated through case challenges, brainwriting, and local games to co-create practical solutions rooted in Filipino values of unity and shared responsibility. Youth leaders shaped the workshop design, while mentoring and harvesting sessions deepened engagement. Communication tools like WhatsApp ensured coordination, and trust was built through consistent community interaction. Partnerships with youth councils and local governments enhanced impact, while flexibility addressed weather disruptions and logistical challenges.

Prizes and next steps

Findings from the thematic analysis of the eligible open call submissions will inform the development of a consensus practical guide. A systematic review of youth co-creation and a co-creation conceptual framework will provide supplementary data to make the guide comprehensive. We are simultaneously organizing a series of participatory co-creation sessions between May and July involving the finalists, commended submissions, and the public to co-create social media assets and selected sections of the practical guide. The four finalists have also received invitations to attend the participatory co-creation workshop at the STI/HIV 2025 World Congress in Montreal, Canada, with full travel support from the INSPIRE team.

Acknowledgement

We acknowledge the Social Entrepreneurship to Spur Health (SESH), Social Innovation in Health Initiative (SIHI), and the Innovative Network on the Science and Practice of Implementation, Research, and Engagement (INSPIRE) team. The INSPIRE Center advances dissemination and implementation (D&I) science to adapt, scale, and sustain evidence-based HIV interventions for adolescents and young adults (AYA) in low- and middle-income countries (LMICs). As part of the PATC³H-IN network, INSPIRE applies an Appreciative Inquiry approach that builds on system strengths to drive change. Through its Capacity Supporting Core, Advanced Methods and Modeling Core, and Community Engagement and Dissemination Core, INSPIRE supports training, advanced methods, and engagement strategies across six PATC³H-IN countries: Nigeria, Malawi, Kenya, South Africa, Zambia, and Tanzania. INSPIRE’s vision is to end the HIV epidemic among adolescents and young adults aged 10–24 years. The Center is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Number UM2HD116395.

References

1. Oertzen, Anna-Sophie & Odekerken, Gaby & Brax, Saara & Mager, Birgit. (2018). Co-creating services—conceptual clarification, forms and outcomes. Journal of Service Management. 29. 10.1108/JOSM-03-2017-0067.
2. OECD (2019), The Innovation System of the Public Service of Brazil: An Exploration of its Past, Present and Future Journey, OECD Public Governance Reviews, OECD Publishing, Paris, https://doi.org/10.1787/a1b203de-en.
3. Crowdsourcing in health and health research: a practical guide. Geneva:  World Health Organization; 2018. TDR/STRA/18.4.  Licence: CC BY-NC-SA 3.0 IGO.