Journal of Telemedicine and Telecare最新文献

{"title":"Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system.","authors":"Stephanie A Robinson, Jessica M Lipschitz, Ndindam Ndiwane, Felicia R Bixler, Bella Etingen, Mark S Zocchi, Stephanie L Shimada, Jennifer A Palmer, Terry J Newton, Nilesh Shah, Timothy P Hogan","doi":"10.1177/1357633X251371113","DOIUrl":"10.1177/1357633X251371113","url":null,"abstract":"<p><p>IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure, due to its subjective and complex nature. This evaluation examined alignment among stakeholder perceptions of context related to connected care implementation across VHA.MethodsA national, cross-sectional survey assessed perceptions of 11 contextual factors relevant to connected care implementation as identified in published reviews within the implementation science literature. Across 142 VHA facilities and 18 regions, surveys were sent to four stakeholder groups: clinical team members, connected care coordinators, facility leadership, and regional leadership. Mean scores for each factor were compared between stakeholder groups using Welch's ANOVA and Bonferroni-corrected post-hoc comparisons.ResultsA total of 5541 respondents (36.1% response rate) participated. Organizational Culture and Climate was rated the most favorable contextual factor (mean = 3.9, SD = 0.7), while Financial Resources was perceived as least favorable (mean = 3.0, SD = 1.0). Significant differences emerged between the perceptions of frontline workers (clinical team members, connected care coordinators) and leadership (facility, regional). Clinical team members rated nearly all contextual factors less favorably than facility leadership. Coordinators similarly rated most factors less favorably than leadership.DiscussionFindings highlight a misalignment between leadership and frontline workers in their perceptions of organizational context for implementing connected care technologies. Leadership viewed key contextual factors (e.g. Organizational Readiness to Change, Leadership Support) more favorably than frontline workers. This misalignment may impact implementation success, suggesting a need for strategies to better align stakeholder perceptions.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251371113"},"PeriodicalIF":3.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the cost-of-living crisis on patient preferences towards virtual consultations.","authors":"Tetiana Lunova, Katherine-Helen Hurndall, Roberto Crespo, Peter Howitt, Melanie Leis, Kate Grailey, Ara Darzi, Ana L Neves","doi":"10.1177/1357633X241255411","DOIUrl":"10.1177/1357633X241255411","url":null,"abstract":"<p><p>IntroductionSince 2021, the world has been facing a cost-of-living crisis which has negatively affected population health. Meanwhile, little is known about its impact on patients' preferences to access care. We aimed to analyse public preference for the modality of consultation (virtual vs face-to-face) before and after the onset of crisis and factors associated with these preferences.MethodsAn online cross-sectional survey was administered to the public in the United Kingdom, Germany, Italy and Sweden. McNemar tests were conducted to analyse pre- and post-crisis differences in preferences; logistic regression was used to examine the demographic factors associated with public preferences.ResultsSince the onset of crisis, the number of people choosing virtual consultations has increased in the United Kingdom (7.0% vs 9.5% <i>P</i> < 0.001), Germany (6.6% vs 8.6%, <i>P</i> < 0.008) and Italy (6.0% vs 9.8%, <i>P</i> < 0.001). Before the crisis, a stronger preference for virtual consultations was observed in people from urban areas (OR 1.28, 95% CI 1.05-1.56), while increasing age was associated with a lower preference for virtual care (OR 0.966, 95% CI 0.961-0.972). Younger people were more likely to switch to virtual care, while change to face-to-face was associated with younger age and lower income (OR 1.34, 95% CI 1.12-1.62). Older adults were less likely to change preference.ConclusionsSince the onset of the cost-of-living crisis, public preference for virtual consultations has increased, particularly in younger population. This contrasts with older adults and people with lower-than-average incomes. The rationale behind patients' preferences should be investigated to ensure patients can access their preferred modality of care.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1175-1185"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the @ctivehip tele-rehabilitation with the fear of falling of older adults with hip fracture and their family caregivers: Secondary analysis of a non-randomised controlled trial.","authors":"Rafael Prieto-Moreno, Pablo Molina-García, Mariana Ortiz-Piña, Marta Mora-Traverso, Fernando Estévez-López, Miguel Martín-Matillas, Patrocinio Ariza-Vega","doi":"10.1177/1357633X241257972","DOIUrl":"10.1177/1357633X241257972","url":null,"abstract":"<p><p>IntroductionOsteoporotic hip fracture is a major health problem. Falls, the primary cause, might lead to a persistent fear of falling (FoF) among older adults, affecting their daily activities and rehabilitation. While in-person interventions exist, limited research is available on the effects of tele-rehabilitation on the FoF after a hip fracture. Thus, this study aims to test the association of the @ctivehip tele-rehabilitation programme