{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:39:59Z","timestamp":1787510399857,"version":"build-2736575974"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Dutch Brain Foundation"},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["555002022"],"award-info":[{"award-number":["555002022"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      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 \u2018whole systems action\n                      <jats:italic>program\u2019<\/jats:italic>\n                      , named Charge Your Brainzzz (CYB), to promote healthy sleep in Dutch adolescents aged 12\u201315, by integrating theory- and evidence-based behavior change methods using the Intervention Mapping Protocol within a systems science approach, combined with stakeholder engagement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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\u2019s components, this study offers a replicable roadmap for addressing complex public health challenges, paving the way for innovative, system-oriented solutions in health promotion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-025-23989-2","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:11:28Z","timestamp":1760699488000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Charge Your Brainzzz: the systematic development of a whole systems action program promoting sleep health in adolescents"],"prefix":"10.1186","volume":"25","author":[{"given":"Danique M.","family":"Heemskerk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Busch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica T.","family":"Piotrowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carry M.","family":"Renders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maartje M.","family":"van Stralen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"23989_CR1","doi-asserted-by":"crossref","unstructured":"Gariepy G, Danna S, Gobi\u0146a I, Rasmussen M, Gaspar de Matos M, Tynj\u00e4l\u00e4 J, et al. How Are Adolescents Sleeping? Adolescent Sleep Patterns and Sociodemographic Differences in 24 European and North American Countries. J Adolesc Health. 2020;66(6, Supplement):S81\u2013S8.","DOI":"10.1016\/j.jadohealth.2020.03.013"},{"issue":"1","key":"23989_CR2","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1038\/s41562-020-00965-x","volume":"5","author":"D Kocevska","year":"2021","unstructured":"Kocevska D, Lysen TS, Dotinga A, Koopman-Verhoeff ME, Luijk MPCM, Antypa N, et al. Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis. Nat Hum Behav. 2021;5(1):113\u201322.","journal-title":"Nature Human Behaviour."},{"key":"23989_CR3","unstructured":"Stevens G, van Dorsselaer S, Boer M, de Roos S, Duinhof E, ter Bogt T, van den Eijnden R, Kuyper L, Visser D, Vollebergh W, de Looze M. HBSC 2017 Gezondheid en welzijn van jongeren in Nederland. Utrecht: University of Utrecht; 2018."},{"key":"23989_CR4","unstructured":"Knoops K. Jaarrapport Landelijke Jeugdmonitor 2023: Middelengebruik en psychische gezondheid bij jongeren. 2023."},{"issue":"1","key":"23989_CR5","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.smrv.2013.03.005","volume":"18","author":"T Shochat","year":"2014","unstructured":"Shochat T, Cohen-Zion M, Tzischinsky O. Functional consequences of inadequate sleep in adolescents: a systematic review. Sleep Med Rev. 2014;18(1):75\u201387.","journal-title":"Sleep Med Rev"},{"issue":"11","key":"23989_CR6","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18115533","volume":"18","author":"U Albakri","year":"2021","unstructured":"Albakri U, Drotos E, Meertens R. Sleep health promotion interventions and their effectiveness: an umbrella review. Int J Environ Res Public Health. 2021;18(11): 5533.","journal-title":"Int J Environ Res Public Health"},{"issue":"10112","key":"23989_CR7","doi-asserted-by":"publisher","first-page":"2602","DOI":"10.1016\/S0140-6736(17)31267-9","volume":"390","author":"H Rutter","year":"2017","unstructured":"Rutter H, Savona N, Glonti K, Bibby J, Cummins S, Finegood DT, et al. The need for a complex systems model of evidence for public health. Lancet. 2017;390(10112):2602\u20134.","journal-title":"Lancet"},{"key":"23989_CR8","doi-asserted-by":"publisher","DOI":"10.1093\/sleepadvances\/zpae019","author":"CJ Gaskin","year":"2024","unstructured":"Gaskin CJ, Venegas Hargous C, Stephens LD, Nyam G, Brown V, Lander N, et al. Sleep behavioral outcomes of school-based interventions for promoting sleep health in children and adolescents aged 5 to 18 years: a systematic review. Sleep Adv. 2024. https:\/\/doi.org\/10.1093\/sleepadvances\/zpae019.","journal-title":"Sleep Adv"},{"issue":"1","key":"23989_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-024-01571-0","volume":"21","author":"DM Heemskerk","year":"2024","unstructured":"Heemskerk DM, Busch V, Piotrowski JT, Waterlander WE, Renders CM, van Stralen MM. A system dynamics approach to understand Dutch adolescents\u2019 sleep health using a causal loop diagram. Int J Behav Nutr Phys Act. 2024;21(1): 34.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"23989_CR10","unstructured":"Meadows DH. Thinking in systems: a primer. White River Junction: Chelsea Green Publishing; 2008."