Co-designed workplace resistance exercise training to improve metabolic and musculoskeletal health in office workers with Type 2 Diabetes Mellitus, A mixed-methods formative evaluation study

AIMS: This mixed method study aimed to co-design a feasible, evidence-informed, and stakeholder-endorsed workplace-based resistance exercise (RE) intervention. METHODS: Following a systematic review based informed pool of RE and their dose, a 12-member multidisciplinary expert panel and end-user office workers with T2DM participated in a two-round consensus process. A two-round survey was conducted to inform quantitative suitability of RE exercise and concurrently qualitative focus group discussions were administered to capture operational barriers, facilitators, and behavioral modification parameters. RESULTS: Seventeen RE's were systematically identified from the contemporary literature. Twelve exercises met the predefined numeric consensus threshold, while five were excluded (I-CVI < 0.80). Finally, 7 RE's achieved a high final content validity score (I-CVI = 0.869). The final co-designed intervention prescribes following dose, 3 days per week across 3 brief workday micro-sessions (10-15-minute morning, 10-15-minute postprandial lunchtime, and 10-15-minute late afternoon. Qualitative analysis synthesized data across seven distinct operational themes, prescription, challenges, behavioral factors, social support, personal factors, general and occupational health considerations. CONCLUSIONS: A feasible, accessible, context specific and stakeholder-validated workplace RE program was developed for desk-bound workers with T2DM. Long-term tracking of specific glycemic fluctuations and musculoskeletal adaptive capabilities will be formally evaluated in upcoming clinical trials. TRIAL REGISTRATION: Clinical Trial Registry-India (CTRI/2025/08/092670).