Table 5. Summary of core activities, co-researcher involvement levels, and content adaptations.

Phase, core activities, and level of co-researcher involvement	Description of co-researcher involvement	Content adaptations to inclusive research practices
Empathize (map the end users’ needs): conducted focus groups to gather insights from end users and performed a literature review to identify user challenges and context
High	Co-researchers were actively engaged throughout all phases of the focus group (preparation, recruitment, data collection, and evaluation).	Themes for the focus groups were refined collaboratively with co-researchers to ensure inclusiveness by representing diverse care perspectives.
Limited	In the literature review, co-researchers were kept informed, contributed to discussing the research question, and reviewed summaries.	The literature review content was contextualized using insights raised by co-researchers during earlier discussions.
Define: (analyze insights from Empathize phase to create a user profile of the intended end users with the needs and desired experiences): identified and clustered contextual factors into core care intentions and developed an interest framework to capture users’ underlying motivations
Low	Co-researchers contributed to reviewing the contextual factors but were not involved in clustering them.	Terminology and categories were adjusted in response to co-researcher feedback to improve clarity and accessibility for all consortium members.
Moderate	Reasonably active contributions in developing the interest framework were supported through peer conversations and guided sessions.	Interest profiles (summaries of key user motivations) and design missions (goals guiding the design process) were co-developed with co-researchers and refined based on their feedback to ensure alignment with users’ real needs.
Ideate (generate a wide range of creative solutions): created user scenarios based on complex care experiences, mapped user journeys and defined functional needs and designed personas (fictional profiles representing typical users), and formed test groups to explore concepts collaboratively
High	The co-researchers co-created scenarios.	Scenarios were modified to reflect lived experiences and concrete examples provided by co-researchers.
Moderate	Feedback was provided by the co-researchers during sessions on the mapped journey and functional requirements.	Personas and requirements were refined based on feedback from the co-researchers to ensure alignment with real-world user experiences. Tools were used to visualize the input of the co-researchers.
High	Test groups were formed and initiated by a co-researcher.	Recruitment effort via the consortium network resulted in diverse groups, including individuals with lived experience and professionals.
Prototype (create functional designs and explore them through performance and usability tests): created and tested low-fidelity prototypes (simplified early versions) of the sensitive virtual assistant and prepared and submitted an ethical approval application for user testing
High	The co-researchers actively interpreted and responded to user feedback.	Prototype elements, such as navigation, instructions, and tone of voice, were adapted by the co-researchers during user feedback sessions.
Moderate	A co-researcher supported the drafting of the ethical application to test the prototypes.	Ethical approval documents, such as the information and informed consent letter, were edited in consultation with a co-researcher.
Test (evaluate functional designs with real users to refine and improve the solution): developed 3 functional sensitive virtual assistant versions with different interaction styles and evaluated these versions in real care environments with end users
Moderate	Co-researchers contributed insights during evaluation sessions, which informed improvements to the sensitive virtual assistant.	Adjustments to interaction styles (eg, tone, responsiveness) in the 3 tool versions were explicitly informed by earlier co-researcher feedback regarding communication preferences.
Moderate	Co-researchers played a key role in guiding the evaluation, interpreting user feedback, and expressing a strong sense of ownership in the process.	Adjustments were made to enhance usability, clarity of instructions, and emotional accessibility based on real-world feedback from participants and co-researchers.