Improving Fundamental Movement Skills during Early Childhood: An Intervention Mapping Approach

The earlier in life that a child can begin mastering fundamental movement skills (FMS), the more positive their physical activity (PA) trajectories and health outcomes are. To achieve sufficient development in FMS, children must be guided with tuition and practice opportunities. Schools and educators provide an opportunity for interventions that improve health behaviours and outcomes for children. The aim of this study was to use intervention mapping (IM) to design a programme of school-based intervention to improve FMS for children aged 4–5 years old. Following the six steps of IM, with each step comprising three to five tasks that require the input of a planning group formed by key stakeholders, a programme of intervention was planned. Prior knowledge and primary and secondary evidence was used to support the development of the programme. A logic model of the problem as well as logic models of change, programme design, production, implementation, and evaluation were proposed or completed within the study. The results can be used to begin to implement an FMS-focussed intervention within school settings within England and propose a sustainable and realistic approach for helping children to develop FMS with the support of well-informed educators who are confident to deliver better FMS practice and PA opportunities.


Physical Activity and Fundamental Movement Skill Interventions during Early Childhood
There is an abundance of studies in the literature supporting the relationship between FMS competency and PA throughout childhood [1,2]. The earlier a child can begin mastering FMS through appropriate tuition and practice opportunities [3], the more positive their PA trajectories [4] and health outcomes, including adiposity and motor development, will be [5]. Despite this evidence, during the early years, research should focus on both FMS competency and performance of PA as separate elements of a child's health behaviours.
The literature during early childhood shows that the relationship between FMS and PA is weak [6]; despite this, the relationship is seen to strengthen into middle childhood and adolescence [2]. This provides a strong basis and argument for the dedicated provision of FMS practice and PA opportunities for a young population to promote and instil healthy behaviours and habits.
Interventions to increase FMS competency in children are common [1,[7][8][9], specifically during early childhood [10,11]. However, many interventions fail to use in-depth planning and mapping procedures to create interventions that can be implemented with long-term, sustainable approaches and that are based on the needs of key stakeholders [12]. This results in the benefits of interventions being short-lived and lacking longitudinal follow-ups, which brings into question the lasting effectiveness and sustainability of these programmes, a concern expressed by early years educators in England [13]. Despite these issues, recent

Introduction to Intervention Mapping
Intervention mapping was initially designed to be used in health promotion interventions and programmes [12]. It is underpinned by a number of key principles, including the participation of key stakeholders, bottom-up and iterative approaches, consideration of wider influences and determinants on behaviour, underpinning theory, and an aspiration to intervene [35]. IM is composed of six key steps. These six steps are made up of related tasks ( Figure 1) to complete the mapping process and result in the creation of a programme of effective, sustainable interventions [36]. As a reflection of the principle of participation, a planning group of key stakeholders is involved throughout the IM process to inform its development. In Step 1, existing evidence is crucial to understanding the problem that an intervention aims to solve and address. The existing literature examined within this introduction and unpublished data collected in relation to this research study help to establish the problem within the population, informing the logic model of the problem. This evidence also helps to establish what needs to be changed through individual behaviours in addition to changes within the environment, which ultimately inform the logic model of change established in Step 2, which is composed of programme outcomes and objectives. In Steps 3-5, programme design, production, and implementation form the mapping process, and these components should be informed by key stakeholder opinions and experience, including qualitative data sets [13].
Step 6 of the mapping process allows an evaluation plan to be established. This plan should consider practical and meaningful ways to evaluate the effectiveness and the need for improvement of a programme. The design of this plan should be informed by pre-existing reliable and valid measurements [24] used to measure the desired population.
Reflecting an understanding of the wider influences on health, intervention mapping is heavily influenced and informed by Bronfenbrenner's [37] socioecological model (SEM; Figure 2), which highlights that an individual's behaviour is influenced by several different determinants that exist at different levels and interact between these levels. When considering a child's FMS competency and PA levels, we can consider determinants using the layers of the SEM.

1.
Individual determinants are examined, including a child's beliefs and attitude towards PA in addition to their enjoyment of activity.

2.
These determinants can be affected by a child's immediate interpersonal environmental determinants, including members of a child's family, their friends, and their peers, with knowledge and belief being shared between these groups.  3.
Organisational and institutional determinants are highly influential for children, especially in the early years. All children in England can experience the school setting, and therefore, it remains a key determinant influencing children's choices and behaviours. A sense of community can help to foster better health behaviours. Stronger relationships between parents and schools, in addition to efforts by local authorities, can determine the health of a community. 4.
The highest-level determinant is public policy. When this determinant is considered, examining the policy for early PA and PE, in addition to dissemination of policy and statutory training of practitioners are key determinants. It is therefore important that programmes of intervention focus beyond the end recipient and includes key stakeholders. Reflecting an understanding of the wider influences on health, intervention mapping is heavily influenced and informed by Bronfenbrenner's [37] socioecological model (SEM; Figure 2), which highlights that an individual's behaviour is influenced by several different determinants that exist at different levels and interact between these levels. When considering a child's FMS competency and PA levels, we can consider determinants using the layers of the SEM. Combining what the authors of this study know about FMS and PA, interventions during early childhood, and the school environment, these three elements should be considered to be important for early childhood health and PA. As aforementioned, there have been multiple interventions at the school level, and although IM has been used to plan interventions to combat obesity in early childhood populations [38][39][40], to the authors' knowledge, there are no studies to date that have used the IM approach proposed by Bartholomew-Eldredge et al. [12] to increase FMS competency in early childhood, and as such, this research is a novel contribution to the field.

This Research
Considering the evidence introduced here, the authors believe IM proposes a suitable and robust method to plan interventions, having been recommended as a valuable tool for early childhood intervention development [41]. The aim of this study was to present a set of initial IM process and outcomes for developing effective FMS interventions within schools for the early years age group as the 'first-step' in several processes leading to optimal and sustainable outcomes for intervention programmes. IM is used as a framework to structure and guide the approach in this study.
Reflecting an understanding of the wider influences on health, intervention mapping is heavily influenced and informed by Bronfenbrenner's [37] socioecological model (SEM; Figure 2), which highlights that an individual's behaviour is influenced by several different determinants that exist at different levels and interact between these levels. When considering a child's FMS competency and PA levels, we can consider determinants using the layers of the SEM.

Methods and Results-Six Steps
This study followed a non-traditional IM format, detailing the initial stages of IM development with scope for further study consideration. This means that the researchers were pragmatic and practical when developing this IM iteration. This article uses multiple perspectives based upon the SEM, focussing on the child at the centre (individual), their parents as key interpersonal influences, teachers at the organisational level, and researchers who could be considered to be on both the community and national levels, depending on their work and impact. Data was taken from multiple sources, including the authors' own work, to identify the most important determinants to these children. The authors also used these multiple perspectives and sets of data to shape the solutions that are proposed throughout this article, showing a strong alignment with IM principles, including participation, a bottom-up approach, and intervention. Sharing the information from IM development at formative and summative phases on process and impact are important in order for others to gain from this work, and as recommended by the IM workbook, publishing work before the end of the process is a valuable process [42]. Further depth and explanation on how these goals were achieved are given appropriately within each step.

