Involving stakeholders in planning the scale-up of a health promotion intervention: a practical example

Abstract Scaling up health promotion interventions is complex. Despite the potential effects and impact on society, factors related to the intervention itself, potential adopters or implementers, and contextual factors can hinder or promote widespread scale-up. Frameworks such as the PRACTIS (PRACTical planning for Implementation and Scale-up) guide and approaches such as Design Thinking offer practical guidance for researchers to increase the likelihood for successful scale up. SuperFIT is an integrated intervention approach aiming to promote healthy energy balance-related behaviours in children aged 2-4 years. To date, SuperFIT has been implemented in over one hundred childcare locations, reaching at least 1800 children per day. A local PA-providing organisation is responsible for the implementation of SuperFIT. The aim of this project was twofold: to identify the needs of future adopters and implementers of SuperFIT (i.e. What information and materials do you need?) and to develop the relevant tools and implementation strategies. We used a co-creation approach, combining stakeholder interviews (n = 6) based on the PRACTIS guide to identify gaps and needs, with creative sessions (participants n = 8) and multiple thinking-out-loud sessions (participants n = 6) to generate solutions that would be relevant to implementers. Stakeholders included researchers with experience in SuperFIT and implementation science, implementers and managers of the current and new PA-providing organisations. Gaps were identified and summarised under three main themes: 1) a lack of clarity what SuperFIT entails, 2) SuperFIT adaptations to new implementation contexts, 3) the skills and implementation capacity required to ‘train the trainer’. Creative sessions assisted the generation of prototype tools. We have learnt the value of patience and perseverance, as some obstacles need time to be overcome.