Intervention adaptation protocol for the holistic school-based intervention, Youth-Physical Activity Towards Health, within a Danish context

Introduction: In recent years, the concept of physical literacy (PL) has gained interest worldwide. Yet, only a few interventions targeting PL exist on a global scale. A promising theory-based and nationally tested intervention, Youth-Physical Activity Towards Health (Y-PATH), has proven to be effective in improving children and adolescents’ physical activity levels and motor skills in Ireland. Aim: Using this protocol we aim to context-adapt the Irish Y-PATH into an intervention that works through the schools in Denmark and targets PL among pupils in 4^th and 5^th grades. Methods and analysis: We apply a stepwise approach to intervention adaptation, inspired by the Medical Research Council’s guidance for developing complex interventions as well as the ‘consensus informed guidance for adapting interventions to achieve a good fit between the intervention and context’ (ADAPT) process model and its principles and actions outlined by Graham Moore and colleagues. First, we combine evidence synthesis with stakeholders and researchers’ engagement to identify relevant and tentative adaptations and to understand barriers and enablers to the promotion of physical literacy in school-based interventions. Next, we further adjust and improve our intervention adaptation ideas by collecting detailed data through interviews with purposively sampled stakeholders and pre-pilot tests of selected prototypes of materials in a ‘real-world’ setting. Finally, we clarify the intervention adaptations – its components, materials, and content – in a discussion with purposively sampled stakeholders, and finally, we test the study design. Expected results and outcomes: A Danish version of the Y-PATH intervention, ready for feasibility testing within a Danish context, and a TIDieR intervention description checklist suitable for testing and further refinement in a feasibility study. The process will further increase our knowledge and understanding of the Danish school context as well as the teacher and pupil’s needs for an intervention promoting PL.