Study Design
Using the six-step process of IM ( Figure 1) proposed by Bartholomew-Eldredge and colleagues [12], each step and series of related tasks was adopted as a framework to guide the research, and when referring to IM, Bartholomew-Eldredge et al. [12] are acknowledged. IM programmes are designed using a strong basis in theory, evidence, and stakeholder holder involvement. This requires the formation of a 'planning group' made up of key stakeholders to the programme to shape the development of interventions in a way that is needs-led and practical, and the members highlight and guide the choice of key theories and evidence to inform the programme while relating the goals and aims of the programme to real-life situations and outcomes. The planning group's contribution is pivotal in achieving the sustainable nature of the individual interventions and whole programmes proposed through this method.
The six-step model and its associated tasks are further explained in the following sections; because IM is an iterative process, the authors discuss the steps/tasks combined with the results from this study that emerged from their deployment, and this helps preserve the context in a way that would not be possible if the method and the results were separated. Each section states how each task within each step of the mapping process was completed and how the planning group was involved. Although further involvement of the planning group may have been advantageous at various stages of this study's process, this was not always realistic for the lead researcher and the members of the planning group. The authors used a more pragmatic approach by using several initial focus group sessions within Step 1, with the planning group split into respective groups (children, parents, researchers, and educators) where necessary. Proposed questions for each step of the planning process were discussed at this first step (and can be viewed in the Supplementary Materials) of the IM process, and the results are detailed in each respective section. If there was a need for further elaboration or information from the planning group, individuals were contacted separately via email or telephone during the later stages of the IM process. This approach was used to appropriately reduce the participants' burden.
This study displays a strong mixed-methods design, with the use of a planning group to convey their needs and opinions in addition to the use of the data collected in previous studies [13,24], including currently unpublished empirical quantitative data. Mixing data in the planning, collection, analysis, reporting, and interpretation stages of this study was essential, and the mixed-methods approach to the reporting of findings and the future assessment of the IM process are also demonstrated, with numerical programme outcomes and qualitative discussions with key stakeholders. The current approach provides a comprehensive, participant-informed, and informative account facilitated via the IM process [12].
Ethical approval (ETH2021-3572) was gained from the University of Derby Science and Engineering Ethics Committee, and all participants completed written and verbal assent before involvement in any stage of the IM process.

Step 1: Logic Model of the Problem
As shown in Figure 1, Step 1 comprised four steps. A planning group was established, followed by a needs assessment and the production of a logic model of the problem. Subsequently, the programme context, population, setting, and community were identified, and finally, the broad programme goals were stated.

Task 1.1: Establish the Planning Group
The planning group included representatives of the target population-i.e., children-and environmental agents and programme implementers-i.e., teachers, members of school senior leadership teams, parents, and PA and motor competence researchers. Other stakeholders to consider in further IM iterations include local authority representatives and community coaches.
Participants of the planning group were recruited through word of mouth, social media, contacts from previous research studies, and outreach via email by the lead researcher, and where necessary, gatekeeper approval to work with children in school settings was gained. The planning group was considered to be trustworthy and knowledgeable in the subject matter. Children who participated in this study were recruited from two schools in the central area of England. As a preliminary and small-scale mapping process, it was concluded that samples should reflect critical mass and representativeness, and therefore, for every SLT member, there should be 3-4 early years foundation stage (EYFS) teachers (represented in Dobell et al. [13]), and for each EYFS teacher, there should be around 10 children. The parents of the children recruited were also invited to participate, in addition to parents who expressed an interest through social media or word of mouth. The invited researchers were invited by the lead researcher to participate and had pre-established connections through institutional relationships or networking.
Prior to their involvement, participants were provided with a participant information sheet and the opportunity to contact the lead researcher to ask any questions they had about the research project before consenting to take part. For child participants, consent was first gained from the school headteacher, and subsequently, parents were asked to consent to their child's participation within the study. Verbal consent was gained from the children at each visit.

Planning Group Protocol and Involvement
Planning group focus groups were used to explore and to execute several of the tasks in Steps 1-6; however, the focus group protocols are explained in Step 1. The lead researcher felt it was important to engage with the stakeholders in multiple ways to ensure all views could be expressed by both the group and as individuals and to reduce participant burden by splitting participation into smaller activities. The lead researcher held regular discussions with all members of the research team at each stage of the process, ensuring reliable and valid research outcomes.
Three focus groups took place following a semi-structured approach using a proposed schedule of questions covering areas for Step 1-6 (see Supplementary Materials); the main aim was to facilitate discussion between members of the planning group and establish the key and prominent themes discussed by the members. The focus groups were recorded and transcribed verbatim. Focus group discussion followed a constructionist research paradigm which argues that there are multiple realities that create a social reality. This is especially true of this study due to the number of stakeholders involved and how they each view early childhood PA and practice.
Two adult focus groups were formed. Group one consisted of four parents of 4-5-year-olds (FG1P). Group two consisted of three PA and MC researchers (FG1R). The final sub-group of the planning group comprised two groups of children aged 4-5 years of age (FG1C). Although key to the planning group, specific focus groups were not held with teachers, coaches, or school senior leadership members. This was deemed appropriate, as previous work by the authors collected a wealth of information related to IM from these key stakeholders (see [13]). Where focus groups did not seem appropriate to the context, other means, including written feedback sheets, were administered.
Traditional, formal focus groups were deemed unsuitable for young children; therefore, during their focus group, children completed a 'write, draw, show and tell' task [43] to facilitate the expression of young children's feelings and ideas. To inform Step 1, children were asked to 'write or draw about what you enjoy about PE'. Following the drawing and/or writing, the children shared their work with the rest of the group and told them about what they had produced. Children were further prompted by the researcher or the class teacher to give as full answers as possible. The works the children produced were each photographed and assigned a participant code ( Figure S3, Supplementary Materials).

Task 1.2: Needs Assessment and Logic Model of the Problem
Within the second task of Step 1, a needs assessment of the literature and existing knowledge was conducted to establish the problem, whose problem it is, who the problem was affecting, what behaviours and environmental conditions are causing or are related to the problem, and the determinants of these behaviours and the environment (Table 1). First, the problem was stated: Problem: children are not sufficiently competent at FMS in the early years. This negatively affects their levels of PA, quality of PA, and opportunities for PA social interactions; this leads to unhealthy PA habits developing, causing poor health outcomes such as obesity.
The planning group was consulted during the focus group discussions about their thoughts and ideas for areas that had been missed, overlooked, or that should be added into the needs assessment. A summary of themes and comments made in the focus groups relating to Step 1 can be found in Table S1 in the Supplementary Materials. This table also provides key comments and quotes from the interviews undertaken in Dobell et al. [13] study to support Step 1.

