{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:46:04Z","timestamp":1785735964471,"version":"3.56.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004955","name":"\u00d6sterreichische Forschungsf\u00f6rderungsgesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004955","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      As health systems across Europe face the dual pressures of environmental change and demographic aging, the need for a socio-ecological transformation that integrates health, equity, and sustainability has never been more pressing. Informal caregivers are central to long-term care systems, yet they often face time poverty, fragmented support, and unequal access to resources. These are conditions that can also constrain participation in health-promoting and climate-friendly everyday practices. This study reports a participatory co-design process that developed and iteratively refined\n                      <jats:italic>CareCompass<\/jats:italic>\n                      (PflegeKompass), a hybrid (digital\u2013analogue) network-mapping and task-coordination concept for rural caregiving contexts in Austria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using a Design Thinking framework, we conducted three sequential in-person workshops in the region Waldviertler Kernland with\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913 stakeholders (informal caregivers, community \u201cthird-space\u201d actors, health professionals, and regional management). Workshop artefacts (posters, prioritisation outputs, and annotated prototype flows) and field notes were synthesised through an artefact-centred design synthesis informed by inductive coding and participant prioritisation outputs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings show that caregivers' primary challenge is coordination under uncertainty requiring timely access to information and resources, contingency management when support fails, financial strain, and cumulative planning effort. These insights translated into concrete equity-by-design needs: offline-first and low-threshold interaction using familiar calendar\/list elements; role-based visibility and selective sharing to support privacy and prevent relational conflicts; and an onboarding model anchored in a locally trusted facilitator rather than a purely digital adoption. Prototype testing further revealed \u201ctrust and dignity\u201d as design material, motivating a shift from a graphical network map to a list-based representation to avoid social comparison and shame.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We contribute a transferable account of rural co-design for caregiving technologies, demonstrating how hybrid infrastructures, trust-sensitive representations, and explicit implementation conditions can be embedded early to support equitable, climate-resilient care coordination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1823169","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:07Z","timestamp":1785735067000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Designing trustworthy, low-threshold care coordination: co-creating a hybrid CareCompass with rural informal caregivers"],"prefix":"10.3389","volume":"8","author":[{"given":"Martin","family":"Ernst","sequence":"first","affiliation":[{"name":"Center for Digital Health & Social Innovation, University of Applied Sciences St. P\u00f6lten","place":["St. P\u00f6lten, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Pflegerl","sequence":"additional","affiliation":[{"name":"Ilse-Arlt Institute for Social Inclusion Research, University of Applied Sciences St. P\u00f6lten","place":["St. P\u00f6lten, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Maurer","sequence":"additional","affiliation":[{"name":"Verein Kleinregion Waldviertler Kernland","place":["Ottenschlag, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea E.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Competence Centre for Climate and Health, Austrian National Public Health Institute","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Lampl","sequence":"additional","affiliation":[{"name":"Competence Centre for Climate and Health, Austrian National Public Health Institute","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Turk","sequence":"additional","affiliation":[{"name":"Center for Digital Health & Social Innovation, University of Applied Sciences St. P\u00f6lten","place":["St. P\u00f6lten, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"B1","article-title":"IPCC, 2023: climate change 2023: synthesis report","volume-title":"Contribution of Working Groups I, II and III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change","author":"Calvin","year":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1038\/s41558-020-0691-6","article-title":"From incremental to transformative adaptation in individual responses to climate-exacerbated hazards","volume":"10","author":"Wilson","year":"2020","journal-title":"Nat Clim Chang"},{"key":"B3","doi-asserted-by":"crossref","first-page":"250","DOI":"10.4337\/9781785365119","volume-title":"Heat, Greed and Human Need: Climate Change, Capitalism and Sustainable Wellbeing","author":"Gough","year":"2017"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1016\/S0140-6736(22)01540-9","article-title":"The 2022 report of the Lancet countdown on health and climate change: health at the mercy of fossil fuels","volume":"400","author":"Romanello","year":"2022","journal-title":"Lancet"},{"key":"B5","volume-title":"Health for All\u2013Transforming Economies to Deliver What Matters: Final Report of the WHO Council on the Economics of Health for All","year":"2023"},{"key":"B6","doi-asserted-by":"publisher","first-page":"102433","DOI":"10.1016\/j.futures.2019.06.005","article-title":"Narratives of change: how social innovation initiatives construct societal transformation","volume":"112","author":"Wittmayer","year":"2019","journal-title":"Futures"},{"key":"B7","doi-asserted-by":"crossref","DOI":"10.1787\/461811c4-en","volume-title":"Needs Assessment and Eligibility Criteria in Long-Term Care: How Access is Managed Across OECD Countries [OECD Health Working Papers]","author":"Llena-Nozal","year":"2025"},{"key":"B8","volume-title":"Supporting Informal Carers of Older People: Policies to Leave No Carer Behind [OECD Health Working Papers]","year":"2022"},{"key":"B9","doi-asserted-by":"publisher","first-page":"100589","DOI":"10.1016\/j.jeoa.2025.100589","article-title":"How do women respond to increased care needs of their parents? 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