},{"issue":"1","key":"23989_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-025-01711-0","volume":"22","author":"DM Heemskerk","year":"2025","unstructured":"Heemskerk DM, van Stralen MM, Piotrowski JT, Renders CM, Busch V. Developing a whole systems action plan promoting Dutch adolescents\u2019 sleep health. Int J Behav Nutr Phys Act. 2025;22(1): 33.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"23989_CR12","unstructured":"Eldredge LKB, Markham CM, Ruiter RA, Fern\u00e1ndez ME, Kok G, Parcel GS. Planning health promotion programs: an intervention mapping approach. 4th ed. San Francisco: Jossey-Bass Inc.; 2016."},{"issue":"3","key":"23989_CR13","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/17437199.2015.1077155","volume":"10","author":"G Kok","year":"2016","unstructured":"Kok G, Gottlieb NH, Peters GJ, Mullen PD, Parcel GS, Ruiter RA, et al. A taxonomy of behaviour change methods: an intervention mapping approach. Health Psychol Rev. 2016;10(3):297\u2013312.","journal-title":"Health Psychol Rev"},{"key":"23989_CR14","doi-asserted-by":"crossref","unstructured":"Bartelink N, van Dongen B, Kremers S, Renders C, van Vlokhoven B, vanKoperen M, van Assema P. Supporting schools during the implementation of thehealth-promoting school approach: the roles of a healthy school advisor. Front Public Health. 2022;10:960873.","DOI":"10.3389\/fpubh.2022.960873"},{"key":"23989_CR15","doi-asserted-by":"crossref","unstructured":"Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, Campbell R. The WHO Health Promoting School framework for improving the health and well\u2010being of students and their academic achievement. Cochrane Database Sys Rev. 2014;(4).","DOI":"10.1002\/14651858.CD008958.pub2"},{"key":"23989_CR16","first-page":"299","volume-title":"Health promotion from the perspective of social cognitive theory","author":"A Bandura","year":"2013","unstructured":"Bandura A. Health promotion from the perspective of social cognitive theory. Understanding and changing health behaviour: Psychology Press; 2013. p. 299\u2013339."},{"key":"23989_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/0749-5978(91)90020-T","author":"I Ajzen","year":"1991","unstructured":"Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991. https:\/\/doi.org\/10.1016\/0749-5978(91)90020-T.","journal-title":"Organ Behav Hum Decis Process"},{"issue":"4","key":"23989_CR18","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1177\/109019817400200405","volume":"2","author":"IM Rosenstock","year":"1974","unstructured":"Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr. 1974;2(4):354\u201386.","journal-title":"Health Educ Monogr"},{"issue":"1","key":"23989_CR19","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1348\/014466601164704","volume":"40","author":"M Perugini","year":"2001","unstructured":"Perugini M, Bagozzi RP. The role of desires and anticipated emotions in goal-directed behaviours: broadening and deepening the theory of planned behaviour. Br J Soc Psychol. 2001;40(1):79\u201398.","journal-title":"Br J Soc Psychol"},{"issue":"4","key":"23989_CR20","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1108\/09654281011052646","volume":"110","author":"N Boot","year":"2010","unstructured":"Boot N, van Assema P, Hesdahl B, de Vries N. Professional assistance in implementing school health policies. Health Educ. 2010;110(4):294\u2013308.","journal-title":"Health Educ"},{"key":"23989_CR21","unstructured":"MECS. Pre-vocational Secondary Education (VMBO). Government of the Netherlands-Ministry of Education Culture and Science; 2020. Available from: https:\/\/www.government.nl\/topics\/secondary-education\/different-types-of-secondary-education\/pre-vocational-secondary-education-vmbo."},{"key":"23989_CR22","unstructured":"Heemskerk DM, Vandendriessche A, Busch V, van Stralen MM. School start times: barriers and facilitators of implementing delayed school starting times in secondary schools in Belgium and The Netherlands as perceived by school board members. In preparation."},{"issue":"6","key":"23989_CR23","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1177\/17579139211006747","volume":"142","author":"JD Nobles","year":"2021","unstructured":"Nobles JD, Radley D, Mytton OT, team WSOp. The action scales model: a conceptual tool to identify key points for action within complex adaptive systems. Perspect Public Health. 2021;142(6):328\u201337.","journal-title":"Perspect Public Health"},{"issue":"4","key":"23989_CR24","doi-asserted-by":"publisher","first-page":"316","DOI":"10.34172\/hpp.2023.37","volume":"13","author":"A Vandendriessche","year":"2023","unstructured":"Vandendriessche A, Deforche B, Dhondt K, Altenburg TM, Verloigne M. Combining participatory action research with intervention mapping to develop and plan the implementation and evaluation of a healthy sleep intervention for adolescents. Health Promot Perspect. 2023;13(4):316\u201329.","journal-title":"Health Promot Perspect"},{"key":"23989_CR25","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1146\/annurev-publhealth-040119-094412","volume":"41","author":"L Hale","year":"2020","unstructured":"Hale L, Troxel W, Buysse DJ. Sleep health: an opportunity for public health to address health equity. Annu Rev Public Health. 