Comparison of the four co-created interventions to improve snacking and physical activity behaviour in European adolescents: the SEEDS project.

backgroundNew approaches involving adolescents in designing and implementing interventions are an opportunity to improve healthy lifestyles. This study aims to describe and analyse the differences and similarities between the four country-specific (Greece, Spain, The Netherlands and the United Kingdom) co-created interventions through a Makeathon by adolescents from the European Science Engagement to Empower aDolescentS (SEEDS) project, to tackle unhealthy behaviours. Also, it aims to determine if the barriers/facilitators identified in previous focus groups were addressed in the interventions.

methodsThis comparative design study describes and analyses the differences and similarities among the four co-created interventions from the SEEDS project, which is a cluster-randomised controlled trial using a citizen science approach that actively involves participants in all steps of the scientific process. Two of the relevant steps are the definition of the barriers and facilitators by focus groups and the co-design of the interventions by Makeathons. The interventions co-created in each country related to healthy snacking and physical activity (PA) practice are described using the Template for Intervention Description and Replication (TIDieR) with some extra information about the country context (barriers and facilitators).

resultsThe four interventions have some points in common: type of activities per behaviour (methodology used), face-to-face activities, school hours implementation, and external professionals, teachers, or researchers as providers. However, the difficulties in comparing the interventions are the high diversity of activities and activity frequency among the four countries. About barriers, 2 of 3 modifiable barriers to healthy snacking behaviour and 4 of 6 modifiable barriers to PA and sedentary behaviour were addressed in the intervention, but 6 of 12 barriers to PA seemed not feasible for schools and not address in the intervention. Regarding facilitators, focusing on PA and sedentary behaviour, two of the four facilitators identified and focused on healthy snacking behaviour, and only one of the four facilitators identified was addressed in the interventions.

conclusionsIn four co-created interventions by adolescent ambassadors, most of the barriers identified were addressed whereas the facilitators were not enough addressed. Thus, more effort is needed to completely adapt the intervention to the real interest of adolescents. Future research needs to confirm the SEEDS intervention effect and impact on the desired behaviour.

trial registrationNum. NCT05002049; Date: 2021-08-12.