Adolescents are navigating a period of rapid growth and development within an era of digitalization. Mobile phone ownership among adolescents is nearly ubiquitous, and this provides an opportunity to harness text messaging to promote a healthy lifestyle and reduce chronic disease risk factors. Inclusion of adolescents throughout the design process has been recognized as essential for engagement and future implementation of such interventions. This study aimed to co-design a bank of text messages to promote a healthy lifestyle which are useful, acceptable, and engaging for adolescents aged 12–18 years old. Iterative, mixed-methods design with consumer partnership. Co-design occurred over three stages: text message development, text message review and final refinement and testing. The text message development included literature searches and consumer partnership with an established youth advisory group (n = 16). Participants who gave e-consent participated in text message review. Demographic characteristics were collected, and quantitative surveys were distributed to adolescents (n = up to 50) and health professionals (n = up to 30), who rated text message content for understanding, usefulness and appropriateness (total score out of 15). Final refinement was completed by the research team to edit or remove messages which had low scores and to assess readability and interactivity of the text messages. The Heath Advisory Panel for Youth at the University of Sydney (HAPYUS) identified the top six lifestyle health issues for young people today in relation to chronic disease prevention, which became the key content areas for the text message bank and drafted new text messages. Following text message development, 218 messages were available for review. Adolescents (n = 18, mean age 16.3 [SD 1.4]) and healthcare professionals (n = 16) reviewed the text messages. On average, all reviewers found that the text messages were easy to understand (mean = 13.4/15) and useful (mean = 12.7/15). Based on scoring and open ended-feedback, 91 text messages were edited and 42 deleted. The final text message bank included 131 text messages. The overall program is suitable for a seventh-grade reading level, and interactive. This study describes the process of effectively engaging adolescents to co-design a text message bank intervention, which are useful, acceptable and engaging for an adolescent audience. The effectiveness of the co-designed text message bank is currently being tested in the Health4Me RCT. Today’s adolescents are growing and developing through a period of increased technology use. Most adolescents have access to a mobile phone which can be used to deliver healthy lifestyle information to them through text messages. However, it is important that researchers engage with adolescents as collaborators to develop any information which may be sent to them, to ensure that it is acceptable and engaging. We aimed to co-design a bank of text messages to promote a healthy lifestyle which are useful, acceptable and engaging for adolescents 12–18 years old. We engaged with 16 adolescents from an established youth advisory group who advised on top health issues they face today in terms of leading a healthy lifestyle, which became key content areas for the text message program. They also drafted text messages around these content areas (218 total). Next, the text messages underwent review with 34 adolescents and healthcare professionals to ensure they were useful, easy to understand and appropriate. After the review, the research team edited, deleted and replaced text messages which did not score well. This resulted in a text message bank to promote a healthy lifestyle with 131 text messages which were useful, acceptable and engaging for adolescents 12–18 years old.

中文翻译：

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取得适当的平衡：与青少年共同设计 Health4Me 健康生活方式数字健康干预措施

青少年正处于数字化时代的快速成长和发展时期。青少年拥有手机几乎无处不在，这提供了利用短信来促进健康生活方式和减少慢性病风险因素的机会。人们认为将青少年纳入整个设计过程对于参与和未来实施此类干预措施至关重要。本研究旨在共同设计一组短信，以促进对 12-18 岁青少年有用、可接受且有吸引力的健康生活方式。与消费者合作的迭代、混合方​​法设计。协同设计分三个阶段进行：短信开发、短信审核以及最终细化和测试。短信开发包括文献检索以及与已建立的青年咨询小组（n = 16）的消费者合作。给予电子同意的参与者参与短信审查。收集人口统计特征，并向青少年（n = 最多 50 名）和卫生专业人员（n = 最多 30 名）分发定量调查，他们对短信内容的理解性、有用性和适当性进行评分（总分 15 分）。研究团队完成了最终的细化，编辑或删除得分较低的消息，并评估短信的可读性和交互性。悉尼大学青年健康咨询小组（HAPYUS）确定了当今年轻人与慢性病预防相关的六大生活方式健康问题，这成为短信库的关键内容领域，并起草了新的短信。短信开发完成后，有 218 条短信可供审核。青少年（n = 18，平均年龄 16.3 [SD 1.4]）和医疗保健专业人员（n = 16）查看了短信。平均而言，所有审阅者都发现短信易于理解（平均值 = 13.4/15）且有用（平均值 = 12.7/15）。根据评分和开放式反馈，编辑了 91 条短信，删除了 42 条。最终短信库包含 131 条短信。整体程序适合七年级的阅读水平，并且具有互动性。本研究描述了有效吸引青少年共同设计短信库干预措施的过程，该干预措施对青少年受众有用、可接受且有吸引力。目前，Health4Me 随机对照试验正在测试共同设计的短信库的有效性。当今的青少年正在经历一个技术使用增加的时期，从而成长和发展。大多数青少年都可以使用手机，通过短信向他们提供健康的生活方式信息。然而，重要的是，研究人员作为合作者与青少年合作，开发可能发送给他们的任何信息，以确保其可以接受和吸引人。我们的目标是共同设计一组短信，以促进健康的生活方式，这些生活方式对于 12-18 岁的青少年来说是有用的、可接受的和有吸引力的。我们与来自已成立的青少年咨询小组的 16 名青少年进行了接触，他们就当今面临的首要健康问题提供了健康生活方式方面的建议，这成为短信计划的关键内容领域。他们还围绕这些内容领域起草了短信（总共 218 条）。接下来，34 名青少年和医疗保健专业人员对这些短信进行了审查，以确保它们有用、易于理解且合适。审核后，研究团队对评分不理想的短信进行了编辑、删除和替换。由此诞生了一个短信库，旨在推广健康的生活方式，其中包含 131 条短信，这些短信对于 12-18 岁的青少年来说是有用、可接受且有吸引力的。