2020;41:81\u201399.","journal-title":"Annu Rev Public Health"},{"key":"23989_CR26","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.sleep.2021.01.061","volume":"80","author":"G Rigney","year":"2021","unstructured":"Rigney G, Watson A, Gazmararian J, Blunden S. Update on school-based sleep education programs: how far have we come and what has Australia contributed to the field? Sleep Med. 2021;80:134\u201357.","journal-title":"Sleep Med"},{"issue":"4","key":"23989_CR27","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.smrv.2011.08.002","volume":"16","author":"SL Blunden","year":"2012","unstructured":"Blunden SL, Chapman J, Rigney GA. Are sleep education programs successful? The case for improved and consistent research efforts. Sleep Med Rev. 2012;16(4):355\u201370.","journal-title":"Sleep Med Rev"},{"issue":"6","key":"23989_CR28","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1111\/josh.12509","volume":"87","author":"KF Chung","year":"2017","unstructured":"Chung KF, Chan MS, Lam YY, Lai CSY, Yeung WF. School-based sleep education programs for short sleep duration in adolescents: a systematic review and meta-analysis. J Sch Health. 2017;87(6):401\u20138.","journal-title":"J Sch Health"},{"key":"23989_CR29","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.smrv.2016.10.001","volume":"36","author":"R Gruber","year":"2017","unstructured":"Gruber R. School-based sleep education programs: a knowledge-to-action perspective regarding barriers, proposed solutions, and future directions. Sleep Med Rev. 2017;36:13\u201328.","journal-title":"Sleep Med Rev"},{"issue":"5","key":"23989_CR30","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/j.sleh.2021.07.007","volume":"7","author":"JC Levenson","year":"2021","unstructured":"Levenson JC, Ford HA, Reyes ZMD, Mukundan A, Patel G, Bahary S, Miller E. Designing adolescent sleep interventions with stakeholder input. Sleep Health. 2021;7(5):581\u20137.","journal-title":"Sleep Health"},{"issue":"4","key":"23989_CR31","first-page":"iii","volume":"1","author":"W Who","year":"1986","unstructured":"Who W. Ottawa charter for health promotion. Health Promot. 1986;1(4):iii\u2013v.","journal-title":"Health Promot"},{"key":"23989_CR32","unstructured":"Smith L, Curtis J, Bragge P, Kellner P. Systems thinking and behaviour. Inspiring change: how to influence behaviour for a better world. Monash University ePress, an imprint of Monash University Publishing; 2024."},{"issue":"3","key":"23989_CR33","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s12508-022-00359-6","volume":"100","author":"R Crutzen","year":"2022","unstructured":"Crutzen R. Participatie, systeemdenken en nog een crisis. Tijdschrift voor Gezondheidswetenschappen. 2022;100(3):127\u201330.","journal-title":"TSG - Tijdschrift voor gezondheidswetenschappen"},{"issue":"3","key":"23989_CR34","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1016\/j.chest.2020.09.249","volume":"159","author":"ME Billings","year":"2021","unstructured":"Billings ME, Cohen RT, Baldwin CM, Johnson DA, Palen BN, Parthasarathy S, et al. Disparities in sleep health and potential intervention models: a focused review. Chest. 2021;159(3):1232\u201340.","journal-title":"Chest"},{"key":"23989_CR35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12961-018-0394-x","volume":"16","author":"L Baugh Littlejohns","year":"2018","unstructured":"Baugh Littlejohns L, Baum F, Lawless A, Freeman T. The value of a causal loop diagram in exploring the complex interplay of factors that influence health promotion in a multisectoral health system in Australia. Health Res Policy Syst. 2018;16:1\u201312.","journal-title":"Health Res Policy Syst"},{"issue":"1","key":"23989_CR36","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12889-018-6274-z","volume":"19","author":"A-M Bagnall","year":"2019","unstructured":"Bagnall A-M, Radley D, Jones R, Gately P, Nobles J, Van Dijk M, et al. Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health. 2019;19(1):8.","journal-title":"BMC Public Health"},{"key":"23989_CR37","unstructured":"Radley D, Nobles J, Weir C, Saunders J, Pickering K, Gately P, Sahota P. Whole systems approach to obesity programme. Learning from co-producing and testing the guide and resources. London: Public Health England; 2019."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-23989-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-025-23989-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-23989-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:17:41Z","timestamp":1781612261000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-025-23989-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["23989"],"URL":"https:\/\/doi.org\/10.1186\/s12889-025-23989-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-5919594\/v1","asserted-by":"object"}]},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"assertion":[{"value":"28 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the institutional medical ethics committee of Amsterdam UMC (VUMC 2021.0783). No identifying participant information was collected for the purpose of this study, and informed consent was obtained for all participants before study participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3519"}}