A Massive Open Online Course for Primary Prevention of Stroke: Evaluation of Co-Design Process

Public awareness and understanding of stroke are crucial to reducing its overall burden. Massive open online courses (MOOCs) are free, self-directed online learning platforms that provide accessible education.

This study aimed to describe the process, outcomes, and evaluation of co-designing the Preventing Stroke MOOC.

The co-design process was conducted with various stakeholder groups from July 2020 to December 2024 in Australia over three phases: (1) predesign, (2) co-design, and (3) postdesign. In the predesign phase, we consulted with MOOC researchers and held a half-day in-person workshop with community members to prioritize the stroke prevention topics, structure, format, and features, followed by user testing of a single developed module. The larger study comprised 16 virtual focus groups (14 co-design and 2 user testing focus groups) with community members and health knowledge experts. Of the 14 co-design focus groups, 12 informed the MOOC design, including content, structure, and delivery. This was followed by drafting content for each module, expert review (eg, clinicians and researchers), and development of platform materials. In the postdesign phase, we conducted user testing to collect feedback and evaluated the co-design process to determine how participants' input shaped the final MOOC design.

In the predesign phase, 5 MOOC experts and community members contributed to a pilot module comprising 9 pages on the prioritized topics, including a focus on stories from people with lived experience of stroke. A total of 8 people tested this module, providing positive feedback about content and delivery. The co-design phase engaged 22 participants across 12 focus groups relevant to the MOOC. Their suggestions contributed to the multimedia design of the 7 core modules, with personalization via 9 optional mini-modules. Feedback on technical issues and suggested improvements identified during postdesign user testing were resolved. Evaluation of the MOOC co-design process found that the majority of participants' suggestions gathered during the co-design phase were included in the final MOOC.

A structured, co-design process resulted in the Preventing Stroke MOOC reflecting participants' suggestions and provided important insights on the educational information needed to inform the general population about stroke prevention.