000170174 001__ 170174 000170174 005__ 20260407115449.0 000170174 0247_ $$2doi$$a10.1136/bmjopen-2025-108281 000170174 0248_ $$2sideral$$a148760 000170174 037__ $$aART-2026-148760 000170174 041__ $$aeng 000170174 100__ $$aAltenburg, Teatske M 000170174 245__ $$aPromoting active outdoor play and healthy dietary behaviours through the co-creation of supporting physical and social environments for and with primary school-aged children living in underserved neighbourhoods in Europe: the protocol of the B-Challenged project 000170174 260__ $$c2026 000170174 5060_ $$aAccess copy available to the general public$$fUnrestricted 000170174 5203_ $$aIntroduction An alarmingly low number of children meet public health guidelines for physical activity and dietary behaviours and, therefore, are at increased risk of developing lifestyle-related diseases. This paper describes the protocol of the B-Challenged project, which aims to co-create systemic actions to promote active outdoor play and healthy dietary behaviours before, during or after their outdoor play together with children themselves. Methods and analysis In five European countries, child-centred Participatory Action Research (PAR)—combined with systems dynamics methods—was conducted with 15–20 child co-researchers (aged 9–12 years) and 15–20 adult actors (eg, youth workers, local policy makers). In the first phase, the main drivers of children’s active outdoor play and related dietary behaviours were mapped by (1) analysing existing cohort data, and (2) conducting child-centred PAR. In the second phase, systemic actions targeting the local physical and social environments will be co-created and implemented by child co-researchers and adult actors to promote children’s active outdoor play and related healthy dietary behaviours. A mixed-methods design will be used to evaluate (1) if actions positively contributed to systems change and 6- to 12-year-olds’ outdoor play and related dietary behaviours (140 children per country); (2) the process of conducting multi-actor, child-centred PAR and implementing the co-created actions and (3) if the child-centred PAR positively contributed to child co-researchers’ feelings of empowerment. Ethics and dissemination Ethics approval for the mapping phase was obtained and approval for implementation and evaluation will be obtained from the five local research institutions. Participating children, one of their parents/caregivers and adult actors had given informed consent before participating in the project. Throughout the project, child-friendly methods, materials and language will be applied, and ethical challenges and potential solutions will be discussed. Project results will be disseminated locally and internationally through various channels and activities among the scientific community, professionals—for example, in health and policy making, children and other citizens. 000170174 536__ $$9info:eu-repo/grantAgreement/EC/H2020/101095426/EU/Fostering a European Research Area for Health Research/ERA4Health$$9This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 101095426-ERA4Health 000170174 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es 000170174 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000170174 700__ $$aPawlowski, Charlotte S 000170174 700__ $$aAhrens, Wolfgang 000170174 700__ $$aBrand, Tilman 000170174 700__ $$aBuck, Christoph 000170174 700__ $$aBörnhorst, Claudia 000170174 700__ $$aDzielska, Anna 000170174 700__ $$aKlaufus, Leonie 000170174 700__ $$0(orcid)0000-0001-6173-5850$$aMiguel-Etayo, Pilar de 000170174 700__ $$0(orcid)0000-0003-0454-653X$$aMoreno, Luis$$uUniversidad de Zaragoza 000170174 700__ $$aOkulicz-Kozaryn, Katarzyna 000170174 700__ $$aVrijkotte, Tanja G M 000170174 700__ $$aWink, Renée 000170174 700__ $$aBelmon, Laura S 000170174 700__ $$aChinapaw, Mai J M 000170174 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería 000170174 773__ $$g16, 3 (2026), e108281 [11 pp.]$$pBMJ Open$$tBMJ Open$$x2044-6055 000170174 8564_ $$s509286$$uhttps://zaguan.unizar.es/record/170174/files/texto_completo.pdf$$yVersión publicada 000170174 8564_ $$s3339142$$uhttps://zaguan.unizar.es/record/170174/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000170174 909CO $$ooai:zaguan.unizar.es:170174$$particulos$$pdriver 000170174 951__ $$a2026-03-26-14:31:02 000170174 980__ $$aARTICLE