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A person is determined to be overweight or obese when their body weight is above what is considered healthy for their height (Centers for Disease Control and Prevention, 2020). These conditions represent major public health concerns as they are associated with additional health risks, including cardiovascular disease, diabetes, and other metabolic conditions (J. S. Wang et al., 2023). Several intervention strategies have been implemented for obesity prevention, including policy interventions and community-based interventions (Barquera & Seidell, 2021). In addition, the introduction of new digital technologies has tremendous potential for impacting lifestyle choices and health, providing viable and personalized well-being services to meet individualized needs (Garcia et al., 2022; Kolasa & Kozinski, 2020; Labrique et al., 2020).
However, a top-down approach without the involvement of the user has dominated most of the prevention strategies, resulting in their limited success (McGlashan et al., 2018; Roberto et al., 2015). In addition, in most cases, the digital tools used are not intuitive and easy to use, they may require time-consuming food logging/monitoring, they focus on interventions either via diet or physical activity, and they fail to engage over the long-term.
All of these problems could be overcome by following a bottom-up approach in the design, implementation, and evaluation of the intervention strategies and technological tools; this implies the involvement of the end-users and a wide variety of stakeholders in a synergistic dialogue to co-define multi-modal intervention measures (Willmott et al., 2022).
The involvement of end-users and the wider community can be achieved using a participatory design process that allows stakeholders to express their concerns and provide ideas and suggestions for promoting successful, user-friendly solutions (D’Andrea & D’Ulizia, 2023, 2024; D’Andrea et al., 2015, 2025; Ferri et al., 2020; Loewenson et al., 2014).
The research question guiding this study is: How do we design intervention strategies and healthy lifestyle technological tools for obesity prevention using a participatory process?
This paper aims to answer this research question by exploring the potential of an integrated participatory design process (IPDP) combining two participatory methodologies, namely design thinking (DT) and user-centered design (UCD), to simultaneously investigate the design process from two perspectives: first, at the strategic level; and second, at the technological level. This approach has the benefit that the technological tools are designed in the larger context of the healthcare system rather than as standalone solutions. This IPDP allows for stimulating the engagement of end users and different kinds of stakeholders; the aim is the co-creation of intervention strategies and the co-design of technological tools for obesity prevention.
The proposed IPDP will be implemented within the HealthyW8 project (https://www.healthyw8.eu/) funded by the European Commission under the Horizon program. HealthyW8 aims to step up primary obesity prevention efforts across Europe, endowing them with a multi-disciplinary portfolio approach that combines a large set of interventions and implementation options, based mainly on a healthy lifestyle recommender solution and a human digital twin. The conception of the participatory design process followed to co-define the set of intervention strategies and the functionalities of the healthy lifestyle recommender solution and healthy digital twin is illustrated in this paper. In particular, two well-synchronized cycles have been defined to collect experiences, motivations, and needs regarding intervention strategies and user requirements—as well as to discuss, identify, and prioritize intervention strategies and desired tools’ functionalities for the HealthyW8 portfolio.