Anna Ek

Research problem and hypothesisThis project aims to co-design and evaluate a novel model for family support (Co-fam) linking school and primary health care to promote healthy lifestyle and prevent and manage overweight and obesity among children 6-12 years. Two evidence-based family support programs, the universal Healthy School Start (HSS) and the targeted More and Less (ML) will be combined and delivered in a municipality with a high level of childhood obesity. We hypothesize that Co-fam is effective and feasible to implement with high fidelity and acceptable to professionals and families.Data and methodThe project will be carried out in two phases. In phase 1, the research team together with school and primary health care personnel and parents will co-design the model based on the implementation framework EPIS (Exploration, Preparation, Implementation, Sustainment). We will define referral criteria, identify barriers and facilitators of implementation, and design suitable implementation strategies. Adaptations will be made in both programs to children 6-12 years. Phase 2 consists of an 18-month controlled hybrid type 2 effectiveness-implementation study using mixed methods. Quantitative data will be collected on child and parent level and on fidelity to the model components and costs. Interviews will be performed with key personnel to assess acceptability and feasibility.Societal relevance and utilization The high prevalence of unhealthy behaviors, overweight and obesity among children underlines the societal relevance of this project. Combining a universal and a targeted program creates a new synergistic model tailored to all children’s and families’ needs with potential to be scaled up, lacking today. Bridging the gap between school and primary health care to reduce health inequalities has been urgently requested in national guidelines and recommendations.Plan for project realizationThis project will be performed by skilled intervention and implementation researchers in collaboration with personnel from schools, primary health care and parents. HSS, launched in 2022 in the municipality in collaboration with the education administration, is well-established in all public schools. A primary health care unit in the municipality, partner in this project, has started to implement ML with parents of pre-school age children. This means that the project partners are in the starting blocks and highly motivated to participate in this study.