From Systems Map to Systemic Actions: Co-creating actions to promote physical activity with adolescents and adult stakeholders in YoPA Denmark

Aim Physical inactivity among adolescents remains a major public health challenge, particularly among those in vulnerable life situations. Systems thinking and co-creation are promising approaches for intervention development, yet limited evidence exists on how system insights can be translated into concrete actions. This study aimed to co-create actions targeting systems change to promote outdoor physical activity among adolescents. Methods An 8-month participatory, systems-informed co-creation process was conducted in two Danish youth clubs, involving 24 adolescents, 11 staff members, two researchers, and a facilitator. Across nine co-creation sessions, participants built on a previously developed systems map to translate system insights into concrete actions. Results The co-creation process resulted in four context-specific actions aimed at improving opportunities for outdoor physical activity. Together, the actions addressed the physical environment, maintenance practices, organisational routines, adult facilitation, peer relationships, self-expression, and adolescents’ sense of ownership and belonging. Using the Action Scales Model, the actions primarily targeted system structures through changes to environments, routines, maintenance practices, facilitation, and opportunities for activity. Several actions also addressed system goals and beliefs related to adolescent participation and outdoor physical activity. Conclusion The four actions illustrate how locally identified systemic constraints can be translated into concrete actions addressing multiple aspects and levels of the youth club system. The study provides practical insights into translating system insights into contextually grounded actions. Further research is needed to examine their implementation, interactions with the wider youth club system, and potential influence on adolescents’ outdoor physical activity.