An app-based parenting program to promote healthy energy balance-related parenting practices to prevent childhood obesity: Protocol using the Intervention Mapping Framework

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Background: The family environment plays an important role in the development of children's energy-balance related behaviors (EBRBs). As a result, parents' energy-balance parenting practices (EBRPPs) are eminent targets of preventive childhood obesity programs. Families with a lower socioeconomic position (SEP) may benefit from participating in such programs, but are generally less well reached than families with a higher SEP. Objective: This study describes the application of the Intervention Mapping Protocol (IMP) for the development of an app-based preventive intervention program to promote healthy EBRPPs among parents of children (0-4 years old) with a lower SEP. Methods: The six steps of the IMP were used as a theory- and evidence-based framework to guide the development of the app-based preventive intervention program. Results: In Step 1, behavioral outcomes for the app-based program (ie, children have a healthy dietary intake, sufficient sleep, and restricted screen time/sufficient physical activity) and socio-cognitive (ie, knowledge, attitudes, self-efficacy) and automatic (ie, habitual behaviors) determinants of energy-balance related parenting were identified through a needs assessment. In Step 2, the behavioral outcomes were translated into performance objectives. To influence these objectives, in Step 3 theory-based intervention methods were selected for each of the determinants. In Step 4, the knowledge derived from the previous steps allowed for the development of the app-based program Samen Happie! through a process of continuous co-creation with parents and health professionals. In Step 5, community health services were identified as potential adopters for the app. Lastly, in Step 6, two (randomized controlled) trials were designed to evaluate the process and effects of the app among Dutch parents of infants (Trial 1) and preschoolers (Trial 2). These trials were completed in November 2019 (Trial 1) and February 2020 (Trial 2). Conclusions: The IMP