Intervention Mapping: A Framework to Co-Design the ALAPAGE Programme to Simultaneously Improve Dietary Diversity and Physical Fitness Among Older People.

The needs assessment phase involved 18 participatory meetings with stakeholders and a literature review to identify determinants of behaviour change.

• Stakeholders included professionals from partner organisations, dieticians, and physical activity specialists.
• Seniors were also interviewed during the needs assessment phase.
• This constituted Step 1 of the six-step Intervention Mapping framework applied to the ALAPAGE programme.
• The needs assessment helped identify determinants relevant to both diet and physical activity behaviours among older adults.

The ALAPAGE programme was grounded in the Theory of Planned Behaviour and Goal Setting Theory, supplemented by behaviour change techniques.

• These theoretical frameworks were selected based on the literature and health psychology expertise.
• The theories were adapted to the identified change objectives and translated into practical strategies.
• This constituted Step 3 (Intervention Theory) of the Intervention Mapping framework.
• Behaviour change techniques were used to bridge theory and practical programme content.

The Intervention Mapping process resulted in 31 change objectives adapted to 15 determinants of behaviour change.

• An example change objective was 'setting a personalised goal,' which was selected to address the determinant 'experimenting with behaviour.'
• The 31 change objectives served as the immediate targets of the ALAPAGE programme.
• Identification of change objectives constituted Step 2 of the Intervention Mapping framework.
• The determinants addressed covered both dietary and physical activity behaviours simultaneously.

Thirty practical strategies were organised into seven group sessions as part of the ALAPAGE programme.

• An example practical strategy was 'group discussions.'
• The organisation of programme sequences constituted Step 4 of the Intervention Mapping framework.
• Nineteen pedagogical tools were developed, with an example being '24-h recall sheets.'
• The seven group sessions targeted community-dwelling adults aged 60 years and older in southeastern France.

The 19 pedagogical tools developed for the ALAPAGE programme were tested in a pilot study involving 21 participants.

• The pilot study involved seniors who tested the programme sequence.
• The pilot testing was part of Step 4 (programme development) of the Intervention Mapping framework.
• Steps 5 (implementation) and 6 (evaluation) of the Intervention Mapping process are described in a separate article.
• The ClinicalTrials.gov identifier for the study is NCT05140330, registered 1 December 2021.

Multiple stakeholder groups contributed to co-designing the ALAPAGE programme across different phases.

• Professionals from partner organisations contributed to needs assessment and programme development.
• Dieticians and physical activity specialists helped identify behaviour change determinants, validated the theoretical model, and participated in programme design and testing.
• Seniors were interviewed during needs assessment and tested the programme sequence.
• This multi-stakeholder involvement was structured through the Intervention Mapping co-design framework.

The design process of public health promotion programmes is rarely described in detail, motivating the detailed reporting of the ALAPAGE co-design process.

• The paper aims to present both the co-design process and the theoretical rationale of the ALAPAGE programme.
• The programme targets community-dwelling adults aged 60 years and older in southeastern France.
• The ALAPAGE programme simultaneously addresses determinants of diet and physical activity among seniors.
• The Intervention Mapping framework provided a six-step structured approach for programme development.