on reducing the levels of FoF experienced by both older adults with hip fracture and their family caregivers.MethodsA non-randomised controlled trial (ClinicalTrials.gov; Identifier: NCT02968589) that compared a webpage-based tele-rehabilitation (@ctivehip) against usual care. Fear of falling was assessed using the Short Falls Efficacy Scale-International. Patients' functional status was evaluated using the Functional Independence Measure. Physical performance was assessed by the Timed Up and Go test and Short Physical Performance Battery. We conducted a per-protocol analysis as the primary outcome, and an intention-to-treat approach as secondary analysis.ResultsA total of 71 patients with hip fracture (78.75 ± 6.12 years, 75% women) and their family caregivers participated. Participants in the intervention showed a higher decrease in FoF in comparison to those in the usual care (0.5 Cohen's d; <i>p</i> = 0.042). The reduction in FoF resulting from participation in the tele-rehabilitation programme was mediated by improvements in functional status by 79%. The @ctivehip programme did not decrease FoF of family caregivers.Discussion@ctivehip is associated with a reduction of the FoF in older adults with hip fractures, but not in their family caregivers, with the reduction being mostly explained by improvements in the patients' functional status. Although the intervention seems promising, it should not be applied in clinical settings until confirmed by appropriate-designed randomised clinical trials.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1152-1161"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine: Does it have a place in surgical oncology practice?","authors":"Jesse K Kelley, Kathrine A Kelly, Sydney Rechner, Hannah Brown, Sarah Kim, Sophia Spencer, Elizabeth Martin, Charles Reed, Gerald P Wright, Murwarid M Assifi, Mathew Chung","doi":"10.1177/1357633X241251522","DOIUrl":"10.1177/1357633X241251522","url":null,"abstract":"<p><p>BackgroundTelemedicine has gained traction in surgical subspecialties, particularly since the COVID-19 pandemic. This study aims to identify whether telemedicine can be appropriately integrated within surgical oncology practice.MethodsThis retrospective study evaluated patients who received either telemedicine or office follow-up after undergoing surgical oncology operations between 2016 and 2021. The telemedicine group (TG) and office group (OG) received a 15-question survey regarding their satisfaction with their care. Patient outcomes and responses were analyzed utilizing propensity-score matching in 1:1 fashion.ResultsTelemedicine group and OG each had 21 patients. Length of stay, complication frequency, follow-up frequency, and readmissions frequency within 90-days were comparable between groups. Telemedicine group expressed comparable satisfaction with postoperative care relative to OG (95.2% vs. 85.7%, <i>p</i> = 0.61). All telemedicine patients said they would utilize telemedicine again in the future and would recommend its use to others.ConclusionPatient satisfaction with postoperative telemedicine follow-up is comparable to those with in-person follow-up.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1169-1174"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the precision of an online visual acuity test tool.","authors":"Mauro Gobira, Vinícius Freire, Glauco S Avelino de Aquino, Vanessa Dib, Matheus Gobira, Pedro C Carricondo, Ariadne Dias, Marco A Negreiros","doi":"10.1177/1357633X241252454","DOIUrl":"10.1177/1357633X241252454","url":null,"abstract":"<p><p>ObjectiveThe aim of this study was to assess the precision of a web-based tool in measuring visual acuity (VA) in ophthalmic patients, comparing it to the traditional in-clinic evaluation using a Snellen chart, considered the gold standard.MethodsWe conducted a prospective and in-clinic validation comparing the Eyecare Visual Acuity Test® to the standard Snellen chart, with patients undergoing both tests sequentially. Patients wore their standard spectacles as needed for both tests. Inclusion criteria involved individuals above 18 years with VA equal to or better than +1 logMar (20/200) in each eye. VA measurements were converted from Snellen to logMAR, and statistical analyses included Bland-Altman and descriptive statistics.ResultsThe study, encompassing 322 patients and 644 eyes, compared Eyecare Visual Acuity Test® to conventional methods, revealing a statistically insignificant mean difference (0.01 logMAR, <i>P</i> = 0.1517). Bland-Altman analysis showed a narrow 95% limit of agreement (0.22 to -0.23 logMAR), indicating concordance, supported by a significant Pearson correlation (r = 0.61, <i>P</i> < 0.001) between the two assessments.ConclusionThe Eyecare Visual Acuity Test® demonstrates accuracy and reliability, with the potential to facilitate home monitoring, triage, and remote consultation. In future research, it is important to validate the Eyecare Visual Acuity Test® accuracy across varied age cohorts, including pediatric and geriatric populations, as well as among individuals presenting with specific comorbidities like cataract, uveitis, keratoconus, age-related macular disease, and amblyopia.