Abstract
BackgroundA wide range of interventions has been implemented and tested to prevent obesity in children. Given parents’ influence and control over children’s energy-balance behaviors, including diet, physical activity, media use, and sleep, family interventions are a key strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to identify gaps in the knowledge base.MethodsUsing a comprehensive search strategy, we searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral domains targeted, and sample demographics were extracted from eligible articles using a comprehensive codebook.ResultsMore than 90% of the 119 eligible interventions were based in the United States, Europe, or Australia. Most interventions targeted children 2–5 years of age (43%) or 6–10 years of age (35%), with few studies targeting the prenatal period (8%) or children 14–17 years of age (7%). The home (28%), primary health care (27%), and community (33%) were the most common intervention settings. Diet (90%) and physical activity (82%) were more frequently targeted in interventions than media use (55%) and sleep (20%). Only 16% of interventions targeted all four behavioral domains. In addition to studies in developing countries, racial minorities and non-traditional families were also underrepresented. Hispanic/Latino and families of low socioeconomic status were highly represented.ConclusionsThe limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored interventions. To ensure a broad evidence base, more interventions implemented in developing countries and targeting racial minorities, children at both ends of the age spectrum, and media and sleep behaviors would be beneficial. This study can help inform future decision-making around the design and funding of family-based interventions to prevent childhood obesity.
Highlights
A wide range of interventions has been implemented and tested to prevent obesity in children
Parents are described as integral targets in interventions, given their highly influential role in supporting and managing the four behaviors that affect children’s energy balance [13,14,15]
We used a multistage process informed by the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines to identify family-based childhood obesity prevention interventions that were written in English and published between January 1, 2008 and December 31, 2015 [40]
Summary
A wide range of interventions has been implemented and tested to prevent obesity in children. This was in part due to a number of key reports published in 2007, including an Institute of Medicine (IOM) report on the recent progress of childhood obesity prevention [10] and a report from a committee of experts representing 15 professional organizations appointed to make evidence-based recommendations for the prevention, assessment, and treatment of childhood obesity [11, 12] In both reports, parents are described as integral targets in interventions, given their highly influential role in supporting and managing the four behaviors that affect children’s energy balance (diet, physical activity, media use, and sleep) [13,14,15]. This includes parenting practices and rules, and the environments to which children are exposed, and the adoption of parents’ own behavioral habits by children [15,16,17,18,19]
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