Promoting healthy diet and movement in UK preschoolers: Evidence-based co-development of health promotion materials

Background Excess weight remains a concern for preschool-aged children. To support action in practice, we synthesised systematic review evidence assessing determinants of health behaviours in 0-6-year-olds to inform the co-production of health promotion materials to promote UK preschoolers’ healthy weight. Methods Phase 1: Synthesis of review-level evidence on dietary (i.e. fruit and vegetable, obesogenic food and sugar-sweetened beverage consumption), feeding (i.e. portion size), and movement behaviours (i.e. physical activity and sedentary behaviour) (Spring 2024). Determinants (assessed in cross-sectional, longitudinal and intervention studies) and their direction of association with each behaviour were extracted and synthesised according to the socio-ecological model (i.e. individual, interpersonal, organisational and environmental domains). Phase 2: Phase 1 findings informed five co-design webinars with policy and practice partners, healthcare practitioners and childcare providers (‘interest holders’), co-producing a range of materials to promote healthy behaviours (launched Spring 2025). Results Twenty-nine determinants were associated with two or more health behaviours [individual (n = 8); interpersonal (n = 11); organisational (n = 6); and environmental (n = 4) domains]. Interpersonal determinants (e.g. relating to parents, siblings, other carers) were assessed often and tended to be positively associated with movement and dietary behaviours. Co-design webinars with 51 interest-holders, whose key priorities included supporting healthy weight and promoting physical activity/ healthy food availability, resulted in co-production of a free-to-use infographic; four animations; social media stills and dominos (for children). Conclusions Common determinants of preschoolers’ health behaviours were leveraged to co-develop health promotion materials, incorporating interest-holders’ key priorities. Child-friendly outputs, with diverse representations of families, were co-produced to support UK preschoolers’ healthy weight.