Determinants of these behaviours and environment
Underfunding in communities and schools, poverty, lack of practitioner knowledge of FMS, cultural norms associated with PA FMS = fundamental movement skills, PA = physical activity.
Following the focus group discussions and answering of questions appropriate to Step 1, a final logic model of the problem (Figure 3) was created; this model helps to summarise the sequence used and information established in task 1.2. Reflecting the wider influences on health, the logic model of the problem shows the personal determinants that children face (Phase 4) and the personal determinants that key environmental agents (teachers, etc.) face (Phase 4). These determinants contribute to the environmental conditions that impact the PA/FMS behaviour of children (Phase 3), which contributes to health problems (Phase 2) and children's quality of life (Phase 1).  The planning group was key in describing the context and setting of the interventions as well as key population characteristics and needs. The information provided during the focus groups, which was expressed in a study by Dobell et al. [13], researcher knowledge, and published literature, allowed an asset assessment to be undertaken ( Table 2). The  The planning group was key in describing the context and setting of the interventions as well as key population characteristics and needs. The information provided during the focus groups, which was expressed in a study by Dobell et al. [13], researcher knowledge, and published literature, allowed an asset assessment to be undertaken ( Table 2). The social, information, policy/practice, and physical environments' assets to aid the success of a sustainable intervention were assessed and stated. Although each asset assessment element presented four areas to target, just one example for each area was chosen (Social: primary schools; Information: school newsletters/bulletins; Policy/Practice: teacher training for early years (school level during this intervention); Physical Environment: school spaces). The linked-up approaches of interventions within a programme must consider each asset assessment element fully. All areas of each element of the asset assessment should be considered to be critical, and the iterative process of IM allows for future development within each area. The final task of Step 1 was to state the broad programme goals, i.e., what the programme hopes to achieve overall. Using the logic model of the problem, broad outcomes to be changed through the implementation and maintenance of the intervention programme were stated: (1) increase the FMS competency of children in EYFS; (2) increase the quality of PA of children in EYFS; (3) improve the quality of FMS tuition/guidance.

Step 2: Programme Outcomes and Objectives-The Logic Model of Change
Step 2 comprised five tasks ( Figure 1). The expected outcomes for changes in behaviour and the environment were stated, followed by the performance objectives to achieve these behavioural and environmental outcomes, complimented by the selection of the most important determinants for these behavioural and environmental outcomes. Task 4 created the matrices of change, establishing change objectives for each determinant and leading to the logic models of change being formed and presented.

Task 2.1: Expected Outcomes for Behaviour and the Environment
Following the production of the logic model of the problem, expected behavioural and environmental outcomes for the programme of change were stated. Programme outcomes are the desired changes to be made by implementing the programme, leading to the overall broader programme goals. By 'doing the flip' and moving from focussing on the problem to focussing on the solution, a logic model of change can be formed. Behaviours causing poor health and health problems from the logic model of the problem were 'flipped' to reveal several desirable and health-promoting behaviours, and a selection of the most important behaviours and environmental conditions was made based on the literature and previous knowledge. A list of the potential desired outcomes for the target population's behaviours and environmental outcomes were stated (Table S2 Supplementary Materials). NICE [44] recommend that brief advice is used in intervention outcomes; therefore, within this programme, two main outcomes were stated and taken forward in the next steps. Engaging children in more FMS practice was identified as key. When a cohort of 4-5-year-old children (unpublished data) were examined, most were meeting the PA guidelines, but many children had low FMS competency. This made a clear case to focus on improving FMS over simply improving the children's PA levels. Second, improving the provisions of FMS delivery in school was also revealed as a key outcome. Although teachers feel that there are enough PA opportunities in schools [13], there was identification of a lack of support to implement FMS, and there was some suggestion that the EYFS framework lacked guidance to provide the adequate provisions.

Task 2.2: Performance Objectives for Behavioural and Environmental Outcomes
To reach the desired programme outcomes, performance objectives for the population behaviours and their environment were established. These performance objectives are specific sub-behaviours for the children's health-promoting behaviours; if the children are to perform more FMS practice, they must first engage in these sub-behaviours.
Performance Objectives for Behavioural Outcomes: The following performance objectives are specific sub-environmental actions for teachers/senior leadership teams (SLT) to engage with to change the environmental conditions so that schools can be better prepared to deliver further FMS-related activities.
Performance Objectives for Environmental Outcomes Behaviours are formed by determinants of the individual, whereas environmental conditions are formed by the determinants within the environment which impact people. These determine if a child or teacher (environmental agent) will complete a performance objective (behaviour). Determinants need to be targeted to increase the likelihood of change for the individual and their environment. The determinants for the individual and healthpromoting behaviours included: mastery level of FMS (skills), self-efficacy and physical self-concept, perceived norms, knowledge, fitness level, and sedentary behaviour. The determinants for environment and agents within them included: knowledge, self-efficacy, social norms, parental beliefs, outcome expectations of the setting, and the attitude of the school to PA, physical skills, and health.
The most influential determinants were selected from the previous lists according to how important they were and how changeable they could be with intervention, according to (i) research conducted by the authors ( [13,24], unpublished data), (ii) prior knowledge, and (iii) the literature. For example, self-efficacy is largely reported as an important element of PA as children age [45]; therefore, it was deemed important to focus on when developing this intervention. Levels of FMS competency have also been previously positively influenced through shorter term intervention [8]; therefore, we know FMS competency can change for children through intervention, although longer-term effects have not been demonstrated as successfully. This gives scope for an intervention with a longer-term approach (e.g., over a whole school year) to be developed, keeping in mind individual behaviour changes while targeting environmental agent determinants to ensure better sustainability.

Task 2.4: Create Matrices of Change
This task involved creating matrices or tables. This was achieved when each determinant chosen in Task 2.3 was crossed with a performance objective (Task 2.2) to create change objectives. Using this information, matrices of change objectives were constructed, bringing all the tasks in Step 2 into a consolidated place (please see Tables S3 and S4 in the Supplementary Materials). To ensure the matrices and chosen objectives were relevant to the key stakeholders, the planning group was asked to review these. A written feedback task, which included rating individual behavioural and environmental characteristics (determinants) in addition to perspectives on how achievable the change objectives were perceived to be, was assigned, and the results were gathered. All adult participants (n = 7) were contacted to provide written feedback, and 71% (n = 5) returned this information to the lead researcher.

Task 2.5: Logic Models of Change
Using the performance objectives and behavioural and environmental outcomes established in this step, the three logic models of change were proposed (Figures 4-6).

Step 3: Programme Design
Step 3 comprised three tasks. First, the authors generated the programme's themes, components, scope, and sequence. This was followed by establishing the theory and evidence-based change methods of the programme and, finally, the applied practical applications to achieve change in the interventions.
2.4.1. Task 3.1: Programme Themes, Components, Scope, and Sequence In this task, the theme, components, scope, setting, and sequence of the programme of interventions were generated. These elements of IM require planning group input as

Step 3: Programme Design
Step 3 comprised three tasks. First, the authors generated the programme's themes, components, scope, and sequence. This was followed by establishing the theory and evidence-based change methods of the programme and, finally, the applied practical applications to achieve change in the interventions.

