Co‐designing The Healthy Gut Diet for Preventing Gestational Diabetes: Co‐design methods and process outcomes

Background Gestational diabetes mellitus (GDM) is a common and costly condition of pregnancy. The Healthy Gut Diet for Preventing Gestational Diabetes study is a novel randomised controlled trial that aims to prevent GDM through a diet that modulates the gut microbiota for pregnant women with GDM risk factors. Despite increasing interest in co‐designing interventions with consumers (lived experience experts), co‐design methods and outcomes are often poorly reported. The present study aims to report on the co‐design process used to develop The Healthy Gut Diet intervention. Methods Co‐design occurred across three online workshops with consumer participants (women with a lived experience of GDM, n = 11), researchers (n = 6) and workshop co‐facilitators (including a consumer co‐facilitator, n = 2). The workshops explored women's preferences for the mode and length of education sessions, as well as the types of information and supportive resources women wanted to receive, and undertook a “behaviour diagnosis” to understand barriers and enablers to the target behaviours (eating for gut health). The final intervention is reported according to the Template for Intervention Description and Replication. Results A co‐designed dietary intervention (The Healthy Gut Diet), delivered via telehealth, with a suite of educational and supportive resources that integrates published behaviour change techniques, was developed. Generally, the co‐design process was reported as a positive experience based on participant feedback and evidenced by no participant dropouts over the 3‐month study period. Conclusions Co‐design is recognised as a process that creates a partnership between lived experience experts and researchers who can engage and empower research recipients and improve health behaviours. This co‐design study used professional and lived experience to design a dietary intervention aimed at positively modulating the gut microbiota to prevent gestational diabetes mellitus. Co‐design participants decided preferences for education content, format and delivery, as well as enabling a “behavioural diagnosis” to inform the selection of 40 behaviour change techniques. Highlights Co‐designing dietary interventions with consumers can reduce research waste, improve applicability and intervention adherence, and enable selection of behaviour change techniques. Although increasing in popularity, co‐design methods, processes and outcomes are minimally described in diet research. Co‐desi