Implementation and Feasibility of a Co-designed Intervention to Promote Healthy Eating: Designed by Children for...

The development of healthy dietary behaviours during childhood is crucial for long-term health, and schools represent a key setting for health promotion. Actively involving children in health-related projects offers a meaningful opportunity to encourage and reinforce healthy behaviours. Therefore, this formative pilot study primarily aimed to explore the feasibility, acceptability, and engagement potential of a participatory, school-based dietary intervention involving preadolescent students. During the 2023/24 school year, a participatory research project including a formative pilot study was conducted at a school in Bremen, Germany, aiming to involve children in the co-design, implementation, and formal evaluation of a school-based dietary intervention. Sixth-grade students (11-12 years old) collaborated with researchers over several months to design an intervention for their 5th -grade peers (10-12 years old). The intervention included the free distribution of self-prepared healthy snacks and the display of educational posters. Implementation experiences and participant responses were explored using a child-friendly food neophobia questionnaire, measuring children's reluctance to try unfamiliar foods, alongside narrative methods. Participation in this pilot study was perceived as highly positive by 6th -grade students, who showed increased confidence, self-esteem, and interest as well as skills in nutrition and cooking/baking. The collaborative process fostered strong relationships between students and researchers and supported sutdents' sense of empowerment. Although 5th -grade students generally enjoyed the free snacks, their food neophobia scores showed no significant change, consistent with the formative nature of the study. Overall, the findings highlight the feasibility and acceptability of participatory approaches to school-based nutrition interventions and underscore their potential to promote engagement and empowerment among children. Our results provide valuable insights into participatory development and implementation processes to inform future school-based health promotion efforts.