Intervention Development Protocol for a Health Promoting, Family-based Intervention targeted Socially Disadvantaged Populations in YMCA’s Social Work’s Social Cafes and Kindergartens
Authors: Mygind Lærke , Kurtzhals Mette , Ellekrog Louise Gade , Ravnborg Maria Bille , Seeberg Michael Aagaard , Elsborg Peter , Bentsen Peter 
Published: July 2022

IntroductionThe prevalence of mental and physical disorders amongst children and adolescents is high and is, for many disorders, on the rise. Innovative public health interventions are needed to address this. Despite the existence of multifarious health promotion and prevention interventions targeting children, adolescents, and families, few have proven effective. The family unit is considered essential for the formation of health, wellbeing, and health behaviors over the lifespan. It is especially important for interventions to target families that are socially disadvantaged considering the well-established social gradient in health and wellbeing. Unfortunately, previous interventions have had limited success. This protocol outlines the three-phased approach we plan to use to develop the intervention; 1) Synthesis and prototyping, 2) Testing and feedback, and 3) Refinements and description. The intervention will subsequently be tested, and further developed and adapted, in a feasibility study. We consider this a fourth phase although this document focuses on the formal three-phased development process.ObjectivesWe aim to carefully develop an intervention that works through established civil society platforms (i.e., Young Men's Christian Association (YMCA)’s Social Work’s (YSW) social cafes and kindergartens in Denmark) and targets both health competences and the social, relational dynamics that underlie health and wellbeing deficits within socially disadvantaged families. The process described will ensure that the intervention is based on the best available evidence, is informed by theory and practice, and increase the likelihood of acceptability amongst users, providers, commissioners, and those with community interest.Methods and AnalysisOur three-phased approach is inspired by the revised Medical Research Council (MRC) guidance for developing complex interventions and the key principles and actions for consideration described by O’Cathain et al. (1) and McQueen et al. (2). First, we will combine evidence synthesis with stakeholder and research expert engagement to develop a tentative program theory and to understand barriers and enablers to health promotion, family-based interventions amongst socially disadvantaged populations. Next, we further develop our intervention ideas and adapt our emerging program theory by collecting detailed data through interviews with purposively sampled stakeholders (i.e., users, providers, and commissioners) as well as observations and piloting of intervention components in existing YSW family groups. Finally, we test and refine our program theory, develop intervention materials, map, and clarify our intervention and its intersecting components in a discussion with purposively sampled stakeholders. OutcomeHealth-promoting, family-based intervention targeted socially disadvantaged populations; Evidence-based program theory; Intervention content and materials; TIDIER checklist suitable for testing and further refinement in a feasibility study.