Co-designing physical activity intervention in Danish kindergartens: A design-based research approach

Physical activity in early childhood supports health, psychosocial development, and motor competence, yet many Danish kindergarten children do not meet recommended activity levels. Early childhood settings are therefore key health promotion environments where routines, pedagogical practices, and staff competencies shape children's access to daily physical activity. This study examines how a kindergarten-based intervention can be co-designed to strengthen physical activity by equipping pedagogical staff and supporting enabling environments through participatory, practice-embedded processes using a design-based research approach. Five Danish kindergartens participated in a one-year development phase guided by a complex intervention framework. The process included four iterative domains: context analysis, laboratory work, design experiments, and reflection. Data from observations, interviews, workshops, and prototype testing were analyzed thematically. The co-design process resulted in six elements: active group time with PA prompts; a play catalog with pedagogical cues; a key ring with pedagogical prompts; structured playground activities; designated PA Agents; and a competence development program. Six themes informed the design: Physical activity as an overlooked pedagogical resource; variation in children's physical activity competences; the role of leadership in cultural change; pedagogical staff's bodily engagement; pedagogical judgment as a driving force, and; competence development as an adoption strategy. The process produced a contextually grounded and professionally owned intervention. By strengthening local capacity, ownership, and equitable access to physical activity, the co-design approach supports health promotion embedded in every day kindergarten practice and informs future feasibility testing.