A lifestyle-based needs assessment of two European communities prior to the development and deployment of a digital health coaching smartphone application

Marina Iglesias-Cans^1*Croia Loughnane¹Roisin O'Donovan²Ciprian Iftimoaei^3,4Diana Vasiliu⁵Ingrid Enache⁵Manuela Iftimoaei^5,6Angela Achitei⁵Padraic James Dunne¹

• ¹Royal College of Surgeons in Ireland, Centre for Positive Health Sciences, Dublin, Ireland
• ²University College Cork School of Nursing and Midwifery, Cork, Ireland
• ³Universitatea Petre Andrei din Iasi, Iași, Romania
• ⁴Institutului National de Cercetare - Dezvoltare in Informatica - ICI Bucuresti, Bucharest, Romania
• ⁵ADV, “Alături de Voi” Foundation, Iași, Romania, Iași, Romania
• ⁶Academia Romana Institutul de Cercetare a Calitatii Vietii, Bucharest, Romania

Introduction. There is growing interest and demand for leveraging digital technology to enhance the reach and scalability of health and wellbeing interventions, as a solution to the global burden of noncommunicable diseases. For positive health sciences, digital technology has been identified as a feasible solution to increasing the accessibility, scalability and reach of positive health interventions. While digital health solutions have the potential to improve the health and wellbeing of communities and reduce the burden on health systems, these solutions often take a one-size-fits-all approach in their design and implementation. This study aimed to conduct a Community-Based Participatory Research (CBPR) informed needs assessment in Athy (Ireland) and Iași (Romania) to identify lifestyle-related health challenges, barriers, and digital engagement preferences in preparation for implementing the Connect5 digital health coaching intervention. Methods. A mixed-methods cross-sectional design was employed, involving quantitative surveys (n=219 in Ireland; n=205 in Romania) and qualitative interviews/focus groups. Surveys assessed sociodemographic characteristics, lifestyle habits, barriers, support needs, and digital health perspectives. Results. Both communities reported challenges with sleep, physical activity, sedentary behaviour, and stress, with common barriers including lack of time (due to work/study/childcare) and the high cost of healthy food. Notable variations in lifestyle needs, barriers, and support preferences were observed across sociodemographic groups within each community, including gender, age, education, and residency. Lower socioeconomic groups faced more systemic barriers like high food costs or lack of safe outdoor spaces. Despite different levels of prior engagement with digital solutions, both communities showed strong interest in digital health coaching solutions. Discussion. The findings from this needs assessment will inform the design and implementation of the upcoming Connect5 project and provide broader insights for future digital health initiatives. They highlight the importance of integrating community voices and sociodemographic insights to ensure that digital health solutions are relevant, inclusive, and equitable, ultimately promoting sustained engagement, reducing health disparities, and improving population wellbeing.