Theorizing How Context Influences School-Based Interventions That Support Children's Weight Management: Co-Producing...

Schools can play an important role in supporting child weight management, with evidence suggesting that school-based interventions can be effective, albeit with substantial variation. Part of this variation could reflect the different contexts in which interventions are implemented. Our previous work found that co-production of research and adopting a complex systems model of evidence can be transformative for understanding this context. However, less is known about how co-production helps prioritize elements for exploration or how we should assess the value of co-production in research development. This study addresses these gaps by co-producing a refined logic model (a graphical representation of a theory) of the contextual influencers on school-based weight management to support public health research and policymaking.

This study aimed to (1) identify critical contextual features to consider when planning school-based weight management interventions targeting the intersection of physical activity, healthy eating, and mental well-being; (2) understand the difference that we, as co-producers, make when working together; and (3) identify learning about the process of producing and refining a logic model.

Through collaborative workshops, we refined an existing theoretical framework identifying contextual influences. We critically reviewed existing frameworks for evaluating co-production, creating a new evaluation approach for our collaborative practices, complemented by surveys and workshop feedback.

Six criteria were identified and applied to refine the original logic model, significantly reducing complexity. The revised model prioritized systemic and policy factors, emphasizing environmental structuring rather than individual behaviors, and incorporated a stronger emphasis on life course factors. We used a tool and process developed specifically for this project, which may have broader utility for other research projects, to understand the value of working together. Many of us recognized that the impacts of the project and working together were unexpected and, for some of us, transformational. Nevertheless, we did identify some factors that could support co-production in future. These included the need for clearer initial discussions on positionalities, role expectations, and autonomy.

Our refined model aligns with broader calls to shift away from narratives centered on personal responsibility in children's health. This research further demonstrates the practical value and feasibility of co-produced theoretical frameworks, effectively reshaping the focus of research from the outset and challenging established assumptions.