Charge Your Brainzzz: the systematic development of a whole systems action program promoting sleep health in adolescents

Background  Inadequate sleep among Dutch adolescents is a complex public health issue with detrimental effects on physical and mental well-being. Previous interventions have shown limited or no lasting effects. While systems approaches help to understand and address such challenges, effective prevention efforts require theory- and evidence-based intervention design using behavior change techniques. This study outlines the systematic development of a ‘whole systems action program’, named Charge Your Brainzzz (CYB), to promote healthy sleep in Dutch adolescents aged 12–15, by integrating theory- and evidence-based behavior change methods using the Intervention Mapping Protocol within a systems science approach, combined with stakeholder engagement. Methods  The CYB program was developed based on previously identified key system dynamics influencing adolescent sleep and a detailed action plan targeting these dynamics. The development was guided by a procedure of which several sub-steps from the Intervention Mapping protocol were applied: defining the program goal and prioritizing system dynamics outcomes across various interconnected subsystems, specifying performance objectives, constructing matrices of change objectives, developing program components while selecting theoretical methods and practical applications, and program production and formative testing. Adolescents, parents, teachers, school boards, school care coordinators, youth healthcare professionals, and Healthy School advisors were actively involved.
Results  The theory- and evidence based whole systems action program CYB consists of eight program components and includes: 1) an educational component, 2) a step-by-step guide for implementing school sleep health policies, 3) a parent information evening, 4) an online magazine, 5) Teen Sleep Check, 6) Sleep Guide, 7) Tool for monitoring and early detection for sleep (behavior) problems, and 8) implementation materials including a website.
Conclusions  The CYB program is the first whole systems action program designed to promote adolescent sleep health. Using a Systems Science approach, the Intervention Mapping (IM) protocol, and stakeholder engagement, the program addresses the complexity of the health issue, ensures a solid theoretical foundation for behavior change, and incorporates the lived experiences of the target groups. Beyond presenting the program’s components, this study offers a replicable roadmap for addressing complex public health challenges, paving the way for innovative, system-oriented solutions in health promotion.