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The development of a multilevel intervention to optimise participant engagement with an obesity prevention programme delivered in UK children’s centres

Burton, Wendy; Sahota, Pinki; Twiddy, Maureen; Brown, Julia; Bryant, Maria


Wendy Burton

Pinki Sahota

Julia Brown

Maria Bryant


Poor participant engagement threatens the potential impact and cost effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these. This paper details the development of a participant engagement intervention aimed at promoting enrolment and attendance to a community based pre-school obesity prevention programme delivered in UK children’s centres; HENRY (Health, Exercise, Nutrition for the Really Young).
The Behaviour Change Wheel framework was used to guide the development of the intervention. The findings of a coinciding focused ethnography study identified barriers and levers to engagement with HENRY that informed which behaviours should be targeted within the intervention to promote engagement. A COM-B behavioural analysis was undertaken to identify whether capability, opportunity or motivation would need to be influenced for the target behaviours to occur. APEASE criteria was used to agree on appropriate intervention functions and behaviour change techniques.
A multi-level participant engagement intervention was developed to promote adoption of target behaviours that were proposed to promote engagement with HENRY e.g. ensuring the programme is accurately portrayed when approaching individuals to attend and providing ‘taster’ sessions prior to each programme. At the local authority level, the intervention aimed to increase buy-in with HENRY to increase the level of resource dedicated to engagement efforts. At the centre level, managers were encouraged to widen promotion of the programme and ensure that staff promoted the programme accurately. HENRY facilitators received training to increase engagement during sessions and parent that had attended HENRY were encouraged to recruit their peers.
This paper describes one of the first attempts to develop a theory based multi-level participant engagement intervention specifically designed to promote recruitment and retention to a community based obesity prevention programme. Given the challenges to implementing public health programmes with sufficient reach, the process used to develop the intervention serves as an example of how programmes that are already widely commissioned could be optimised to enable greater impact.


Burton, W., Sahota, P., Twiddy, M., Brown, J., & Bryant, M. (in press). The development of a multilevel intervention to optimise participant engagement with an obesity prevention programme delivered in UK children’s centres. Prevention Science,

Journal Article Type Article
Acceptance Date Jan 2, 2021
Online Publication Date Feb 1, 2021
Deposit Date Jan 7, 2021
Publicly Available Date Feb 2, 2021
Journal Prevention Science
Print ISSN 1389-4986
Electronic ISSN 1573-6695
Publisher Springer (part of Springer Nature)
Peer Reviewed Peer Reviewed
Keywords Public health Intervention; Participant engagement; Obesity prevention; Behaviour Change Wheel; Children’s centres
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Published article (356 Kb)

Copyright Statement
© The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

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