Child opinions related to a core outcome set for school-based healthy lifestyle behavior interventions: the COCOS study

Teatske M. Altenburg; Lotte W. de Vries; Kheana Barbeau; Alyssa Button; Ashley Cox; Louise de Lannoy; Mhairi MacDonald; Rowena Naidoo; Amanda E. Staiano; Mark S. Tremblay; Deirdre M. Harrington

doi:10.3389/fpubh.2025.1519467

Child opinions related to a core outcome set for school-based healthy lifestyle behavior interventions: the COCOS study

Teatske M. Altenburg, Lotte W. de Vries, Kheana Barbeau, Alyssa Button, Ashley Cox, Louise de Lannoy, Mhairi MacDonald, Rowena Naidoo, Amanda E. Staiano, Mark S. Tremblay, Deirdre M. Harrington

Physical Activity And Health

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Including children's perspectives developing health programs is a priority. This study gathered children's perspectives on outcomes in a Core Outcomes Set (COS), which they believe are important to measure in school-based healthy lifestyle behavioral interventions.

Methods: Children aged 8–12 years from six countries across three continents participated in standardized interactive focus groups. An animation video was used to explain all relevant concepts (e.g., “intervention”, “outcomes”) and showed animated children engaging in a variety of lifestyle behaviors at school. Participating children then brainstormed and proposed outcomes they consider important to measure when evaluating a school-based “healthy lifestyle programme”. Next, children individually rated the importance of the outcomes using a traffic light system (red, “not important”; orange, “important”; green, “very important”). Similar outcomes (across focus groups and countries) were merged, and an overall importance rating was given to each outcome (across countries and overall). An outcome was considered important for inclusion in a COS if ≥70% of children scored the outcome as “very important” and <15% scored it as “not important”.

Results: Children (n = 159) proposed 170 unique outcomes. Children proposed thirty-six outcomes in at least two countries, of which 20 outcomes received an overall rating of “very important” in all countries where the outcomes were reported. Of these 20, five outcomes were reported by children in at least four countries: being healthy, healthy diet, concentration, having fun, and feeling happy.

Conclusion: Children reported a wide range of outcomes related to physical and mental health, as well as enjoyment and social skills, such as having fun and making friends. All outcomes reported by children in at least two countries and considered “very important” will be considered for inclusion in the consensus stage of developing a COS for school-based intervention studies aimed at childhood overweight and obesity prevention.

Original language	English
Article number	1519467
Number of pages	9
Journal	Frontiers in Public Health
Volume	13
DOIs	https://doi.org/10.3389/fpubh.2025.1519467
Publication status	Published - 16 Apr 2025

Funding

The author(s) declare that financial support was received for the research and/or publication of this article. This work was partly supported by the Health Behaviours and Chronic Diseases Program of the Amsterdam Public Health Research Institute, South African Sugar Association, the Wellcome Trust Institutional Strategic Support Fund at the University of Leicester and by a Royal Society of Edinburgh Saltire International Collaboration Award, and the U.S. Centers for Disease Control and Prevention High Obesity Program award (CDC-RFA-DP18-1809). None of the funders had a role in the project.

Keywords

obesity prevention
importance ratings
outcomes
children's perspectives
internationals

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3389/fpubh.2025.1519467Licence: CC BY 4.0

Altenburg-etal-FPH-2025-Child-opinions-related-to-a-core-outcome-setFinal published version, 718 KBLicence: CC BY 4.0

1 Finished

Development of a Core Outcome Set for school-based childhood obesity interventions: an international consensus study.
Harrington, D. (Principal Investigator)
Royal Society of Edinburgh
1/11/21 → 31/10/22
Project: Research

1 Article

Development of a core outcome set for school-based intervention studies on preventing childhood overweight and obesity: study protocol
de Vries, L. W., Harrington, D., Grooten, I., Van 't Hooft, J., Deutekom, A. V., Roseboom, T. J., Salmon, J., Chinapaw, M. & Altenburg, T. M., 14 Jul 2022, In: BMJ open. 12, 7, 8 p., e051726.
Research output: Contribution to journal › Article › peer-review

