Co-production of eENHANCE: a web platform to deliver personalised nutrition and exercise support to prevent cancer-related malnutrition and muscle loss

Purpose Access to nutrition and exercise services for people with cancer-related malnutrition varies across health services. This study co-produced a personalised self-guided evidence-based nutrition and exercise web program and evaluated feasibility and acceptability within clinical practice. Methods A co-production approach was utilised following the four phases of Design Thinking in Healthcare. Phase 1 gathered user needs through interviews with consumers and health professionals, which were analysed using thematic analysis. Solutions were generated in Phase 2 to inform content and development of the platform. Phase 3 involved user acceptance testing. Feasibility testing in a clinical setting was undertaken in Phase 4. Results Phase 1: interviews with 14 health professionals (100% female, mean age 59.5 [range 25–57] years) and five people with cancer (100% female, mean age 53.5 [range 57–62] years) generated three themes: (1) patient characteristics, (2) features and functions of the web platform and (3) optimising practice. Phase 2: an 8-week evidence-based self-guided nutrition and exercise program (eENHANCE) was developed based on the interview findings and refined in Phase 3 testing. Phase 4: 20 people with cancer participated in feasibility testing of eENHANCE at a tertiary cancer centre, with high (86%) acceptability of the intervention, compliance with study outcome assessment (67–100%), while 30–100% accessed prescribed modules. Conclusions eENHANCE is a unique self-guided personalised nutrition and exercise program for people at risk of cancer-related malnutrition and muscle loss. High acceptability and feasibility indicate there may be potential to expand access to self-guided programs for people recovering from cancer treatment; however, further work is required in people undergoing treatment and to identify the most appropriate target groups and the optimal strategies to reach them to improve intervention fidelity.