Too Wordy, Too Long and Too Cluttered: User Acceptance Testing, Co-Design, and Early Beta Testing to Adapt the Daily Health Coach for Young Australian Women.

Background/

Objectives

The Daily Health Coach (DHC) is a 12-week Instagram-based nutrition and wellbeing programme originally co-designed and tested in New Zealand to deliver evidence-based, weight-neutral content on nutrition, movement, body image, and wellbeing. This formative, mixed-methods adaptation study examined the acceptability of DHC New Zealand content for young Australian women and identified refinements to improve relevance, engagement, and safety before effectiveness evaluation.

Methods

Using the CODES framework, we conducted three adaptation phases: user acceptance testing, co-design workshops, and early beta testing. Following data-quality screening, 291 young women aged 18-24 years who completed all 12 survey sections were included in Phase 1. Participants rated 84 Instagram-style posts for understanding and usefulness and provided open-ended feedback. Twelve young women participated in co-design workshops, and seven adapted artefacts were beta-tested with eight target users using cognitive walkthrough and think-aloud methods. Quantitative findings were examined descriptively, with sensitivity analyses undertaken to assess robustness to response-quality and sample-composition concerns.

Results

Participant-level mean understanding was 3.99 ± 0.75/5, usefulness was 3.89 ± 0.74/5, and the combined score was 7.87 ± 1.47/10. Post-level combined means ranged from 7.66 to 8.11/10; all 84 posts met a ≥7.5 descriptive benchmark adapted from prior message-testing work, although this is an interpretive aid rather than a validated cut-off. Sensitivity analyses showed a similar overall pattern: ratings were higher in a higher-confidence response-quality sample (n = 199; 8.34 ± 1.20/10), while four posts fell marginally below 7.5 when analysis was restricted to participants not reporting Aboriginal and/or Torres Strait Islander identity (n = 101). Qualitative feedback identified six refinement areas: content features, engagement strategies, clarity, educational accuracy, relevance, and miscellaneous concerns. Co-design and beta testing generated four adaptation priorities: tone, design, engagement, and understanding.

Conclusions

DHC New Zealand content was generally well understood and favourably rated but required targeted refinement for the Australian context. Findings provide formative guidance for final adaptation and subsequent effectiveness evaluation.