Sood Surbhi, Roberts Stuart, Scott David, Keating Shelley, Tan Sze-Yen, George Jacob, Kiss Nicole, Daly Robin, Dunstan David, Tucker Robin, George Elena
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Victoria, Australia.
Department of Gastroenterology and Hepatology, Alfred Health, Victoria, Australia.
J Telemed Telecare. 2025 Aug 19:1357633X251366098. doi: 10.1177/1357633X251366098.
IntroductionBehavioural changes targeting diet and physical activity to achieve weight loss are considered the cornerstones of metabolic dysfunction-associated steatotic liver disease (MASLD) management. Digital health interventions effectively address barriers in accessing such lifestyle interventions particularly for persons in remote and regional communities that have high rates of MASLD and limited access to healthcare. This research uses co-design methodology to inform the development of a multimodal, digital lifestyle intervention for individuals with MASLD.MethodsOver 20 months (May 2023-January 2025), an iterative co-design process guided by the Double Diamond framework-was implemented. Twenty-seven adults (≥18 years) from Alfred Health, Australia participated in one-on-one interviews to explore insights and perspectives during the phase. This included people with MASLD ( = 10; 50% female; mean age: 63.6 years), and healthcare professionals ( = 17; 59% female; mean age: 37.1 years) [dietitians ( = 5), exercise professionals ( = 6) and hepatologists/clinicians ( = 6)], representing a range of ethnic backgrounds. Key themes were synthesised using a reflexive thematic analysis employing a data-driven, inductive approach during the phase. The phase led to actionable suggestions, and final feedback was sought from participants in the phase.ResultsInterviews identified barriers and facilitators that influenced participant engagement and adherence to the digital intervention, highlighting the need for an evidence-based, personalised and holistic approach during the and phases. Five key themes emerged: i) content relevance and adaptability, ii) personalisation, iii) social and community, iv) barriers and facilitators, and v) website interface design. The phase focused on refining the intervention based on participant feedback and phase encompassed finalising the digital intervention.ConclusionsThis iterative co-design process identified the needs and preferences of individuals with MASLD for a multimodal, digital lifestyle intervention. This research will guide a holistic, tailored approach with culturally appropriate resources and community engagement, piloted to assess feasibility.
引言
针对饮食和身体活动的行为改变以实现体重减轻被认为是代谢功能障碍相关脂肪性肝病（MASLD）管理的基石。数字健康干预有效地解决了获得此类生活方式干预的障碍，特别是对于MASLD发病率高且获得医疗保健机会有限的偏远和地区社区的人群。本研究采用协同设计方法为患有MASLD的个体开发多模式数字生活方式干预措施提供信息。
方法
在20多个月（2023年5月至2025年1月）期间，实施了以双钻石框架为指导的迭代协同设计过程。来自澳大利亚阿尔弗雷德健康中心的27名成年人（≥18岁）参加了一对一访谈，以在第一阶段探索见解和观点。这包括患有MASLD的人（n = 10；50%为女性；平均年龄：63.6岁）和医疗保健专业人员（n = 17；59%为女性；平均年龄：37.1岁）[营养师（n = 5）、运动专业人员（n = 6）和肝病学家/临床医生（n = 6）]，代表了一系列种族背景。在第二阶段，使用基于数据驱动的归纳方法的反思性主题分析对关键主题进行了综合。第三阶段得出了可操作的建议，并在第四阶段征求了参与者的最终反馈。
结果
访谈确定了影响参与者参与和坚持数字干预的障碍和促进因素，强调了在第二和第三阶段需要基于证据、个性化和整体的方法。出现了五个关键主题：i）内容相关性和适应性，ii）个性化，iii）社会和社区，iv）障碍和促进因素，以及v）网站界面设计。第三阶段专注于根据参与者的反馈完善干预措施，第四阶段包括确定数字干预措施。
结论
这种迭代的协同设计过程确定了患有MASLD的个体对多模式数字生活方式干预的需求和偏好。本研究将指导一种具有文化适宜资源和社区参与的整体、量身定制的方法，并进行试点以评估可行性。
