JMIR Publications

ABSTRACT

Musculoskeletal injuries (MSKI) are a leading cause of training disruption, increased healthcare burden, medical discharge and reduced readiness in the Royal Navy (RN). Negative health behaviours (poor diet quality, low physical activity, poor sleep, high alcohol consumption, and nicotine use) increase MSKI risk, but this risk varies between individuals. Delivering personalised behaviour change support within a geographically dispersed military organisation is challenging. Digital health technologies offer scalable solutions; however, health interventions are rarely co-designed with personnel. This study aimed to plan and develop a theory-informed, co-designed digital behaviour change intervention to support musculoskeletal health and performance in early-career RN personnel. The planning phase, adopted the Person-Based Approach, involved co-design workshops with early-career RN personnel (n 56), military command personnel and health practitioners (n 11). Data were thematically analysed and mapped to the COM-B (Capability, Opportunity, Motivation, Behaviour Change) model to generate theory-informed guiding principles. The development phase consisted of a 4-day user trial of a digital platform minimum viable product with (n 31) early-career personnel, four military health practitioners and five military research scientists. Qualitative feedback informed iterative refinements. Findings emphasised the need for psychological capability (credible, context-specific guidance), social and physical opportunity (peer connection and practitioner input), and motivation (autonomy-supportive feedback and self-monitoring). A hybrid (practitioner-supported), person-centred, digital platform was considered essential for sustained engagement. User testing of the prototype led to iterative changes to improve acceptability and usability. Thus, a co-designed digital platform can offer an acceptable, scalable, and tailored approach to supporting health and performance interventions.