Healthy Happy Preschoolers: Co-developing health promotion materials with key stakeholders to optimise weight and wellbeing

Background: One in four UK 5-year-olds live with overweight/obesity, with those from low-income families being disproportionately affected. Effective targeted health promotion efforts, engaging key stakeholders in areas of highest need, are required. We describe a 3-phase project, designed to translate research evidence into practice, to optimise health promotion in under-5s.

Methods: In phase 1 (2023), an evidence synthesis of published systematic reviews was undertaken, extracting determinants of obesogenic behaviours in 0-6-year-olds (physical activity (PA), sedentary behaviour, fruit/vegetable consumption, sugar-sweetened beverages, dietary behaviours, portion size). We extracted and mapped common determinants across behaviours, using the socio-ecological model. In phase 2 (early 2024) findings were shared with key stakeholders (policy/practice partners, health visitors, early-years educators). Via online webinars or questionnaires, stakeholders were asked to outline their key health promotion priorities; who they felt promotion efforts should target; and desired material formats (e.g. videos, information sheets). In phase 3 (mid 2024) we will co-develop these health promotion materials, targeting common determinants across multiple health behaviours, evaluating reach and impact.

Results: Phase 1 identified 16 determinants as common to at least two health behaviours, at the individual (e.g. child preference); interpersonal (e.g. modelling); community (e.g. provider training) and societal (e.g. safety) levels. In phase 2, 49 stakeholders contributed to the co-development webinars (n=24) or completed questionnaires (n=25). Their priorities included obesity prevention, sleep health and PA promotion; they stated families with under-5s and childcare providers would benefit most from targeted videos, infographics and social media resources. Iterative co-production of health promotion materials is ongoing, to be launched in summer 2024, with an impact evaluation planned.

Implications: Targeting determinants common to several health behaviours, aligned with stakeholder priorities, has potential to optimise weight and wellbeing in young children. Co-producing evidence-based resources with stakeholders is a feasible and valuable way to promote healthy habits in under-5s.