Procedures and challenges of adapting an existing public health intervention for use in another setting: the ToyBox-Scotland preschool obesity prevention program

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Childhood obesity is a major public health issue, which is reflected in the high number of interventions which have been developed to target the behaviors which cause obesity in childhood such as a lack of physical activity, poor diet, and sedentary behavior. The ToyBox programme was originally developed and tested in mainland Europe, and has now been adapted for use in Scottish preschools. This case describes the systematic approach that was taken to adapt the ToyBox programme. The intervention mapping protocol was used to guide the adaptation process in the absence of guidelines for adapting existing interventions. A Co-creation approach was used to involve stakeholders in intervention adaptation procedures. Preschool practitioners participated in workshops, where proposed intervention components were discussed and agreed upon. Proposed intervention activities were trialed out in a volunteer preschool, and an experienced preschool practitioner assisted in the adaptation of classroom materials, intervention content, and methods of delivery in order align the intervention with Scottish preschool practice. The adaptations resulted in the ToyBox-Scotland intervention being significantly different from the original European programme, whereby two major components of the original intervention were removed, and substantial adaptations were made to the delivery and content of the remaining components. Involving stakeholders in the adaptation of an existing intervention is important to ensure the programme is suitable for those who will be delivering and receiving it. However, it is currently unclear as to how much adaptation should be undertaken, highlighting the need for the creation of evidence-based guidelines for intervention adapters.
Original languageEnglish
Number of pages22
JournalSAGE Research Methods Cases
Publication statusPublished - 27 Jan 2020


  • childhood obesity
  • public health
  • health interventions
  • ToyBox programme
  • Scotland

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