# Supporting the health of working women in midlife: co-designing and testing the acceptability of a digital exercise programme

## TL;DR

This study co-designed and tested a smartphone app to support midlife working women's health through exercise, finding it acceptable but needing improvements.

## Contribution

The novel contribution is a co-designed digital exercise program tailored for midlife working women, tested for acceptability via smartphone app.

## Key findings

- Creating physical and social opportunities were key enablers for engagement with strength training.
- Automatic motivation was identified as a barrier to exercise adherence.
- The app was low effort to use but had neutral user attitude and low perceived effectiveness.

## Abstract

Women in midlife (WiML) report a range of physical and psychological challenges, including the transition to perimenopause and menopause. Combined effects of work and life stressors alongside menopause symptoms in working women are reported to increase absenteeism, reduce productivity and work satisfaction and may result in women exiting the labour market earlier than intended. The aim of this study was to co-design and test a novel exercise programme delivered via smartphone app for working women in midlife. The findings aim to inform targeted support to facilitate exercise for working women in midlife, that could be offered virtually and at scale.

A two-phase process was used to co-design and test a digital exercise programme for WiML, to be delivered via smartphone app. In phase one, participants (n = 12) joined four co-design workshops where collected data was mapped against the Behaviour Change Wheel (BCW). A tailored exercise programme was designed by an exercise physiologist and physiotherapist to meet user needs with a focus on increasing muscle strength. In phase two, a prototype app was developed to deliver the programme digitally. The app was tested for acceptability by a cohort of working women from the education and private sectors (n = 16) using the Theoretical Framework of Acceptability as a reference.

Creating opportunities, both physical and social, were identified as the strongest enablers for improving engagement with strength training exercises for WiML, while automatic motivation was identified as a barrier. The app-based exercise programme was found to be low effort to engage with, but affective attitude towards the app was neutral and perceived effectiveness of the programme was low.

A digital intervention was co-designed and tested by WiML. Findings suggest that combining a flexible programme of aerobic exercise, strength training and pelvic floor exercise via a smartphone application may be an acceptable way to support the health and wellbeing of working women in midlife. Optimisation of the app usability and functionality are needed prior to assessments of effectiveness. Digital workplace interventions are a potentially viable way to address disparities in midlife health and to support healthy ageing in women.

The online version contains supplementary material available at 10.1186/s12905-025-04244-7.