Co-design of a personalised digital intervention to improve vegetable intake in adults living in Australian rural communities

Abstract

Background: Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas. This paper describes the co-design of a digital intervention to improve vegetable intake with rural community members and research partners.

Methods: Active participants in the co-design process were adults ≥ 18 years living in three rural Australian communities (total n = 57) and research partners (n = 4) representing three local rural governments and one peak non-government health organisation. An iterative co-design process was undertaken to understand the needs (pre-design phase) and ideas (generative phase) of the target population. Eight online workshops and a community survey were conducted between July and December 2021. The MoSCoW prioritisation method was used to help participants identify the 'Must-have, Should-have, Could-have, and Won't-have or will not have right now' features and functions of the digital intervention. Workshops were transcribed and inductively analysed using NVivo. Convergent and divergent themes were identified between the workshops and community survey to identify how to implement the digital intervention in the community.

Results: Consensus was reached on a concept for a digital intervention that addressed individual and food environment barriers to vegetable intake, specific to rural communities. Implementation recommendations centred on (i) food literacy approaches to improve skills via access to vegetable-rich recipes and healthy eating resources, (ii) access to personalisation options and behaviour change support, and (iii) improving the community food environment by providing information on and access to local food initiatives.

Conclusions: Rural-dwelling adults expressed preferences for personalised intervention features that can enhance food literacy and engagement with community food environments. This research will inform the development of the prototyping (evaluation phase) and feasibility testing (post-design phase) of this intervention.

Keywords: Adults; Behaviour change; Co-design; Digital health; Intervention; Vegetable intake; Workshop.

Fig. 1

Flow diagram of iterative co-design workshops and community survey with community members and research partners. White boxes represent research partner workshops; light grey boxes present community member (adults) workshops/survey; dark grey box represents research partners and community members together in the same workshop. The same community members attended workshop 1–5. Different community members attended workshops 6 and 7. Community members from workshops 1–7 were invited to join workshop 8. Workshops reflect the co-design phases of pre-design, generative and evaluative as defined by Sanders and Stappers [14]

Fig. 2

MoSCoW prioritisation of functions of the digital intervention identified by participants in the final co-design workshop