Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review

Abstract

Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies.

Risco psicossocial familiar, coping do tratamento da obesidade infantil e controle parental da alimentação

“…This is an example how works the model of pediatric obesity proposed by Smith et al (2018), and how the cumulative exposure to risks and dysregulation in response to stress contribute to pediatric obesity (Evans & Pilyoung, 2013). This sample presents opposition coping strategies, with emotional reactions of sadness and fear, perceiving the stressors as a threat to their need for autonomy; children are less involved in family meals; present greater difficulty in food control, use food as a reward, being in chronic stress conditions, less likely to be adherent to treatment, and requiring multi-professional interventions with health professionals in the social and mental health spheres (Campos et al, 2017;Fenner et al, 2013;Filgueiras & Sawaya, 2018;Matwiejczyk et al, 2018). Expanding the repertoire of coping, as presented by families at medium psychosocial risk ("Targeted") may be a way to increase adherence to treatment; as well as encouraging physical activity as a way of promoting health and preventing the child´s overweight.…”

“…To evaluate the parental stressors and coping with overweight/obesity treatment, we used the Interview on Parental Coping with Overweight/Obesity Child adapted from Guimarães (2015) and based on the Motivational Theory of Coping Scale-12 (Lees, 2007). This protocol contains three domains: 1) Caregiver and child identification data, date/time of administration; e) Demand (identification of stressors) and 3) Coping process.…”

“…Thus, the manner in which parents are coping with their child's obesity and the treatment can affect the health outcome, making coping evaluation important for treatment adherence (Bellodi, 2018). Likewise, one should consider the developmental characteristics of the child and the family process (Matwiejczyk, Mehta, Scott, Tonkin, & Coveney, 2018).…”

Barriers and facilitators to obesity prevention dissemination and implementation efforts in the childcare centre setting from the provider perspective

“…Previous qualitative studies have shown that childcare providers understand that nutrition and physical activity are important for the health of the child, but barriers to implementation include parent cooperation and staff training (Dev et al, ; Lindsay, Salkeld, Greaney, & Sands, ; Lyn, Evers, Davis, Maalouf, & Griffin, ; Rosenthal, Crowley, & Curry, ; Sisson, Smith, & Cheney, ). As the field is currently evolving from the gathering of an evidence base through research to the support of obesity prevention interventions to standardized practice, further exploration of implementation and dissemination barriers and facilitators is warranted (Matwiejczyk, Mehta, Scott, Tonkin, & Coveney, ).…”

“…As the field is currently evolving from the gathering of an evidence base through research to the support of obesity prevention interventions to standardized practice, further exploration of implementation and dissemination barriers and facilitators is warranted (Matwiejczyk, Mehta, Scott, Tonkin, & Coveney, 2018).…”