Table 5 Association between the focus groups results, the final content of the IDEFICS intervention and the intervention mapping steps

Children receive inconsistent messages from family and school (regarding rules and availability of food)

Creating and enhancing uniformity of messages to parents and children by:

Step 1 (Needs assessment)

Step 3 (Selection of theory-based methods and practical strategies)

Step 4 (Program development)

   - Involving parents in environmental and policy changes at the school level

Module 4: Establishment of the school working groups

   - Creating a school environment in which healthy eating behaviours are the easiest choice

Module 8: Environmental and policy changes related to water consumption

Module 9: Environmental and policy changes related to fruit and vegetable consumption

   - Involving the schools in the community platform to trigger collaboration between schools in the same community

Module 1: Establishment of the community platform

   - Learning parents how to create a home environment in which healthy eating behaviours are the easiest choice

Module 10: Educational materials for parents providing strategies to create health promoting family environments

Interaction and quality time with parents (playing, helping, stay home with the children, doing things together ...) is believed to reduce stress in children

Creating a program objective for the predefined behaviour "stress and relaxation"

The predefined behaviour was translated into "Strengthening parent-child relationships"

Step 1 (Needs assessment)

Differences in overall focus group results were larger within countries than between countries.

Creating a structure that enables adaptation of an overall intervention framework within countries and between countries

Module 1: Establishment of the community platform

Module 4: Establishment of the school working groups

Step 5 (Adoption and implementation)

School related policies as a barrier for healthy eating at school (mentioned by the parents)

Creating a school environment in which healthy eating behaviours are the easiest choice

Module 8: Environmental and policy changes related to water consumption

Module 9: Environmental and policy changes related to fruit and vegetable consumption

Step 1 - 3

Involving parents in environmental and policy changes at the school level, communication about food policy to the parents.

Module 4: Establishment of the school working groups

Only the Belgian and Spanish children mentioned receiving lessons about healthy eating.

Providing ready to use nutrition education lessons that can easily be incorporated into the classroom curriculum, stimulate teachers to daily promote healthy eating.

Module 5: Integration of the key behaviours in the classroom activities and providing related homework activities (curriculum-based)

Step 1 - 3

Parents perceive the schools as an important setting for the promotion of healthy eating and physical activity. Parents assigned the main responsibilities for healthy eating and physical activity promotion outside the family context.

Raising awareness among parents about their own role in promoting healthy eating and facilitate their in their ability to create health promoting family environments

Module 10: Educational materials for parents providing strategies to create health promoting family environments

Step 1 - 3

Creating a school environment in which healthy eating behaviours are the easiest choice

Module 8: Environmental and policy changes related to water consumption

Module 9: Environmental and policy changes related to fruit and vegetable consumption

Creating an activity promoting school environment

Module 6: Environmental changes related to physical activity: the active playground

Module 7: Health related physical education curricula

Importance of taste for children's food preferences.

Integrating tasting activities in the classroom activities

Module 5: Integration of the key behaviours in the classroom activities and providing related homework activities (curriculum-based)

Step 1 - 3

Peers are perceived to influence the preferences for certain food items.

Stimulating the eating of healthy products in group, stimulate teachers to be a role model

Module 5: Integration of the key behaviours in the classroom activities and providing related homework activities (curriculum-based)

Step 1 - 3

Media, free booklets and magazines, pamphlets and the food pyramid were channels through which parents receive information regarding healthy eating/living. Controversial opinions were assessed regarding the role of media and television (these channels are perceived to distribute contradictory and less reliable information)

Using the channels mentioned during the focus groups.

Making a distinction between the intervention campaign and less reliable or contradictory information provided by certain media by using the IDEFICS logo on all documents.

Module 2:Long term multimedia and public relations campaign

Step 1 - 3

Time spent outside is perceived to be dependent of opportunities to be physically active and neighbourhood safety (e.g. traffic, teenage gangs).

Stimulating community members to negotiate for larger scale actions that increase and improve the opportunities to be physically active (e.g. increasing the number of playgrounds and parks, providing age appropriate recreation areas) and negotiate for the improvement of neighbourhood safety.

Module 1: Establishment of the community platform

Module 3: Short and a long term perspective for the prevention of childhood obesity developed by local community members

Step 1 - 3

Parents mentioned a lack of structured physical activities offered for preschoolers.

Stimulating schools to include structured physical activities in preschoolers' weekly/daily program.

Module 7: Health related physical education curricula

Step 1 - 3

Informing parents about the existing facilities and opportunities and stimulating them to provide these opportunities to their children (e.g. sports club)

Module 10: Educational materials for parents providing strategies to create health promoting family environments

Stimulating community member to negotiate for an adequate offer of structured physical activities for preschoolers in the community

Module 3: Short and a long term perspective for the prevention of childhood obesity developed by local community members

Parents with low socio-economic status (SES) mentioned that organized activities are often too expensive.

Stimulating community leaders to negotiate for opportunities to participate in low-cost activities and the possibilities for reductions or lower prices for low SES families with children.

Module 3: Short and a long term perspective for the prevention of childhood obesity developed by local community members

Step 1 - 3

Parents had the perception that specialized physical education teachers are better role models and more often recognize the health promoting role of physical education than regular classroom teachers.

Providing physical education teachers with physical activity promoting didactic guidelines to increase physical activity during physical education.

Module 7: Health related physical education curricula

Step 1 - 3

Social support by parents or friends was mentioned as a factor that influences the time playing outside.

Informing parents about the importance of their role in stimulating their child to be physically active.

Module 10: Educational materials for parents providing strategies to create health promoting family environments

Step 1 - 3