Purpose: Participatory Action Research (PAR) is a promising approach to increase the effectiveness and impact of health promotion interventions. A framework guiding the evaluation of interventions developed using a PAR approach is currently lacking. Existing frameworks do not include participants’ experiences in collaborating as co-researchers and the impact of PAR projects on the co-researchers and the larger community. Therefore, the aim of this study was to develop a framework to guide the evaluation of our youth-centred PAR project LIKE (i.e. Lifestyle Innovations Based on Youth Knowledge and Experience).

Methods: We developed an evaluation framework (the Emke framework) based on three existing frameworks, including i) RE-AIM (reach, efficacy, adoption, implementation, and maintenance) (Glasgow et al.) because it is specifically developed for the evaluation of health promotion interventions in the real world; ii) the framework by Saunders et al. because it is developed for assessing health promotion program implementation; and iii) the framework by Jurrius focusing on the quality aspects of conducting youth-centred participatory research.

Results: The Emke framework is divided in the evaluation of 1) the co-creation process and 2) the implementation of co-created actions or innovations, which are both iterative processes. Our framework includes six elements: preconditions, recruitment, participants, iterative implementation, perceived effects, adoption and sustainability. All elements are applicable to both the co-creation and implementation process, yet the interpretation differs. For example, the element ‘implementation’ focuses on whether the actions are implemented as contextually appropriate, but also whether the co-creation process has been implemented as contextually appropriate; on the extent to which co-researchers could influence the co-creation process, and on the collaboration between researcher and co-researchers.

Conclusions: This study provides a framework which can be used to guide evaluations of PAR projects and gains a better understanding of barriers, facilitators and potential impact of PAR projects.

Background : The high prevalence of sleep deprivation and reduced sleep quality in adolescents is an important public health concern, suggesting effective interventions are needed. Using a participatory approach in which a group of adolescents is strongly involved in the development of sleep interventions is promising, especially when it is combined with the Intervention Mapping protocol to guide the development process. This approach not only leads to more tailored interventions, but also brings along benefits for the adolescents that were involved, such as increased feelings of self-esteem and empowerment. The aim of this study was to evaluate the process of collaborating with adolescents to develop a sleep intervention.

Methods: Two secondary schools offering general education in Flanders, Belgium, participated in this study. In each school, an action group with adolescents (age 13-15 years old, n = max. 10) was set up to develop a school-specific intervention. During weekly sessions (n= 29) with the researcher, the action groups went through the different steps of Intervention Mapping. Focus groups were performed with each action group at four different times points during the development process to evaluate the participatory process. Interviews were audio-recorded and thematic content analysis was performed using Nvivo 11.

Results: A sixteen-week long intervention focusing on healthy sleep, regular sleep patterns, screen time, physical activity, nutrition and relaxation was co-created. The participatory approach in combination with Intervention Mapping was very well received by adolescents. The action groups experienced ownership of the intervention through the shared decision-making and reported to have learned a lot about sleep as a health problem, handling big projects and social interactions. During specific steps of the development (the more theoretical steps), the adolescents suggested to use more active methods. Also, the adolescents expressed not always feeling supported by peers or teachers.

Conclusions: Combining a participatory approach with Intervention Mapping is feasible and the adolescents enjoyed the process. To maximize support for the intervention, future researchers should consider starting the fifth step of Intervention Mapping (i.e. planning for implementation) earlier in the process, and should look for more opportunities to involve peers outside of the action group.

Purpose: To tackle current obesity issues in the younger population, one valuable approach would be to involve children in the development of healthy food products that they would enjoy and actively chose. The aim of the study was to define a suitable process to brainstorm for healthy snack ideas with children, focusing on pleasure and healthiness. Two different settings were explored: creative focus group (CFG) and online setting (ONL).

Method: Three steps were defined to generate ideas: (1) Show &Tell: comprising a photovoice exercise, i.e. photo taking and -elicitation, commonly used in participatory research, to understand what children ate; (2) Reflect: a sorting task of the pictures to discuss and reflect their perception (3) Create: an idea generation step, in which a newspaper article describing the invention was created. Participants were recruited as convenience samples, from after-school activities (CFG) or school class (ONL). Three groups of seven 9-12 y.o. children participated in the 1.5 h CFG. For the ONL setting a school class, N=51, 10-11 y.o., participated within their Health and Nutrition education during three weeks.

Results: The proposed multi method process enabled an in-depth exploration of preadolescents' snacking habits. Pleasure, availability and convenience were identified as main drivers of their choices. Healthiness also emerged as a relevant factor and was discussed from many angles: i) in the context of physical exercise; ii) as a nuanced food characteristic (healthier and unhealthier versions of the same), linked to parental food restriction; iii) in relation to the frequency of consumption and to wellbeing. Both settings produced actionable ideas for new snacks, product names and packaging. Participants were more prone to consider healthiness in the presence of the moderator (CFG) while the peer-to-peer interaction in the ONL was more pleasure-focused. The feedback and observations from the study, particularly in the creative focus group setting, implied that the creative approach was highly engaging for participants.

Conclusion: Results from the present study demonstrate that preadolescents can create actionable new healthy food product ideas, using enabling and creative techniques, both in focus groups and online settings.