Assessing stakeholder engagement and ripple effects of co-created health promotion interventions

Abstract Background This study focused on intervention development and implementation in the Our Healthy Community (OHC) project. The aim was to assess stakeholder engagement and ripple ef-fects of co-created health promotion interventions in OHC in two Danish municipalities. Methods Assessment of stakeholder engagement was based on an adaptation of Rosenblatt's Engagement Score (0=passive, 1=observer, 2=follower, 3=supporter, 4=contributor, 5=ownership, 6=leading). Engagement was scored and tracked quarterly for a period of two years (April 2023 to April 2025) in the municipality action groups. For each action group, the total engagement score of all stakeholders was summed and the average engagement score for each group calculated. Ripple effects were continually recorded by collecting information from stakeholders, social media, and local newspapers. The information was graphically mapped for each municipality. Results Two action groups were established in each municipality. In municipality B the two groups were merged to one. The results show a total of 60 stakeholders were involved in the process of developing activities promoting health and well-being among schoolchildren (municipality A, n = 24) and adolescents (municipality B, n = 36). Preliminary results suggest that the average engagement score increased over time in all the action groups, more in municipality A (3.4 and 3.7) than B (2.2). Over the study period multiple ripple effects were registered in both municipalities. Municipality A had more ripple effects than municipality B and the ripple effects were more well-defined. Conclusions Several stakeholders were involved the development and implementation of health promotion activities in both municipalities, and stakeholder engagement increased in both munici-palities over a two-year period. However, scores were consistently higher in municipality A than in municipality B, and more ripple effects were captured in municipality A.