Co-design is a useful process for enacting children's meaningful participation in shaping health-promoting neighbourhoods.

Co-design with children must be safe, empowering, and evaluated.

Cultural context is a key consideration when co-designing with children.

Framework and checklist for ‘impactful co-design’ with children to support practitioners, policy-makers, and researchers.

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, policy-makers, 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 co-design as one useful process to enact children's meaningful participation.

Participatory design

Policymakers

Children's rights

Healthy development

Healthy environments

Child-friendly cities

© 2024 The Authors. Published by Elsevier Ltd.