Lotte Hardeman, Dr. Andreas Wallin, Prof. Dr. David Moulaee Conradsson, Prof. Dr. Breiffni Leavy, Prof. Dr. Franziska Albrecht, Prof. Dr. Melvyn Roerdink, Prof. Dr. Eling D. de Bruin, Prof. Dr. Jean-Jacques Temprado, Prof. Dr. Erika Franzén

Ongoing; expected to be completed in Fall 2025.

INTRODUCTION: Applying digital health technologies (DHTs) for health promotion and disease prevention is recommended by official bodies such as the World Health Organization. User-centered co-design with patient and public involvement is considered best practice for developing such interventions. While well-established frameworks are available to broadly guide such procedures, there is a need to better focus and guide the co-design process by preceding contextual research. Moreover, more specific guidance on additional methodological steps for the validation of DHT components and to facilitate their implementation, scalability, and sustainability would benefit the research community.

OBJECTIVES: This manuscript presents a consensus-based refined methodological guideline (called Co-Develop-IT) that delineates best practices for each step along the full lifecycle of DHT-enhanced training concepts – from contextualization through co-development and evaluation to implementation.

METHODS: The Co-Develop-IT guideline was developed through biweekly meetings of the authors between August 2024 and February 2025, combined with written elaboration, feedback, and revisions between the meetings to gradually develop a consensus on the best practice recommendations.

RESULTS: The Co-Develop-IT guideline consists of eight phases and is directed toward multidisciplinary teams of experts coordinating projects on DHT-enhanced training concepts. It is applicable to any type(s) of end-user(s), exercise type(s), intended context(s) of use (e.g., primary healthcare, community health services, telemedicine) and overarching goal(s) (e.g., health promotion, primary through tertiary disease prevention; including rehabilitation). The guideline integrates and refines previous methodological frameworks and expands on existing best practices by introducing five distinct preparatory contextual research phases preceding generative co-design and development. These novel phases are dedicated to harmonizing interests and clarifying the level of involvement of all contributors (particularly between research, industry, healthcare, and end-users), aligning co-design procedures with expectations and requirements of relevant interest-holders, collaboratively delineating clear strategies to monitor project progression, and facilitating implementation, scalability, and sustainability of the solutions to be developed.

CONCLUSION: The Co-Develop-IT guideline proposes best practices for how participatory research and patient and public involvement may be efficiently implemented and structured to benefit the establishment of individually tailored DHT-enhanced training concepts. Its main novelty lies in guiding the structured establishment of a more robust conceptual groundwork through extensive preparatory contextual research phases, aimed at better targeting tailored co-development efforts toward successful implementation. We advocate for the continued refinement and consolidation of this methodological guideline to help the field strike a better balance between maximizing the benefits and mitigating the increased resource demands of collaborative research practices – ultimately maximizing its real-world impact.