Co-designing for the Triad: Design Considerations for Collaborative Decision-Making Technologies in Pediatric Chronic Care

2026-03-25

AI Summary

This study addresses the challenges in collaborative decision-making among adolescents with chronic kidney disease, their caregivers, and healthcare providers, which stem from divergent situational awareness and misaligned mental models. Through participatory co-design workshops involving all three stakeholders—collectively conceptualized as a “care triangle”—the research proposes design principles for collaborative decision-support technologies that emphasize ongoing decision practices, alignment of mental models, development of adolescent autonomy, and explicit articulation of latent care challenges. The work identifies hierarchical barriers in situational awareness that impede triadic collaboration and constructs a family-centered collaborative decision-making framework. These contributions offer critical design insights for digital health technologies aimed at fostering shared understanding and empowering families in pediatric chronic illness management.

Technology Category

• Humans and AI: Planning and Decision Support for Human-Machine Teams
• Reasoning under Uncertainty: Sequential Decision Making
• Cognitive Modeling & Cognitive Systems: Conceptual Inference and Reasoning

Application Category

• User Modeling, Personalization and Recommendation: Accountability, Transparency, and Ethics for personalization
• Responsible Web: Consent frameworks and practices on the web
• Economics, Online Markets and Human Computation: Incentives in network design for Web infrastructures and ecosystems

Abstract

In pediatric chronic care, the triadic relationship among patients, caregivers, and healthcare providers introduces unique challenges for youth in managing their conditions. Diverging values, roles, and asymmetrical situational awareness across decision-maker groups often hinder collaboration and affect health outcomes, highlighting the need to support collaborative decision-making. We conducted co-design workshops with 6 youth with chronic kidney disease, 6 caregivers, and 7 healthcare providers to explore how digital technologies can be designed to support collaborative decision-making. Findings identify barriers across all levels of situational awareness, ranging from individual cognitive and emotional constraints, misaligned mental models, to relational conflicts regarding care goals. We propose design implications that support continuous decision-making practice, align mental models, balance caregiver support and youth autonomy development, and surface potential care challenges. This work advances the design of collaborative decision-making technologies that promote shared understanding and empower families in pediatric chronic care.

Problem

• pediatric chronic care
• collaborative decision-making
• triadic relationship
• situational awareness
• care coordination

Innovation

• co-design
• collaborative decision-making
• pediatric chronic care
• situational awareness
• mental models