Highlights • We review multiple youth participatory approaches relevant for the promotion of health equity. • We identify commonalities and distinctions on processes including power and level of impact. • We review evidence for impact and consider illustrative cases for addressing health inequities. • We identify research directions for advancing youth participation and health equity.

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Highlights • Gaps in the youth participation and physical activity intervention literature are addressed. • YPAR was implemented in aftercare, and with a physical activity intervention for youth-led change. • Individual/systems change occurred in the program with YPAR with a physical activity intervention. • Strategies for decreasing physical activity disparities are discussed.

Aims: To translate evidence-based programs (EBP) for a new setting, attention must be given to the characteristics of the intervention and the local setting, as well as evidence that is compelling to decision-makers. This paper describes the history of a partnership and stakeholder recommendations to inform the adaptation of an EBP for primary care. Methods: We established a community advisory board (CAB) consisting of stakeholders with expertize in primary care delivery. A thematic analysis was conducted with fieldnotes and transcriptions from CAB meetings and regular meetings with participating clinics. Results: We found that (a) parenting programs with a focus on behavioral and physical health are appropriate for this setting, (b) variability in the structure of primary care means implementation must be tailorable, and (c) financial and organizational outcomes are compelling for decision-makers. Conclusion: Factors related to the content and structure of evidence-based programs are uniquely related to distinct implementation outcomes of interest to key stakeholders. K E Y W O R D S health services research, implementation science, integrated delivery of health care, organizational decision making, parenting, pediatric obesity, primary health care

Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. Using Self-Determination Theory (SDT) as a framework, this study examined staff perspectives on the strengths and barriers within under-resourced ASPs for establishing a social-motivational climate for encouraging and supporting youth PA. Analysis of semi-structured staff interviews (28 staff; 7 ASPs) indicated that staff had knowledge and value for establishing a PA-supportive motivational climate. However, the feasibility of implementing PA curricula was identified as challenging across programs. Findings suggest increased need for staff training and supports to provide a PA climate that meets the developmental needs/interests of all youth, with particular attention toward increasing the PA of girls and older program youth. Furthermore, striking an appropriate balance between PA and other competing program demands (e.g., academics) will be required to optimize on the effectiveness of PA program components.