Task 3.1: Programme Themes, Components, Scope, and Sequence
In this task, the theme, components, scope, setting, and sequence of the programme of interventions were generated. These elements of IM require planning group input as well as researcher knowledge created within the wider research project [13,24] (unpublished data) and existing literature (what has and has not worked in the past) [11,46,47]. Within the initial focus groups (FG1P, FG1R, and FG1C), the second section of discussion centred around the key elements to inform Step 3. Questions were component-and theme-centred, including 'What characters/books do you find engage children in learning', and 'When designing a multicomponent intervention, what is the maximum number of components you would suggest using'. The information gathered from these focus groups and interviews from Dobell et al. [13] are shown in Table S5 in the Supplementary Materials. The following sections explain how the theme, components, scope, and sequence should achieve successful delivery of the programme.
The theme is a general organising construct for the programme that usually relates to the change objectives and intervention environment, and as such, this programme's theme was EYFS FMS in school. This established the simple name of the programme, 'The FMS School Project', making the components of the interventions recognisable. Through stakeholder engagement, additional themes to engage children were established as important; therefore, the framework created was developed using suggestions of themes for activities to inspire children's engagement, including animals, superheroes, and book characters ( Table S5 in Supplementary Materials).
The components make up the body of the intervention and must be strongly related to the performance and change objectives identified in Step 2 (Table 3). This programme was made up of two main components/interventions, which are related to one another and will be discussed in further detail in Step 4. The chosen methods and practical applications (see Section 2.4.2) involved within each component of the intervention are detailed in Task 3.3, and an outline is provided in Table 4. A framework intervention, which describes and guides teachers to improve children's FMS with the autonomy of the intervention structure and implementation activities, was chosen over an intervention of strict set session deliveries for teachers to follow. Previously, educators mentioned the need for adaptability in delivery; a framework helps to demonstrate how sessions can work in the chosen setting but allow the flexibility of adaptation to individual classes and abilities [13]. Unpublished observational data evidenced that children across a single EYFS class will likely need the adaptability that a framework intervention provides. The researcher focus group (FGR1) also highlighted the need for teachers to have ownership of the intervention to improve implementation, longevity, and sustainability.  Within IM, the intervention scope must be realistic not only to meet the goal of being sustainable for the implementers and maintainers, but also for use by the individuals and environmental agents. When the previous literature was explored, it was found that it is common for school-based FMS interventions to last over a term (10 weeks) and to be delivered by an individual external to the school (researchers/coaches). Pedological literature continues to argue that delivery by teachers that work with children on a continued and regular basis is important not only for development of skills, but also for the relationships between children and teachers [48]. This method also helps to promote teacher education, knowledge, and self-efficacy. Therefore, it was important to this programme of intervention to ensure the delivery of intervention two (framework) was by teachers. The scope of this programme of interventions includes the delivery of the intervention to teachers (training) and the delivery of the intervention by teachers within schools (framework). The scope considers who delivers the intervention, how it is delivered, the setting of delivery, how long it is delivered, and the evaluation of its elements ( Table 3).
The sequence of the intervention relates to the order of how the components should be delivered. This intervention is made up of two key components, and one must be delivered before the other can occur: teacher training by delivery partners, followed by a school-based framework implementation delivery by teachers at the EYFS. These would both require evaluation following their delivery as carried out by the implementer (see Step 5).

Task 3.2: Theory and Evidence-Based Change Methods Chosen
Following Task 3.1, initial theory and evidence-based change methods that were well-suited to the ideas generated through the previous steps were chosen to deliver the programme of interventions. Change methods are rooted in behavioural theories and psychological principles and are defined as general processes for influencing change at individual and environmental levels and the determinants within these. Kok et al. [49] specifically developed a taxonomy of behaviour change methods for IM to help to guide the decisions made within this task. The definitions and parameters provided help with framing the scope of each method and deciding whether it would fit well with the components, scope, and sequence (Task 3.1). Change methods were split into categories to address different areas of the problem. Using basic methods to begin with, to identify the broad ways to create change for a school-based intervention, these methods were matched with practical applications (Task 3.3). The chosen change methods are shown in Table 4, which also presents the broad practical applications chosen.

Task 3.3: Practical Applications to Achieve Change in Intervention
The final task of Step 3 was to start to design practical applications, practical techniques that operationalise the change methods chosen, to be used within the individual interventions of the programme, fitting within the intervention group(s) and the context. Therefore, this task collated information provided by the planning group, the Dobell et al. [13] practitioner interviews, and the written feedback exercises (Table S6 in the Supplementary Materials) with the performance outcomes and change objectives within the logic models of change (Step 2). Regularly suggested applications by the planning group and successful applications within the literature were considered within the programme of intervention context. For example, multiple educators have mentioned the need for adaptability and to build from a 'framework' to provide teachers with structure [13]; therefore, it was deemed a possibly appropriate method. In Table 4, the basic behaviour change methods and practical applications according to the determinants of the problem can be seen. The parameters of these are also stated. The adaptable framework and training for teachers were then further developed by choosing behaviour change methods from Table 4 and developing these via the specific and detailed applications as intervention elements (Table 5). Providing detailed change methods and applications in addition to the population, context, and parameters of each method were stated to show how implementation could occur within EYFS settings.  Parameters: Gain frames to be used rather than loss frames to use positive messages; self-efficacy of parent and child to be considered PA = physical activity, PE = physical education, EYFS = early years foundation stage, STEP = space, task, equipment, people.

Step 4: Programme Production
In Step 4, there were four tasks ( Figure 1). Task 4.1 refined the programme's structure and organisation of interventions, followed by the preparation of the plans for the programme's materials. Subsequently, the programme's message, materials, and protocols were drafted, and finally, the materials drafted in that task were produced, pre-tested, and refined.

