Socioculturally Appropriate Internet-Based Geriatric Care Model for Older Adults Living With HIV: Experience-Based Co-Design Approach

Kristina M Kokorelias^{1

2

3

4}, Marina B Wasilewski^{2

3

5}, Dean Valentine¹, Andrew D Eaton^{6

7}, Erica Dove³, Paige Brown⁸, Stuart McKinlay⁸, Christine L Sheppard⁷, Esther Su¹, Hardeep K Singh^{2

3

9}, Ashley Flanagan⁴, Alice Zhabokritsky^{10

11

12}, Reham Abdelhalim¹³, Rabea Parpia¹⁴, Rahel Zewude¹¹, Laura Jamieson¹⁵, Sharon Walmsley^{10

11

12}, Luxey Sirisegaram¹

Affiliations

¹ Section of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada.
² Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
³ Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
⁴ National Institute on Ageing, Toronto Metropolitan University, Toronto, ON, Canada.
⁵ St John's Rehab Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁶ Faculty of Social Work, Saskatoon Campus, University of Regina, Saskatoon, SK, Canada.
⁷ Factor-Inwentash School of Social Work, University of Toronto, Toronto, ON, Canada.
⁸ Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁹ KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
¹⁰ Infectious Diseases, Department of Medicine, University Health Network, Toronto, ON, Canada.
¹¹ Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.
¹² CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.
¹³ Burlington Ontario Health Team, Joseph Brant Memorial Hospital, Burlington, ON, Canada.
¹⁴ St Michael's Hospital, Toronto, ON, Canada.
¹⁵ Ontario Federation of Indigenous Friendship Centres, Toronto, ON, Canada.

PMID: 40424610
PMCID: PMC12152441
DOI: 10.2196/67122

Socioculturally Appropriate Internet-Based Geriatric Care Model for Older Adults Living With HIV: Experience-Based Co-Design Approach

Kristina M Kokorelias et al. JMIR Aging. 2025.

. 2025 May 27:8:e67122.

doi: 10.2196/67122.

Authors

Affiliations

¹ Section of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada.
² Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
³ Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
⁴ National Institute on Ageing, Toronto Metropolitan University, Toronto, ON, Canada.
⁵ St John's Rehab Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁶ Faculty of Social Work, Saskatoon Campus, University of Regina, Saskatoon, SK, Canada.
⁷ Factor-Inwentash School of Social Work, University of Toronto, Toronto, ON, Canada.
⁸ Undergraduate Medical Education, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁹ KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
¹⁰ Infectious Diseases, Department of Medicine, University Health Network, Toronto, ON, Canada.
¹¹ Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.
¹² CIHR Canadian HIV Trials Network, Vancouver, BC, Canada.
¹³ Burlington Ontario Health Team, Joseph Brant Memorial Hospital, Burlington, ON, Canada.
¹⁴ St Michael's Hospital, Toronto, ON, Canada.
¹⁵ Ontario Federation of Indigenous Friendship Centres, Toronto, ON, Canada.

PMID: 40424610
PMCID: PMC12152441
DOI: 10.2196/67122

Abstract

Background: Older adults living with HIV face challenges accessing regular geriatric care, and while virtual care services could offer a solution, they may come with limitations.

Objective: This study aimed to co-design a culturally appropriate virtual care model tailored to older adults' needs using the experience-based co-design methodology.

Methods: We used a qualitative, experience-based co-design approach with 19 older adults living with HIV. The process involved 3 phases: identifying needs through interviews and questionnaires, codeveloping a care model prototype through focus groups and a workshop, and refining the model using feedback from a world café format. Data were analyzed using thematic content analysis.

Results: The co-design process led to a virtual care model prototype that directly addressed participants' key needs. These included personalized communication methods, simplified technology interfaces for easier access, and culturally responsive care practices. Participants emphasized the importance of privacy in virtual consultations, flexible scheduling to accommodate health fluctuations, and ongoing support for managing both HIV and aging-related conditions. Their feedback shaped a model designed to bridge service gaps, offering a more inclusive, accessible, and patient-centered approach to virtual geriatric care.

Conclusions: This study co-designed a potential virtual geriatric care model grounded in the experiences of older adults living with HIV. By integrating participants' insights throughout the design process, the model offers a promising approach to improving care for this vulnerable population. Future directions for research to test this model are proposed.

Keywords: HIV; co-design; older adults; qualitative research; virtual care.

©Kristina M Kokorelias, Marina B Wasilewski, Dean Valentine, Andrew D Eaton, Erica Dove, Paige Brown, Stuart McKinlay, Christine L Sheppard, Esther Su, Hardeep K Singh, Ashley Flanagan, Alice Zhabokritsky, Reham Abdelhalim, Rabea Parpia, Rahel Zewude, Laura Jamieson, Sharon Walmsley, Luxey Sirisegaram. Originally published in JMIR Aging (https://aging.jmir.org), 27.05.2025.

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Conflict of interest statement

Conflicts of Interest: KMK is an Associate Editor for JMIR Rehabilitation and Assistive Technologies.

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Socioculturally Appropriate Internet-Based Geriatric Care Model for Older Adults Living With HIV: Experience-Based Co-Design Approach

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Socioculturally Appropriate Internet-Based Geriatric Care Model for Older Adults Living With HIV: Experience-Based Co-Design Approach

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Abstract

Conflict of interest statement

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