Abstract
Aim Effective evidence-based interventions have an important role in obesity prevention. Our aim was to present a qualitative synthesis of setting-based health promotion interventions on obesity, from Nordic countries and the Netherlands. Methods A systematic review of the literature was completed for studies in the community, schools, and worksite, with BMI as an outcome. A descriptive analysis was completed for all full-text articles meeting the inclusion criteria. Results Thirty-three articles were identified: 7 whole of community, 3 worksite, and 23 school-based interventions. The studies were largely quasiexperimental in design (21/33), with follow-up from 4 months to 8 years. The explicit use of theory was not featured in many of the studies (20/33). No consistent direction for BMI change could be identified in the whole of community interventions (2/7 positive, 2/7 negative, and 3/7 no effect) and no effect for worksite (3/3 no effect) or many of the school-based interventions (1/23 negative, 4/23 positive, 15/23 no effect, 1/23 BMI significant increase only for control group and 3/23 no data available). Conclusions There is a need to prioritise interventions with study designs of high quality, theory, and a participatory approach, for optimal implementation and evaluation of obesity prevention interventions.
Highlights
NA: not available. aAdditional references for further information on baseline data and design. bFor the studies on schools, representativeness referred to the schools as units and not to the children/students participating. cBaseline characteristics description or matching, if baseline Body Mass Index (BMI) was not mentioned we considered Na. dBased on what is discussed or reported in the article, we did not consider NO in cases where I and C were in proximity, unless a possibility of contamination is discussed. eDoes not apply, no control group
Among the whole of community, one fulfilled [45] and one did not fulfil [39] this criterion, two worksite-based interventions [34, 36] and one school-based intervention [29] fulfilled, and one [32] did not fulfil this criterion. This is the first systematic review focusing on setting-based interventions on obesity prevention in Nordic countries and the Netherlands, which includes all age groups and types of settings
Results for BMI change showed no consistent direction for whole of community interventions (2/7 positive, 2/7 negative, and 3/7 no effect), no effect for worksite-based interventions (3/3), and no effect for many of the school-based interventions (1/23 negative, 3/23 positive, 15/23 no effect, 1/23 BMI significant increase for control group only, and 3/23 no data available)
Summary
Obesity Prevention: A Systematic Review of Setting-Based Interventions from Nordic Countries and the Netherlands. E aim of this review was to identify, synthesise, and evaluate the quality of interventions including environmental components based in the in settings from Nordic countries and the Netherlands, aimed at preventing obesity where BMI was measured and reported as an outcome. Further assessment of the outcomes of each study was reviewed with information extracted including the outcomes measured, description of the study population units, response rate and loss to follow-up, randomisation used, selection process for setting or community of choice, summary of intervention implemented, and lastly the outcome related to BMI. BMI not measured or recorded as an outcome n = 24 Intervention largely individual-based n = 9 Participants do not meet the inclusion criteria n = 2 Short term results n = 2 Not the primary article of a study describing BMI outcomes n = 13 Mass-media campaign n = 1. Quasiexperimental changes in PA, diet, smoking, BMI, BP, and cholesterol 6 yrs
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