{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:09:48Z","timestamp":1779361788621,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A limited number of physical activity programmes exist for Chinese people with young\u2010onset (18\u201340 years) type 2 diabetes amid its rising global prevalence. This study aims to develop a multimodal intervention for improving physical activity levels for individuals with young\u2010onset type 2 diabetes using co\u2010design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The development process included three stages. Stage 1 involved synthesising the findings of a review of existing physical activity interventions and a qualitative study of exercise experiences of young adults with type 2 diabetes. This generated a list of candidate intervention elements and behaviour change techniques to inform the co\u2010design process. Stage 2 involved the development of animated trigger films, using findings from stage 1, to present the physical activity experiences of people with young\u2010onset type 2 diabetes. In stage 3, a series of co\u2010design workshops engaging relevant stakeholders were conducted, utilising the outputs from the previous two stages and aligning with the Design Thinking theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010five participants (12 young adults with type 2 diabetes, 12 healthcare professionals, and one family member) attended co\u2010design workshops to develop the intervention. The co\u2010design process resulted in a logic model for a tailored programme\u2013IPAYD (Improving Physical Activity in people with Young\u2010onset type 2 Diabetes). This programme integrates behaviour change techniques across four elements: individualised goal setting and planning, exercise monitoring, a peer support forum, and educational resources. An eHealth platform was preferred to deliver the programme, incorporating one\u2010to\u2010one consultations and optional group sessions to enhance social support and social interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Through stakeholder engagement in a co\u2010design process, this study makes a novel and much\u2010needed contribution to developing a physical activity intervention for Chinese people with young\u2010onset type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient and Public Contribution<\/jats:title>\n                    <jats:p>An advisory group of six Chinese young people with type 2 diabetes met online and communicated through a project\u2010focused WeChat group. They contributed to the animated film scripts, the topic guide of the workshops, the design of the intervention materials, and how to conduct the workshops to align with Chinese culture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70580","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T06:50:27Z","timestamp":1770187827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co\u2010Designing a Multimodal Physical Activity Intervention for Individuals With Young\u2010Onset Type 2 Diabetes (18\u201340 Years) in China"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9849-3621","authenticated-orcid":false,"given":"Xiaoyan","family":"Zhao","sequence":"first","affiliation":[{"name":"Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery &amp; Palliative Care, King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angus","family":"Forbes","sequence":"additional","affiliation":[{"name":"Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery &amp; Palliative Care, King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haya Abu","family":"Ghazaleh","sequence":"additional","affiliation":[{"name":"Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery &amp; Palliative Care, King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Medicine, Sun Yat\u2010sen University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The Third Affiliated Hospital, Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Duaso","sequence":"additional","affiliation":[{"name":"Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery &amp; Palliative Care, King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m997"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0334-z"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-072385","article-title":"Global Burden of Type 2 Diabetes in Adolescents and Young Adults, 1990\u20102019: Systematic Analysis of the Global Burden of Disease Study 2019","volume":"379","author":"Xie J.","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l2349"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30186-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00225-5"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002800"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2020.039"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2024.104884"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1425"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30150-1"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2022-002935"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781009237024"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-53705-0_16"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cities.2024.105372"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2196\/43597"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.70063"},{"key":"e_1_2_11_20_1","volume-title":"Design Thinking","author":"Rowe P. 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