ArticleBMJ open2026
Healthy Madrasas: a qualitative study using normalisation process theory and co-production approach to explore translation of a childhood obesity prevention intervention in Islamic religious settings from one UK city to another.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildhood obesity remains high in the UK, with a higher prevalence among children from ethnic minority groups. The 'Healthy Madrasa' programme was developed and implemented in Bradford, UK, to support obesity prevention in Muslim children by working with Islamic religious settings such as madrasas.
objectivesThe aim of this study was to explore how the 'Healthy Madrasa' programme could be adapted for delivery in another UK city where the proportion of people from the Muslim faith is lower and the ethnic composition is more diverse.
designA qualitative study involving a co-production workshop and eight focus groups was conducted utilising topic guides guided by the normalisation process theory (NPT). Data were analysed thematically using NVivo software (V.15) and mapped onto the constructs of the NPT.
settingBristol City, UK (2024-2025).
participants34 participants took part, including representatives of Islamic organisations, voluntary sector organisations, public health experts and Muslim parents. Data were collected through one co-production workshop (n=15, 47% female) and eight focus groups (n=19, 100% female) of which two were conducted as individual interviews due to single attendance (n=1).
resultsThree constructs of the NPT have been identified. Participants showed positive engagement towards the programme 'cognitive participation, NPT', they highlighted an equity gap in current provision due to issues of inclusivity, safe space and the lack of culturally appropriate opportunities for Muslim girls 'coherence, NPT'. However, barriers to 'coherence, NPT' were noted by Muslim parents, stating that cultural and religious conservatism might hinder female participation in the programme. 'Collective action, NPT', included the practicalities of transferring the programme to Bristol and assigning the roles and responsibilities. Participants emphasised the importance of creating an 'Islamic community-led' steering group, inclusive of diverse communities, building effective partnerships with other relevant organisations and supporting the programme with sufficient resources, such as culturally acceptable funding, space and volunteers.
conclusionsThis study generated a co-produced preliminary roadmap for implementation. Further collaboration with stakeholders is required to achieve coherence and collective action before the programme's operationalisation in Bristol.
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