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Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study

Natalie J Taylor12*, Pinki Sahota134, Judith Sargent1, Sally Barber1, Jackie Loach1, Gemma Louch1 and John Wright1

Author Affiliations

1 Bradford Institute of Health Research, Bradford Teaching Hospitals NHS Trust, Bradford BD9 6RJ, UK

2 Australian Institute of Health Innovation Faculty of Medicine, University of New South Wales, SYDNEY NSW 2052, UK

3 Nutrition and Dietetics, Leeds Metropolitan University, Leeds LS1 3HE, UK

4 School of Health and Wellbeing Faculty of Health and Social Sciences, Leeds Metropolitan University City Campus, Calverley Street, Leeds LS1 3HE, UK

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:142  doi:10.1186/1479-5868-10-142

Published: 28 December 2013



Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population.


IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres.


HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity.


We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.

Childhood obesity prevention; Intervention mapping; Behaviour change; Cultural adaptation; Diet; Physical activity; Parenting; Theoretical domains framework