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1162-1168"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory design in telehealth research: Practical case examples.","authors":"Jane Clemensen, Kristina G Holm, Pernille R Jakobsen, Charlotte M Jensen, Charlotte Nielsen, Dorthe B Danbjørg, Anthony C Smith, Mette J Rothmann","doi":"10.1177/1357633X241262820","DOIUrl":"10.1177/1357633X241262820","url":null,"abstract":"<p><p>Participatory design (PD) is a methodology that emphasizes user participation in the design of new technologies to leverage change within organizations and services. PD originated in the computer science field in the 1970s and 1980s when new programs and technologies were developed to empower workers, by involving them in decisions that affected them. PD in health research has been proven to change clinical practice. Genuine user involvement that includes all stakeholders, and robust collaborations across sciences, sectors, and disciplines are basic elements of successful research to change clinical practice and to implement novel technical and organizational approaches. This paper summarizes seven case studies involving the use of PD in telehealth research. All cases presented promoted organizational changes supported by health information and communications technology, and have been implemented at either international, national, regional, or local levels. We describe how PD can be applied in health sciences and used to facilitate organizational changes, new perspectives, and new communications methods. The relevance and suitability of PD as a research design in health science is explained, and recommendations for conducting PD studies in telehealth research are presented. In PD, mutual learning and co-creation is facilitated. Consequently, learning from users, rather than studying them, corroborates our understanding and the emergence of new knowledge.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1193-1200"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of telehealth care on escalation to emergency care: A systematic review and meta-analysis.","authors":"Anna M Scott, Sharon Sanders, Tiffany Atkins, Madeleen van der Merwe, Carla Sunner, Justin Clark, Paul Glasziou","doi":"10.1177/1357633X241259525","DOIUrl":"10.1177/1357633X241259525","url":null,"abstract":"<p><p>ObjectiveWe compared the impact of accessing healthcare (1) by telehealth (via telephone or video) vs face-to-face; and (2) by telephone vs video telehealth care, on escalation to emergency care.MethodsWe searched Medline, Embase and Cochrane CENTRAL to 24 July 2023; and conducted a citation analysis on 19 September 2023. We included randomised controlled trials. Risk of bias was assessed using Cochrane Tool 2. We calculated risk ratios for dichotomous outcomes and standardised mean difference for continuous outcomes.ResultsTen trials compared telehealth (five telephone, four video, one both) to face-to-face care. Six were overall low, three some concerns and one high risk of bias. There were no differences between telehealth and face-to-face for visits to the emergency department (RR 1.07, 95% CI 0.89 to 1.29), hospitalisations up to 12 months (RR 0.89, 95% CI 0.56 to 1.41), deaths or other adverse events. Costs of care were similar, as were patient satisfaction scores.Six trials compared telephone to video telehealth: three were overall low, two some concerns, and one high risk of bias. There were no differences between telephone and video for visits to the emergency department (RR 0.67, 95% CI 0.41 to 1.12), hospitalisations (RR 1.04, 95% CI 0.73 to 1.48), deaths, other adverse events, costs, or patient satisfaction. Healthcare provider satisfaction was high.ConclusionsTelehealth care - delivered by telephone or by video - may be an appropriate alternative to face-to-face provision of care, as it does not increase the likelihood of escalation of care to the emergency department for patients in primary care, hospital outpatients, post-discharge patients or residents in aged care.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1059-1077"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming health care: Investigating Influenzer, a novel telemedicine-supported early discharge program for patients with lower respiratory tract infection: A non-randomized feasibility study.","authors":"Tatjana Sandreva, Maria N Larsen, Maja K Rasmussen, Thyge L Nielsen, Charlotte von Sydow, Thomas A Schmidt, Thea K Fischer","doi":"10.1177/1357633X241254572","DOIUrl":"10.1177/1357633X241254572","url":null,"abstract":"<p><p>BackgroundThe COVID-19 pandemic has posed unprecedented challenges to healthcare systems globally, necessitating innovative care models like hospital-at-home and virtual care programs. The Influenzer telemedicine program aims to deliver hospital-led monitoring and treatment to patients at home. Integrating telemedicine technology with domestic visits provides an alternative to traditional hospitalization, with the aim of easing the burden on healthcare facilities without compromising patient safety. To evaluate the effectiveness of the Influenzer program, a randomized controlled trial is proposed. This study aimed to assess the feasibility of the proposed clinical trial design.MethodsA non-randomized feasibility study was conducted at the Department of Pulmonary and Infectious Diseases at Nordsjaellands Hospital offering a telemedicine-supported early discharge program to patients with lower respiratory tract infections, including COVID-19. The feasibility of trial procedures, including recruitment, adherence, and retention, was