Co-Design in Action: Families and Health Systems Creating Change Together in Alamosa
For nearly two years, ABCD has had the privilege of working alongside families and health system partners in the San Luis Valley to explore a simple but important question: What happens when families help design the healthcare experiences meant for them?
In partnership with ZERO TO THREE's Evidence to Impact Center, the Colorado Department of Early Childhood and the Colorado Department of Public Health & Environment and many local partners including SLV Health and Valley-Wide Health Systems, ABCD brought families and community partners together in the San Luis Valley to redesign how families access healthcare for their children.
Starting with What Matters to Families
Co-design is more than asking families for feedback. It is a working partnership in which people with lived experience help identify priorities, develop ideas, and shape solutions alongside the organizations and systems involved.
Families in the San Luis Valley began by sharing their experiences with a small group of facilitators and identifying the issues that mattered most to them. Four priorities emerged:
Confidentiality
Parent mental health
Individualized care
Psychological safety in care
Families began by sharing stories that were examples of what health and well-being meant for their families and what experiences impacted them most, good/bad. After months of talking about these themes and thinking through a series of “solutions” the families presented their ideas directly to local health system staff. Together they explored what could realistically be implemented within existing capacity, logistical considerations, and legal requirements.
Turning Family Priorities into Action
Families and health systems worked together to create and distribute materials for other local families to receive when at the doctor’s office for a child’s visit.
Priorities from families turned into real, tangible materials, a document called "Your Child's Visit" and a family questionnaire, which were piloted at San Luis Valley Health and Valley-Wide Health Systems from June through August 2026. Feedback was collected from 59 anonymous families that used the materials, with overall positive results that they were easy to understand, clear, and explained well by staff. Feedback also showed that materials changed the experience of the visit entirely: most reported that care felt more personalized, providers used questionnaire info to improve the visit, and families felt more prepared for future visits.
The open-ended feedback said it best. When asked what was most helpful about the materials, families most often just said "all of it". One response said:
"Because my child was more comfortable, I felt better, could think clearly."
What It Takes to Make Co-Design Work
The project also taught us important lessons about what authentic family partnership requires. Nearly two years is a significant commitment. What kept families showing up came down to real support: trustworthy childcare, compensation for their time (just like any other job), meeting times that worked around jobs and school pickup, food, and advance notice.
Logistics alone weren’t enough. Trust, relationships, honesty, and a shared commitment to seeing the work through kept families and partners at the table:
“We thought it would be 6 months. It turned into almost 2 years”.
Families stuck around to see real change and see the project through. Health systems and supporting partners shared how valuable and unique this type of project was. Even before seeing any results.
As one partner reflected:
"We've already been successful. All along, the most important part was this group of families that we've had the honor of sharing space and time within a safe space. The cherry on top is that we've done something.”
That may be one of the most important lessons from this project: co-design is not simply a meeting, survey, or engagement strategy. It is a relationship.
Taking What we Learned to Other Communities
Through trust, listening, honesty, and collaboration, families and local health systems turned lived experience into meaningful changes in their community.
Now, we want to help other communities do the same.
Drawing from what we learned in the San Luis Valley, ABCD has developed three practical co-design guides: one for families, one for health systems, and one for communities. These resources are designed to help others create the conditions for authentic partnership and develop solutions grounded in the unique strengths, experiences, and needs of their own communities.
Interested in bringing co-design to your community? Explore our how-to guides for families, health systems, and communities (Links Coming Soon!)
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