Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review.

Manou Anselma,Mai J M Chinapaw,Daniëlle A Kornet-Van Der Aa,Teatske M Altenburg,Rebecca E Hasson

doi:10.1371/journal.pone.0237969

Manou Anselma, Mai J M Chinapaw + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0237969

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Abstract

This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9-12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599.

Highlights

Obesity in children remains a major public health problem, with overall rates still rising [1], especially in children from families with a low socioeconomic position [2, 3]
Effective components of obesity prevention interventions in children identified in systematic reviews include school policies regarding the availability of foods and beverages meeting nutritional standards; targeting multiple behaviors and system levels; encouragement of environments and cultural practices at school and home that support healthy behavior; education of children, parents and teachers on healthy nutrition and physical activity; improvement of physical education programs and physical activity possibilities in policy and practice [11, 16,17,18,19,20]
The current review aims to summarize the effectiveness of interventions targeting physical activity, sedentary behavior and/or dietary behavior among 9–12 year old children from low socioeconomic environments

Summary

Introduction

Obesity in children remains a major public health problem, with overall rates still rising [1], especially in children from families with a low socioeconomic position [2, 3]. When children adopt healthy energy balance-related behaviors at a young age, they are more likely to continue these habits into adolescence and adulthood [6]. Adopting healthy habits at an early age is an important public health target [7, 8] This is especially true for children living in low socioeconomic neighborhoods, where many children experience multiple barriers to engage in healthy behavior such as lack of finances and transport, and are at an increased risk of developing obesity [9, 10]. Effective interventions are needed that stimulate healthy energy balance-related behaviors in children from low socioeconomic environments to reduce health inequalities between children from lower and higher socioeconomic positions. To reduce health inequalities between children from lower and higher socioeconomic environments, more insight is needed in interventions and intervention strategies that are effective in stimulating healthy energy balancerelated behaviors among children from low socioeconomic environments

Results

Discussion

Conclusion