Task 4.1: Refine Programme Structure and Organisation
Within Step 4, the aim was to produce an effective programme by refining the structure and organisation of the theoretical change methods and applications that were proposed in Step 3. This step organised how these systems of change would be delivered within the programme itself and the chosen implementation environments. The application created at this stage described the theme, scope, sequence of delivery, and delivery channels/vehicles of this programme. At the highest level, this programme has two main interventions: teacher training and the delivery of an adaptable framework for children. The interventions were made up of multiple constituent parts (applications) to achieve the programme's goals, which include the behavioural and environmental outcomes, performance objectives, and change objectives that were established in the previous IM steps. Within Table 6, the system of delivery, who delivers each part, and how and when they are delivered can be seen; they are integral to the organisation and structure of the programme. This includes channels of delivery and communication (interpersonal or mediated), which are key for disseminating the information about the intervention and delivering it effectively. Figure S1 within the Supplementary Materials also represents the overall structure and organisation of the programme, demonstrating where practical applications should sit. Using the information gathered in the prior IM steps and from the planning group's input (Tables S5 and S7), plans for the materials were produced. Full working documents were produced for a framework booklet (FMS information practical sessions, ideas for classroom sessions, evaluation, and assessment) and one of three training session slides, and they will be further described in the following sections (these are available upon request from the corresponding author A.P.D.). Specifications and working documents were not produced for all applications within this study in order to be pragmatic in the approach and development of future research (this research was completed as part of a three-year PhD project). However, descriptions for these future specifications were made and would include promotion videos of the intervention, local authority communications with schools, additional parental communications, more in-depth classroom activity approaches, and websites for sharing information. Table 7 presents all of the programme's components, their descriptions, and the producers needed for these. Collaboration with other experts, e.g., media producers and website creators, would be essential in creating an intervention of high quality that is sustainable and will have a meaningful impact. In the next task, the plans to create the components were put into practice (and this process would need to occur for the remaining elements in Table 7 during future research). The overall message of the programme was to increase FMS and PA through structure and fun during the early years with a method designed to engage the participants, implementers, adopters, and maintainers of the programme, with this key message being strongly informed by the focus group sessions and by the Dobell et al. [13] interviews. As the theme centred around improving FMS for EYFS children and the setting was schools, the programme was named 'The FMS Schools Project'; the logo can be seen in Figure S2 (Supplementary Materials).
Using this central theme, the materials and protocols to support the practical applications chosen in Step 3 and plans made in Task 4.2 were drafted, including a framework booklet document and training sessions for teachers. The booklet is a key material for both the training intervention and the delivery of the school intervention. It is divided into sections framing key intervention elements and written with teachers in mind by presenting the evidence from research and the literature in a non-specialist and consumable way.
The first section helps teachers to strengthen their understanding of FMS, PA, and health by introducing and reinforcing what FMS are by visually splitting them into their domains (locomotor, object control, and stability). This is further developed by acknowledging how FMS should be part of PE for EYFS children while linking back to health and academic outcomes for children. The second section of the booklet focusses on how to plan for FMS tuition in school and how teachers can improve and promote it within the EYFS as well as on key delivery methods. This information within these two sections compliments the first session of training, which explores why FMS and PA are important for children's health and how the school environment can help to improve these outcomes for children. In the practical workshop setting, this is achieved by first surveying the teacher's current school environment and what they already do well before exploring where improvements could be made.
The third section of the booklet provides an array of practical activity suggestions, with many being informed by the children's preferences presented in FG1C (Table S7 and Figure S3, Supplementary Materials). The practical sessions are split by specific FMS domains: locomotor, object control, and stability, or a combination of skills; this is followed by how to gain formative feedback with children. Throughout the focus groups (FG1R and FG1P) and previous interviews [13], there was a clear suggestion that activities should occur outside of allotted physically active times. For example, this could be done by linking another curricular area such as maths or literacy to FMS learning. The fourth section focusses on these opportunities by using techniques to increase stimulus and knowledge around FMS. These sections of the booklet compliment session two of the training intervention, which introduces teachers to how to use the framework activities in school as well as using their own knowledge and ideas to implement better FMS.
The fifth section provides information to help teachers prepare to help children set goals and to subsequently assess their improvements in FMS and PA as a whole group of children and individually. These sections were strongly informed by the voice of the parents (FG1P) and researchers (FG1R), who commented on the need for assessment to be implemented into the existing school reporting framework. Finally, the sixth section lays out ideas for setting homework tasks for children with the consideration of the home environment. This section also details how to engage parents in aiding the success of the programme. Previous qualitative work highlighted the differences in home environments, especially those of deprivation and the need for practice activities to be on a small scale with none or limited equipment use [13]. This section focusses on these elements so they can be achieved by as many children as possible. These two sections support the delivery of the third training session, which focusses on the overall delivery of the programme, the measures for success, and how to create 'homework' for children and parents. The remaining materials from Table 8 would also be produced around the central theme, ensuring continuity across materials and 'branding'.  The materials drafted in Task 4.3 were produced as prototypes (rapid experiments to test ideas quickly, simply, and at low cost) for this programme of study. This aided gathering data to validate ideas proposed before from researchers, the literature, and the planning group. Future research should engage in the development of all programme materials with the required experts to produce them, including media promotions and parent packs. These were not developed in this study due to the constraints of this being a PhD project.
Within the process of IM, once the materials have been produced, they should be pre-tested with the target population of the interventions, and the results of these pretests should be evaluated. Pre-testing should include the involvement of the planning group, particularly the intervention end users/participants (children), and those delivering it (teachers). Testing the structure and organisation of the programme and individual intervention applications and components reveals any issues or ineffective elements but also strengths, which can help establish the most effective protocol and materials when identified. Using planning group feedback and questions such as 'does this method interest you?' and 'would this protocol/delivery suit your setting?' embraces stakeholder involvement and ownership. Within these testing periods, it is key to observe the thoughts around sustainability of the interventions, such as the regularity of delivery and the potential for other factors/determinants within the environment to disrupt this. The evaluation methods should be well-designed to fit within the pre-test delivery rather than as a standalone element.
In this study, there was scope to pre-test one element of the intervention materials with the planning group. By using Section 3 from the framework booklet, a prospective session was planned using several of the activities presented in the booklet (Supplementary Material Session S1); this was pre-tested with two classes of EYFS children from the planning group. Class teachers were also invited to be part of the session. As part of intervention refinement, children were asked to provide formative feedback; the session leader asked the children if the session was 'really good fun', 'okay fun', or 'not so fun'. Across the two classes, 67% of the children found the trial session 'really good fun', whereas 10% said it was 'okay fun', and the remaining 23% said it was 'not so fun'. The children were then asked what would have made the session better or what they really enjoyed. Many children commented on the use of equipment as fun, whereas other children wanted to play more sports-based games to make the session more exciting and structured. Teachers provided comments throughout the session to the session leader, with a clear theme that the session would work for some children, but other children require more rules and structure to their activity. Using this formative feedback from the children and teachers, further refinement of programmes materials was performed. The remaining materials drafted and produced in Task 4.3 were not pre-tested in this study due to time and resource constraints, but this opens the opportunity for future research and intervention development. Table 8 shows the pre-test plan for all of the materials from Table 7.

