Abstract
IntroductionInterventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population.MethodsIM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres.ResultsHAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity.ConclusionWe have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.
Highlights
Interventions that make extensive use of theory tend to have larger effects on behaviour
The literature review indicated that antenatal and postnatal BMI, diet, and physical activity (PA), breastfeeding, and infant diet and PA were all modifiable risk factors associated with childhood obesity
The use of Medical Research Council (MRC) guidelines for complex interventions [14], and national guidelines and policy to develop a multidimensional approach to tackling childhood obesity by involving local healthcare teams who work with the family to enhance motivation and behaviour change, are likely strengths of this approach
Summary
Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. Given that ‘parents are receptive to and capable of some behavioural changes that may promote healthy weight in their young children’ [10]; p.337, it has been recommended that parenting programme components (parenting skills and practices) are incorporated into childhood obesity prevention programmes [11,12]. Intervention programmes often fail to report on factors such as a rationale, development, theoretical basis, exact content, and method of implementation [9]. This lack of transparency may be forcing researchers and practitioners to ‘guess’ how interventions have been developed, what works and why. Ensuring clear understanding and consistent approach to the nutrition, infant feeding and physical activity elements of the programme (new to these parenting practitioners), and their delivery using the manual and activities including cultural adaptation delivered by specialist practitioners (dietician , infant feeding and PA specialists) The manual
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