analyzed. Also, participants' characteristics and trajectory during the intervention, including telemedicine and domestic services, were assessed.ResultsNineteen patients were enrolled from June 2022 to April 2023 and treated at home. Forty patients were not enrolled as 15 (25%) were non-eligible according to study protocol, 15 (25%) refused to participate and 10 (17%) had not been approached. Subjects treated at home had comparable clinical outcomes to those treated in the acute hospital, no major safety incidences occurred and patients were highly satisfied. Participants demonstrated 99% adherence to planned daily monitoring activities. In total, 63% completed all survey assessments at least partially including baseline, at discharge, and 3 months post-discharge, while 89% participated in a follow-up interview. No participants withdrew their consent.ConclusionsThe feasibility study documented that the Influenzer home-hospital program was feasible and well accepted in a Scandinavian setting in terms of no withdrawals and excellent participant adherence to the planned daily monitoring activities. Challenges in the organizational structures including patient recruitment and data collection required resolution prior to our randomized clinical trial. Insights from this feasibility study have led to the improved design of the final Influenzer program evaluation trial.Trial registrationClinicalTrials.gov, NCT05087082. Registered on 18 August 2021.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1138-1151"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The agreement between face-to-face and tele-assessment of ataxia severity scales in multiple sclerosis patients with ataxia.","authors":"Gungor Beyza Ozvar Senoz, Fatma Ayvat, Ender Ayvat, Muhammed Kilinc","doi":"10.1177/1357633X251369245","DOIUrl":"10.1177/1357633X251369245","url":null,"abstract":"<p><p>BackgroundTele-assessments are becoming increasingly important to increase access to healthcare services and facilitate patient follow-up. Whether they can provide results with similar accuracy to face-to-face assessments remains relevant.ObjectiveThe aim of this study was to compare the face-to-face and tele-assessment scores of the International Cooperative Ataxia Rating Scale (ICARS) and Assessment and Rating of Ataxia (SARA) in ataxic MS patients and to examine their suitability for tele-assessment.MethodsThe participants were assessed both online and face-to-face. Randomization determined which method would be used first to assess the participants. ICARS and SARA were used in the assessments. Face-to-face assessments were conducted as part of routine clinical practice by one researcher, while teleassessments were performed via real-time video by two different researchers. The video was recorded and reassessed one week later. The agreement and correlation between face-to-face and teleassessments were analyzed using intra-class correlation coefficients (ICC), Bland-Altman Plots, and Pearson's/Spearman's correlation coefficients.ResultsThis study included 20 patients with ataxic MS with an EDSS score of 3.6 ± 0.66. The inter-rater reliability of tele-assessments (ICC_ICARS = 0.97; ICC_SARA = 0.97) achieved excellent reliability. Intra-rater reliability of the tele-assessment was excellent (ICC_ICARS = 0.99; ICC_SARA = 0.99). High correlations were observed in ICARS and SARA scores between face-to-face and tele-assessment methods according to assessors (<i>r</i> > .80 for all).ConclusionICARS and SARA are reliable and agreed-upon tests that can be used with tele-assessments, offering similar data to face-to-face methods.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251369245"},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-design of a digital health lifestyle intervention for adults with metabolic dysfunction-associated steatotic liver disease.","authors":"Surbhi Sood, Stuart Roberts, David Scott, Shelley Keating, Sze-Yen Tan, Jacob George, Nicole Kiss, Robin Daly, David Dunstan, Robin Tucker, Elena George","doi":"10.1177/1357633X251366098","DOIUrl":"10.1177/1357633X251366098","url":null,"abstract":"<p><p>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-<i>discover, define, develop, deliver-</i>was implemented. Twenty-seven adults (≥18 years) from Alfred Health, Australia participated in one-on-one interviews to explore insights and perspectives during the <i><u>discover</u></i> phase. This included people with MASLD (<i>n</i> = 10; 50% female; mean age: 63.6 years), and healthcare professionals (<i>n</i> = 17; 59% female; mean age: 37.1 years) [dietitians (<i>n</i> = 5), exercise professionals (<i>n</i> = 6) and hepatologists/clinicians (<i>n</i> = 6)], representing a range of ethnic backgrounds. Key themes were synthesised using a reflexive thematic analysis employing a data-driven, inductive approach during the <i>define</i> phase. The <i>develop</i> phase led to actionable suggestions, and final feedback was sought from participants in the <i>deliver</i> 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 <i>discover</i> and <i>define</i> 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 <i>develop</i> phase focused on refining the intervention based on participant feedback and <i>deliver</i> 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.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251366098"},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}