1.M. Scientific session: Promoting healthy weight and wellbeing in children with multi-setting, multi-component interventions

Abstract Childhood obesity affects more than 340 million children worldwide and is characterized by WHO as one of the most serious public health challenges. Obesity in childhood can have serious consequences for child wellbeing and increases the risk of adverse health outcomes in adulthood. Prior efforts to prevent childhood obesity have shown limited effects, and interventions often focused on only one setting and behavioral component (e.g., physical activity in school). The objective of this workshop is to discuss the potential for promoting healthy weight and wellbeing in children using multi-setting, multi-component interventions which target all arenas of children's daily lives and address structural determinants of health. The workshop will be based on learnings from Generation Healthy Kids (GHK), a multi-setting, multi-component intervention targeting Danish children aged 6-11 years. The GHK intervention is based on a socio-ecological framework and whole systems thinking and involves elements targeting families, schools, after-school clubs, local communities, and food environments, while striving to address children's diet, physical activity, screen media use, and sleep. The intervention is evaluated in a cluster-randomized trial from August 2023-June 2025 at 23 Danish schools and local communities, including approx. 1,500 children, and also involves a thorough process evaluation. The workshop includes four presentations highlighting examples from three different GHK intervention settings with different intervention components to illustrate the complexity of multi-setting, multi-component interventions. First, we provide an overview of prior evidence on childhood obesity prevention and the design and methods of GHK. This is followed by a focus on the free school lunch program, including barriers, facilitators, and contextual factors influencing implementation. Subsequently, we present experiences from the GHK local community intervention, focusing on co-creation with local stakeholders and children, and finally, we discuss lessons learned from involving supermarkets in creating healthier food environments. Flash cards and participant votes are used throughout the workshop to involve participants in reflecting on transferability of findings to their own contexts. The workshop ends with a 20-min Q&A on facilitators and barriers for implementing interventions to promote healthy weight among children in schools and communities; how lessons from GHK can be applied in workshop participants’ own settings and countries; and main prerequisites for long-term sustainability of multi-setting interventions. Overall, the workshop will provide participants with insights and inspiration into promises and potential pitfalls of novel multi-setting, multi-component interventions to promote healthy weight and wellbeing in children. Key messages • Targeting multiple settings and creating health-promoting environments around children and families is crucial to prevent childhood obesity. • Multi-component interventions for childhood obesity prevention require close involvement of local stakeholders, sensitivity to context, and sufficient time and resources to support implementation.