Work

Combining the behaviour change wheel framework with a co-design approach to develop an outpatient physical activity intervention for adolescents with depression: a blueprint

Year: 2026

Type: article

Abstract: Background Physical activity (PA) benefits adolescents with depression, yet current interventions often lack theoretical rigor and tailored development, limiting their effectiveness. Objective To systematically co-develop a multi-component, theory-driven intervention to increase PA among outpatient adolescents with depression, guided by the eight-step Behaviour Change Wheel (BCW) framework and participatory co-design. Methods Inpatient adolescents (8♀, 2 ♂, 1 ⚧, 16.8 ± 1.8 years) participated in six BCW-aligned co-design workshops. Content was analysed deductively via BCW steps and inductively for participants’ insights. Themes were mapped to Capability, Opportunity, Motivation – Behaviour (COM-B) constructs to inform intervention components and behaviour change techniques. Results COM-B mapping revealed key needs related to psychological capability (e.g., building confidence and skills), social opportunity (e.g., fostering connection and trust), and reflective motivation (e.g., cultivating intention and value around physical activity). The identified intervention strategy operationalized by the selected behavior change techniques include physiotherapist-led counselling, structured in-house confidence-building PA sessions, optional peer support groups, a voluntary peer-buddy system, and guidance into psychologically safe, inclusive community clubs. Visual analogue scale ratings (8.5–9.7) demonstrated high acceptability and feasibility. The proposed delivery model aligns with the Belgian reimbursement system for physiotherapy. Conclusions This study provides a transparent, replicable BCW- and co-design–based framework for PA promotion in adolescents with depression. To enhance sustainability and impact, future research should engage early with policymakers, community partners, and sports organizations and pilot hybrid models to assess behavioural, organizational, and policy-level outcomes.

Source: Mental health and physical activity

DOI: 10.1016/j.mhpa.2026.100758