Open Access
File
7 Citations (Scopus)

18 Downloads (Pure)

Best poster at the 2022 Scottish Physical Activity Research Connections Annual Conference
Harrington, D. (Recipient), 11 Nov 2022
Prize: Prize (including medals and awards)

3 Visiting an external academic institution
1 Hosting an academic visitor

Amsterdam UMC Location AMC, Amsterdam, The Netherlands
Harrington, D. (Visiting researcher)
24 Feb 2025
Activity: Visiting an External Institution › Visiting an external academic institution
Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Harrington, D. (Visiting researcher)
14 Jun 2024
Activity: Visiting an External Institution › Visiting an external academic institution
Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Harrington, D. (Visiting researcher) & Altenburg, T. M. (Visiting researcher)
11 Dec 2022 → 13 Dec 2022
Activity: Visiting an External Institution › Visiting an external academic institution

Cite this

Altenburg, T. M., de Vries, L. W., Barbeau, K., Button, A., Cox, A., de Lannoy, L., MacDonald, M., Naidoo, R., Staiano, A. E., Tremblay, M. S., & Harrington, D. M. (2025). Child opinions related to a core outcome set for school-based healthy lifestyle behavior interventions: the COCOS study. Frontiers in Public Health, 13, Article 1519467. https://doi.org/10.3389/fpubh.2025.1519467

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abstract = "Introduction: Including children's perspectives developing health programs is a priority. This study gathered children's perspectives on outcomes in a Core Outcomes Set (COS), which they believe are important to measure in school-based healthy lifestyle behavioral interventions.Methods: Children aged 8–12 years from six countries across three continents participated in standardized interactive focus groups. An animation video was used to explain all relevant concepts (e.g., “intervention”, “outcomes”) and showed animated children engaging in a variety of lifestyle behaviors at school. Participating children then brainstormed and proposed outcomes they consider important to measure when evaluating a school-based “healthy lifestyle programme”. Next, children individually rated the importance of the outcomes using a traffic light system (red, “not important”; orange, “important”; green, “very important”). Similar outcomes (across focus groups and countries) were merged, and an overall importance rating was given to each outcome (across countries and overall). An outcome was considered important for inclusion in a COS if ≥70% of children scored the outcome as “very important” and <15% scored it as “not important”.Results: Children (n = 159) proposed 170 unique outcomes. Children proposed thirty-six outcomes in at least two countries, of which 20 outcomes received an overall rating of “very important” in all countries where the outcomes were reported. Of these 20, five outcomes were reported by children in at least four countries: being healthy, healthy diet, concentration, having fun, and feeling happy.Conclusion: Children reported a wide range of outcomes related to physical and mental health, as well as enjoyment and social skills, such as having fun and making friends. All outcomes reported by children in at least two countries and considered “very important” will be considered for inclusion in the consensus stage of developing a COS for school-based intervention studies aimed at childhood overweight and obesity prevention.",

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AU - Button, Alyssa

AU - Cox, Ashley

AU - de Lannoy, Louise

AU - MacDonald, Mhairi

AU - Naidoo, Rowena

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ER -

Child opinions related to a core outcome set for school-based healthy lifestyle behavior interventions: the COCOS study

Abstract

Funding

Keywords

UN SDGs

Access to Document

Fingerprint

Projects

Development of a Core Outcome Set for school-based childhood obesity interventions: an international consensus study.

Research output

Development of a core outcome set for school-based intervention studies on preventing childhood overweight and obesity: study protocol

Prizes

Best poster at the 2022 Scottish Physical Activity Research Connections Annual Conference

Activities

Amsterdam UMC Location AMC, Amsterdam, The Netherlands

Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Cite this