Step 5: Programme Implementation Plan
Step five comprised four tasks. First, we identified the potential adopters of implementation for the programme, which was followed by stating the outcomes and performance objectives for the programme's use by the adoptees. The creation of matrices of change objectives for use with the programme and designing the implementation interventions to be used were the final two tasks.
2.6.1. Task 5.1: Identify Potential Adopters of Implementation for the Programme Step 5 requires the key stakeholders for intervention success (effectiveness) to be identified. Using the planning group's previous inputs within the initial focus groups (FG1P, FG1R, FG1C) and previous interviews [13], the implementers, adopters, and maintainers of the programme were identified.
Implementers are considered to be those who will put the interventions within the programme into practice; in this case, they are those who will implement teacher training and framework intervention delivery. For interventions to be successfully adopted, they should be specific to the setting of adopters of the programme, such as schools, clubs, and local authorities. Finally, the implementers and adopters will work together to become maintainers of the programme of change, especially where positive changes are observed, leading to the specified programme objectives and outcomes.
Within this programme, four key stakeholders were identified: • Implementers: Local authorities, delivery partners • Adopters: Teachers, School senior leadership teams (SLT) • Maintainers: Local authorities, delivery partners, teachers, School SLT Stakeholders may not exclusively have a singular role in intervention delivery, as mentioned in the list. Local authorities must engage with schools and leadership teams to get them on board with the intervention and to train educators to use the intervention/programme, making them implementers. Consequently, the local authorities must have a method of disseminating the training to educators, and this is via delivery partners. Delivery partners may have different roles in different local authorities but are likely to be public health staff, health visitors, or PA and sports-based professionals. Importantly, it is not specified who this would be, giving authorities the freedom to choose, which could ultimately result in better sustainability. These delivery partners must ensure the maintenance of a relationship with a school and of the training intervention. The adopters of the programme are those based within the school setting, hosting and delivering the programme. Teachers are the 'frontline' staff to this intervention by delivering it to children, aided with the support of their school SLT. These teachers must be trained by the implementers. Finally, all roles come together to be the maintainers of the programme. A local authority must commit to keeping delivery partners available for the training of teachers. School SLT and teachers must commit to continuing to deliver the programme to future classes to help change social norms and beliefs while increasing FMS mastery in EYFS children through the programme.
Considerations to the maintenance of the programme, such as funding and higherlevel policy, to ensure time and sufficient structure is in place to allow for the interventions are pivotal. Therefore, members of the school SLT, local authority, and national government should be considered to be key maintainers of the programme and influence later iterations of the IM process. For the implementers, adopters, and maintainers, the main outcomes were stated for the dissemination, implementation, adoption, and maintenance of the interventions. These outcomes were then split down into performance objectives in a similar way to the tasks in Step 2. These were informed by questions used within the focus groups, with a focus on the sustainability of the programmes and their implementation. The outcome and performance objectives are stated in Table 9. Table 9. Outcomes and performance objectives for programme use. Using these outcomes and performance objectives for the programme, further matrices of change (as in Step 2) were produced (Supplementary Materials; Tables S8-S11) to provide the implementers, adopters, and maintainers with change objectives to aim for, making the programme tangible, implementable, meaningful, and measurable. The proposal for the assessment of these objectives was made within the evaluation plan in Step 6.

Task 5.4: Design Implementation Interventions
In Table 10, the change objectives of dissemination, adoption, implementation, and maintenance are supported by theoretical methods and practical applications, as in Step 3. The delivery channels used within these applications were also considered. These include mediated channels, such as local authority communications with schools (monthly newsletters, meetings, conferences, emails), using videos on social media to promote the intervention, and a website explaining the intervention and how to sign up, and interpersonal channels such as local authority communications with schools via health workers/visitors. Some of the maintenance objectives link closely with the main training and framework interventions. For example, a teacher must evaluate the programme at the end of the year to ensure that sustainable maintenance in their school is achieved. Although this action is a key part of maintenance of the programme, the information for teacher evaluation would be provided in the training and framework documentation seen in the two main interventions. Many of the theoretical methods suggested support the method of facilitation by providing local authorities and teachers with materials to help them achieve adoption, implementation, and maintenance. Guidance documents for LA on allocations for DP planning and delivery time of training DP = delivery partner, LA = local authority, SLT = senior leadership team, CPD = continued professional development.

Step 6: Programme Evaluation Plan
Finally, within Step 6 ( Figure 1), a plan to evaluate the whole programme and the effectiveness of individual interventions was produced through four tasks. The effect evaluation was planned to establish if the programme of interventions had the desired effect on the target population(s) (teachers, and children). The process evaluation examines how the intervention was implemented and adopted in the desired settings (schools), and it identifies the key implementation characteristics, answering the question of if the desired effect on the population was or was not achieved, and helping to uncover issues within the interventions.

Task 6.1: Process and Effect Evaluation Questions
The first task of the evaluation plan was to write effect and process evaluation questions for the programme.

1.
Has the programme improved children's physical self-efficacy and academic performance? 2.
How much does the PA level and FMS mastery of the children completing the programme change from pre-to post-intervention? 3.
What was the impact of the programme on teachers' knowledge and self-efficacy to teach and plan for FMS at the EYFS? 4.
What was the impact on the children's knowledge and enjoyment of FMS? 5.
What was the structure of FMS delivery like in the participating schools before the intervention?
Process Questions

1.
What parts of the intervention worked well, and why? What did not work as well regarding the implementation, and why? 2.
What elements of the interventions have been sustained post-intervention? 3.
What aided dissemination and adoption of the programme? 4.
How often are teachers planning and using the framework in schools? 5.
If schools continue to use the programme, why? 6.
Have the participants (children) enjoyed the delivery of the intervention in schools? 2.7.2. Task 6.2: Indicators and Measures for Assessment, Task 6.3: Evaluation Methods, and Task 6.4: Evaluation Execution The final three tasks of Step 6 were collapsed together to achieve a more concise nature of work. With effect and process questions established, the identification of the indicators and measurements for these variables were chosen (Table 11 and Table S12 (Supplementary Materials)), informed by the focus group discussions (FG1P and FG1R, [13]). The planning group was asked to suggest important 'real-world' outcomes to the programme of interventions that effect the user, implementers, and adopters (Table S12). Finally, the methods of evaluation were chosen (qualitative and quantitative), and the proposed plan for effect and process evaluations was created (Table 11). The plans were designed to be easy to follow and implement in the school setting, with the activity designed for participants (children), implementers, adopters, and maintainers (local authority and teachers) to complete. Given the importance of the role of theory in helping inform practice, the process evaluation was guided by using the RE-AIM framework [50], which has been used to evaluate the impact of varied public health interventions for over 20 years [51]. The RE-AIM framework aims to support the development of multi-level intervention at the individual, environmental, and policy levels, and it uses the five dimensions of reach, efficacy, adoption, implementation, and maintenance. In this study, the authors proposed to complete evaluation in each of the following areas: reach of interventions, effectiveness of the interventions, adoption of the  Each of these methods may capture more than one element of evaluation, which can be observed in Table 11.

