Hostname: page-component-6bb9c88b65-s7dlb Total loading time: 0 Render date: 2025-07-25T19:31:21.489Z Has data issue: false hasContentIssue false

Co-design of a digital lifestyle intervention for Australian adults with metabolic dysfunction-associated fatty liver disease

Published online by Cambridge University Press:  21 May 2025

S. Sood
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
S.K. Roberts
Affiliation:
Department of Gastroenterology and Hepatology, Alfred Health, Melbourne, Victoria, Australia Central Clinical School, Monash University, Melbourne, Victoria, Australia
S.E. Keating
Affiliation:
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
D. Scott
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
S.Y. Tan
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
J. George
Affiliation:
Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Westmead, New South Wales, Australia
N. Kiss
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
R.M. Daly
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
D.W. Dunstan
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
E.S. George
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common liver disease globally, affecting 1 in 3 Australian adults and up to 39% in rural communities(1). Behaviour changes targeting diet and physical activity to achieve weight loss are considered the cornerstones of MAFLD management. A Mediterranean diet (MedDiet) rich in wholegrains, vegetables, fruits, fish, olives, raw nuts and seeds is recommended in key global guidelines as the optimal dietary pattern for MAFLD(2). Additionally, research evidence indicates moderate-intensity aerobic exercise is effective in reducing liver fat and improving cardiometabolic health(3). Given the higher rates of MAFLD in rural communities and their limited access to healthcare services, digital health interventions present a valuable opportunity to improve the accessibility, availability and personalisation of healthcare services to address this important unmet need. However, no digital interventions to address health risk behaviours in MAFLD including diet and physical activity, are currently available. This research aimed to use best practice co-design methodology to develop a web-based healthy living intervention for people with MAFLD. An iterative co-design process using the Double Diamond Framework, including four key phases was undertaken over 12 months. Twenty-seven adults (≥ 18 years) were recruited from The Alfred Hospital, Australia. This included people with MAFLD (n = 10; 50% female; mean age: 63.6 years), healthcare professionals (HCPs) (n = 17; 59% female; mean age: 37.1 years) [dietitians (n = 5), exercise professionals (n = 6), and clinicians/hepatologists (n = 6)]. Phase 1–discover. Barriers and facilitators were explored through semi-structured interviews to understand the needs of the target population regarding accessibility, appearance, resources and application of the web-based intervention. Interviews were virtual, conducted one-on-one via ZoomTM, transcribed and inductively analysed using NVivo. Phase 2–define. A reflexive thematic analysis identified five key themes within the data. These included: i) web-based functionality, navigation and formatting, ii) holistic behaviour change including MedDiet and physical activity, iii) digital health accessibility, iv) knowledge and resources, and v) intervention duration and reminders. Phase 3–develop. The knowledge gained from this process lead to the development of the web-based intervention taking into consideration expressed preferences for features that can enhance knowledge about the condition, offer dietary and physical activity support via targeted resources and videos, and increase engagement via chat group and frequent reminders. Phase 4–deliver. The co-design has led to the development of a web-based healthy living intervention that will be further evaluated for feasibility and implementation in a pilot trial. The resulting intervention aims to achieve behavioural change and promote healthier living amongst Australians with MAFLD. This knowledge has the potential to drive strategies to reduce barriers to accessing healthcare remotely, making the web-based intervention a valuable tool for both patients and professionals.

Information

Type
Abstract
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

References

Adams, LA, Roberts, SK, Strasser, SI et al. (2020) J Gastroenterol Hepatol 35(9), 16281635.10.1111/jgh.15009CrossRefGoogle Scholar
George, ES, Reddy, A, Nicoll, AJ et al. (2002) Liver Int 42(6), 13081322.CrossRefGoogle Scholar
Keating, SE, Sabag, A, Hallsworth, K et al. (2023) Sports Med 3(12), 23472371.10.1007/s40279-023-01918-wCrossRefGoogle Scholar