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Content Development for a Multilevel Intervention to Operationalize Behavior Change Theory and Improve Parenting

Breanne C Wilhite¹, Erin Hennessy¹, Christina Economos¹

¹The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, United States, 1 7815046421.

JMIR Pediatrics and Parenting

|August 26, 2025

Abstract

Background:

Theory-informed strategies for engaging parents in children's physical activity (PA) promotion show promise. However, behavior-change interventions must become more rigorous in both their application of theory and the reporting of its use to continue to advance the field.

Objective:

This study aims to elucidate how 2 behavior change theories were used to develop parent communication materials in a 20-week communications campaign, nested within a multilevel (school-home) intervention to promote children's PA. The innovation described in this study is derived from the Supporting Physical Literacy at School and Home (SPLASH) feasibility study (2021-2022).

Methods:

A team of 7 experts, including graduate students, researchers, faculty, and child PA specialists, collaboratively designed the process used to develop the intervention content. With experience in theory-informed interventions and health-related communication campaigns, they held recurring meetings to refine the approach.

Results:

A four-step process was used to develop the theory-informed parent communication materials: (1) establish a theoretical foundation for communication materials (ie, social cognitive theory and self-determination theory) and conduct focus groups with the priority population; (2) identify and select PA parenting behaviors aligned with evidence and behavioral theories to form PA parenting objectives that advance children's PA; (3) identify theoretical determinants of parent behavior change and outline methods for applying determinants to address PA parenting objectives; (4) operationalize theory-informed strategy and draft, review, and finalize materials. Parent communications were delivered through print materials and electronic channels, including email, text messages, Facebook (Meta Platforms, Inc), and activity videos.

Conclusions:

This descriptive study advances progress in the development of school-based PA promotion efforts seeking to incorporate parent engagement strategies by detailing how behavior-change theories can be operationalized to improve PA parenting behaviors. This methodology is valuable for others seeking to translate theoretical constructs into behavior-change communication messages.

Keywords:

behavior change theory communication material design multilevel intervention physical activity parenting school-based physical activity theory-informed design

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