Discussion and Summary
This study was the first to begin to plan an FMS intervention for early childhood populations using IM by iteratively planning and developing interventions in collaboration with key stakeholders. The authors appreciate that not all steps of the IM process were completed, but they were given consideration and recommendation for further work to be completed. This work is important for advancing knowledge of what really matters within FMS and PA interventions for children, and this work goes beyond the traditional approach of many interventions where only Step 4 of the principles of IM (programme production) are adopted for their organisation within reporting. The many tools and tasks involved in the IM process were operationalised within this article to ensure new learning emerges; this knowledge is essential for the future planning of programmes of intervention.
The key findings show the thorough and rigorous process of the IM-enabled development of a practical and feasible plan for future intervention for the early years and their specific health behaviours. This section will summarise the emerging outcomes from the current IM process with a socioecological focus, highlighting areas for future development through the following structure: • This study collated evidence from two previous studies by the authors [13,24], unpublished empirical evidence, and existing literature to identify that children are underachieving in their FMS proficiency at the age of 4-5 years old, and by using previous knowledge from IM [12] and a planning group, the behaviours and determinants leading to this issue were identified. Importantly, as evidenced in previous qualitative work [13], children have a lack of opportunity to develop FMS, both at home and also at school, where educators' practices are not well-structured, guided, or informed by their own continued professional development or training. This is underpinned by a lack of knowledge, lack of self-efficacy for delivering FMS, and the expected social norms of FMS and physical development teaching for the EYFS [13,32,48,53]. These interpersonal and community-level influences shown in the SEM (Figure 2) play a crucial role in enhancing a child's opportunity and environment to progress their FMS proficiency. On the other hand, children have low FMS competency, which is likely to be personally determined by their enjoyment of PA [54], self-efficacy in their movement ability [45], and knowledge of FMS. Therefore, the current landscape at an educational/policy and personal level leaves children lacking in FMS proficiency, leading to insufficient levels of PA as they age and potentially poor health outcomes in childhood and adulthood.

What Can Be Changed?
The use of a systems science approach, including creating a causal systems map of how this intervention is to be implemented beyond the school level, should be established [55]. This approach is similar to the 12 local delivery pilots delivered by Sport England [56], promoting a whole systems approach by using local places and people to deliver more PA while understanding the barriers and determinants to people getting or remaining active. The pilots promote the inclusion of local people as key stakeholders in addition to reflecting, testing, and learning from the processes that they put in place, reflecting key IM principles.
Within the current programme of intervention, the individual, their environment, and the environmental agents within it (interpersonal-, community-, and policy-level) need to be changed to provide a multi-level approach to intervention. Addressing this problem by creating supportive environments for children to practice FMS within is essential. The majority of children in England attend school at ages 4-5 years old [57], meaning there is a community-level opportunity to intervene due to their contact with children and ability to train educators within these settings. This identifies that for the current IM process, the targeting of teachers within the EYFS of primary schools in England is crucial. This includes targeting critical determinants, including teachers' knowledge, self-efficacy, social norms, and their outcome expectations of the intervention, as explored in previous interviews [13]. Individual behaviours were considered important within this intervention, despite the children's young age and lack of autonomy over the choice of activities in their day-to-day life. Like the environmental agents, the determinants of the children's behaviours, such as children's enjoyment of FMS, knowledge of what FMS performance and activities are, and their self-efficacy of their FMS and physical performance, are important to think about when aiming for change for this population group. These determinants were understood by engaging with key stakeholders.
Although this IM process focussed on teacher-level intervention, the researchers felt there would also be a need for an intervention at the senior leadership team (SLT; headteachers, governors, deputies) level (organisational level), which reflects the IM principle of multi-level influences and stakeholder involvement. These individuals may not implement the intervention but are influential in decisions that facilitate engagement with the intervention. The intervention at the SLT level would be similar in terms of information to influence teacher training programmes; however, this would be based around the key benefits of improving children's FMS and how to promote this at the early years and as a whole school. The primary PE and sport premium funding [31] provides funds for schools to focus on implementing this kind of provision and intervention for staff and children. Therefore, developments around the specific use of funding [32] and how best to support the EYFS staff in the delivery of the intervention proposed in this programme would be key factors.
Parental attitudes and beliefs around school provision should also be considered an important determinant of the environment to target. Parental attitudes are particularly influential on their child's behaviours, including their motivation to perform PA [22,58], and thus, they may be influential on their attitudes to PA and PE in the school setting. It is important to consider socialising agents such as the home environment and familylevel intervention in future work [21,59]. The focus group discussions conducted with the planning group identified 'bringing the intervention into the home' during future implementation or holding interventions exclusively outside of school settings. A child's parents'/carers' actions are important influencers in their choices and behaviours, and they want 'to get support to bring it into the home'. Literature has explored the reduction of childhood obesity in the home setting by using IM [38,39], indicating the use of FMS interventions outside educational settings to be a possibility, although harder to use to intervene due to the broad variation of domains within individual homes. Socioecological approaches use a holistic lens that identifies the influential determinants across the layers of the model, recognising the levels of influence on an individual [37]. Therefore, future IM processes should strongly consider how to positively influence FMS environments outside of school settings, such as the home. Consideration of the variation in SES would be pivotal within future programmes, as children from lower SES backgrounds reportedly spend less time doing PA [30]; therefore, it is likely that these children spend less time practicing FMS. These children are also more likely to be overweight or obese [60], meaning that the need to improve their physical competency through such programmes will be pivotal to their future health and heath behaviours.

How Can It Be Changed?
When identifying the determinants of behaviours and the environment, there is a clear vision to what needs to be changed for the individual and their environment. By establishing broad programme goals, behavioural and environmental outcomes, and performance objectives and change objectives by giving a broad-to-narrow and specific approach, intervention methods and applications can be planned (Tables 4 and 5).
It is easy to say 'the self-efficacy of teachers to provide FMS specific teaching needs to increase', but how can this process be achieved? This is where small and manageable change objectives should be established. As seen in the Matrices of Change (Supplementary Materials), it can be ensured that teachers improve their own self-efficacy by identifying ways for them to understand how to identify improvements needed in the FMS of children, giving them the appropriate means of planning sessions and more effective ways they can engage their children in FMS practice.
Likewise, for children, it is known that their mastery level of FMS needs to be improved, but what are the potentially effective methods for achieving this within the proposed intervention? By increasing the time children have for PA at school, there may be greater improvements in their FMS [61,62] when partnered with setting goals that are FMS-focussed while providing better structured environments for FMS practice through the target changes for the environmental agent (teacher).
What has emerged from this IM process is the need to identify the most influential determinants of the behaviours and environments from multiple sources of knowledge, the literature, and the planning group. As the first IM study to do so for this age group, it should be considered that the most influential determinants are actually identified in future IM iterations, and that some determinants may be considered to be less important in future iterations.

What Is the Design of Change?
Intervention design can take many forms, and IM processes target multiple behaviour change theories [49] to address several intervention areas as important. In effect, several small interventions to create behaviour change was proposed as part of a programme (Tables 4 and 5) and helps to suggest multiple ways to intervene with the end users (children), the implementers (teachers), and their different determinants using practical applications. A key outcome from this study is the preparation of a framework for teachers to use to directly target the change in children's behaviours. The framework helps to provide guidance, support, and structure, and it simultaneously enhances autonomy and ownership of the intervention [63] for the teacher and children. A framework must be supported by the enhancement of the educator's knowledge, self-efficacy, and expectations of using a framework delivery. Therefore, the supporting intervention includes the training of teachers for framework delivery in school settings [64]. The FMS School Project Booklet provides a section of activities focussed on physically improving children's FMS. Using previous literature and intervention techniques to inform this section was important. Two key elements used in the booklet include que words, which were successfully used by Foweather et al. [65] to improve children's FMS performance. Additionally, the STEP model has been widely used in coaching and educational practices to allow for inclusive teaching [66]. This section also approaches the use of different pedagogies in the FMS sessions by giving linear and non-linear examples for teachers to choose and use [67].
Intervention design should be pragmatic and realistic to the users and adopters, ensuring the intervention can be effectively implemented in the desired setting with the target population [12]. The intervention is designed to ensure teacher burdens and workloads will be minimally increased when implemented, which was identified as important in the previous literature [13] and the planning group. The materials that support and make up fundamental elements of the interventions proposed in this programme have been designed to (a) support the training delivery within this intervention (recapping knowledge taught and provided in these sessions) and (b) be quick and easy to use in educational planning, delivery, and evaluation of the programme by providing pre-made materials.

Who Needs to Be Involved in Change and How?
Intervention requires the collaborative efforts of many stakeholders to improve the possibility of success, as highlighted by the systems science approach [55]. This programme focusses on improving the provisions in schools by using teachers as adopters and maintainers of the intervention, with children as the end users with the desire to change their PA and FMS behaviours. However, other key stakeholders include but are not limited to (from intrapersonal-level to organisation-and policy-level stakeholders):

•
Parents-although parents have no direct role to play within the current intervention and its delivery, they can enhance the success and long-term outcomes achieved during the intervention period by engaging with the resources provided to them during the intervention. Engaging directly with parents is at the discretion of each individual school, and as with all interventions, it will have varying degrees of success. Despite this, communication with parents and the role they can play should be considered to be critical, especially in future work. • School SLT-these key stakeholders must agree that using the intervention, training their staff, and use of the framework intervention is sustainable and worthwhile within their school.

•
Local authorities-they are key partners in the implementing the programme in schools. Without local authorities, there is no initial platform to deliver and communicate the intervention from. Their influence on schools within the local authority should be key in ensuring sufficient and successful intervention uptake. In the long-term, which is dependent on intervention success and stakeholder opinion, local authorities could stipulate a mandatory need for the intervention in schools at the EYFS level. • Delivery partners-they are key players within the local authority set-up, as they provide the training sessions for the intervention to teachers. They should support schools and teachers beyond the training, ensuring successful implementation within school environments. • Public-policy makers at the government level represent the highest and possibly most influential level this intervention could reach: affecting public policy. The requirement for a statutory FMS intervention or improved framework at the EYFS could be pivotal to ensuring healthier and more active lifestyles for children from an early age. This programme could be delivered locally but be evaluated at a national level, much in the way children are assessed in literacy and maths skills.

How Can Change Be Evaluated?
When evaluating the changes achieved by the intervention, the process and its effects should be considered. As shown in Step 6, curating questions, followed by planning the use of practical techniques, is important for evaluation implementation. Using the RE-AIM framework [50] and evaluating the reach, efficacy, adoption, implementation, and maintenance of the intervention at the individual and community levels helps to focus the evaluation. Future work should also use this framework at the policy level. Working with government policymakers to implement policy changes for the early years and EYFS curricula in relation to more specific FMS tuition, guidance, and practice for this age group would be a critical policy change. The reach of the policy change and effects at the delivery level (EYFS settings); the efficacy of the policy change for the teachers and children involved (evaluating whether it achieved what it set out to: increase teacher knowledge, delivery, and confidence; increase children's FMS competency and likelihood to continue with good PA habits); the adoption of the policy by local authorities, schools, and educational settings; the implementation of what the policy prescribes or recommends; the maintenance of policy use at the government level, local authority level, and school level will be essential to constructive evaluation processes.
This IM plan developed the effect evaluation around the most important variables to be changed during the intervention, according to the environment, individual behaviour, and their determinants:

•
Environmental outcome: teachers planning to teach FMS • Behavioural outcome: children practicing FMS • Determinants: improving teachers, parents, and children's knowledge of FMS, increasing the self-efficacy of the teachers to deliver FMS content/activity in school settings, providing children with an enjoyable intervention/FMS practice Future intervention should consider if the intervention approach being used targets the elements listed previously while considering how these may be evaluated.
During the process evaluation, attention should be paid to how the intervention is delivered during implementation and in practice. This evaluation process should provide important information about:

•
The completeness of delivery: was the programme delivered as intended with all its elements, and if not, why? • Continuation of the intervention: once implemented in the school setting, was it continued successfully and appreciated by the adopters, maintainers, and users of the programme? • Participant exposure: did the participants of the intervention receive the appropriate dose of the intervention?
These elements of process evaluation may help provide important answers as to why the intervention did or did not work [68]. The methods for evaluation at the process and effect levels should be pragmatic and realistic; this intervention avoided using overly scientific measures of progress, as these are unrealistic in school settings. Observations, questionnaires, and conversations with key stakeholders of the intervention, including the use of card sorting activities, were deemed to be important in these processes.

Strengths and Limitations
When examining the strengths of the current study, to the authors' knowledge it is the first to use IM to plan an FMS intervention for EYFS children within school settings, thereby providing a high level of novelty. This means that the processes throughout were strongly rooted in the use of the socioecological model and engagement with a planning group throughout that included stakeholders from varying levels of the model. The study brought together researcher knowledge, existing literature, and stakeholder engagement to address their wants and needs.
Reflecting on the limitations of the current study, many of the materials proposed in this study have not been drafted, produced, or pre-tested with the planning group or stakeholders. This also represents a need to engage with the appropriate producers to establish and create these materials. Despite the current planning group in this study, there is certainly still scope to engage with other key members, including local authorities, third sector organisations and charities, and the national government. Due to local authorities being identified as implementers in the current IM process, their involvement in future development and research should be considered pivotal. A further limitation of this study is the small sample size used with the current planning group and the use of convenience sampling. This limits the cultural, socioeconomic, and geographical transferability of the results within this study. However, the authors recommend the drafting, production, and pre-testing of materials with larger planning groups across a varied socioeconomical, cultural, and geographical sample to improve these outcomes. Engaging with planning groups representative of communities across England would be important in future work.

Conclusions
This study aimed to provide an important and well-informed basis for the development of future interventions. By considering the socioecological model when designing the current programme of intervention, the researcher's attention was focussed on the individual and the influence of their interpersonal environment, organisational environment, community environment, and policy environment on their behaviours and health outcomes. The identification of these influences and knowledge built within this study as well as in previous research has played a key role in the aims of the intervention and the outcomes to be achieved. This IM study shows that initial intervention may aim to aid children and their interpersonal and organisational environment at the school and teacher levels to provide better structure and opportunity to develop FMS, which may lead to improved levels of PA and positive changes in health outcomes.

Supplementary Materials:
The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/children10061004/s1, Figure S1. Task 4.1: Programme structure and organization; Figure S2. The FMS School Project logo; Figure S3. Drawings produced by children in FG1C about their favourite part of physical educationFigure S4. Task 6.4: Child Process Evaluation Card Sort; Figure S5. Teacher card sort;  Table S12 Step 6: Planning group Focus group themes and comments. Session S1. Session plan for EYFS children.

Data Availability Statement:
The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy issues.

Conflicts of Interest:
The authors declare no conflict of interest.