Effectiveness of a multi-disciplinary family-based programme for treating childhood obesity (The Family Project)

SummaryObjectiveFamily‐based interventions represent a potentially valuable route to increasing child physical activity (PA) in children. A dual meta‐analysis and realist synthesis approach examined existing interventions to assist those developing programmes to encourage uptake and maintenance of PA in children.DesignStudies were screened for inclusion based on including participants aged 5–12 years, having a substantive aim of increasing PA by engaging the family and reporting on PA outcome. Duplicate data extraction and quality assessment were conducted. Meta‐analysis was conducted in STATA. Realist synthesis included theory development and evidence mapping.ResultsForty‐seven studies were included, of which three received a ‘strong’ quality rating, 21 ‘moderate’ and 23 ‘weak’. The meta‐analysis (19 studies) demonstrated a significant small effect in favour of the experimental group (standardized mean difference: 0.41; 95%CI 0.15–0.67). Sensitivity analysis, removing one outlier, reduced this to 0.29 (95%CI 0.14–0.45). Realist synthesis (28 studies) provided insight into intervention context (particularly, family constraints, ethnicity and parental motivation), and strategies to change PA (notably, goal‐setting and reinforcement combined).ConclusionThis review provides key recommendations to inform policy makers and other practitioners in developing evidence‐based interventions aimed at engaging the family to increase PA in children, and identifies avenues for future research.

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“…Forty‐seven interventions met inclusion criteria (Fig. ), of which 31 (66%) demonstrated a significant positive effect on physical activity.…”

Section: Resultsmentioning

confidence: 99%

Family‐based interventions to increase physical activity in children: a systematic review, meta‐analysis and realist synthesis

et al. 2016

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“…Additional initiatives to prevent further increases and reduce existing levels of sedentary behavior in mothers and children are crucial. Focusing PA promotion at the family-level could increase the public health impact and effectiveness of these interventions [61-63]. The success of these efforts will continue to be challenged by rapid urbanization, technological advances, and socioeconomic development, so PA policy and interventions must be cognizant of how these factors influence PA and inactivity patterns.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal, cross-cohort comparison of physical activity patterns in Chinese mothers and children

Dearth‐Wesley

Gordon‐Larsen

Adair

et al. 2012

Int J Behav Nutr Phys Act

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BackgroundThere is limited evidence comparing adult and child physical activity (PA) trends and examining parent–child PA associations within a newly industrialized country setting. PA research within a newly industrialized country setting is particularly important given the negative effects of rapid urbanization, socioeconomic growth, and technological advances on PA behaviors. The purpose of our study was to examine trends and associations in PA behaviors in Chinese mother-child pairs and to investigate relationships between PA behaviors and socioeconomic variables in this dyad.MethodsWe studied PA behaviors in 2 separate cohorts of mother-child pairs (n = 353) followed over a 2–4 year time period using longitudinal data from the China Health and Nutrition Survey (2000 Cohort: 2000–2004; 2004 Cohort: 2004–2006). Comparable mother-child PA behaviors included total metabolic equivalent hours per week (MET-hrs/wk) from active commuting, leisure-time sports, and sedentary behaviors. Logistic regression models were used to examine associations between mother and child PA and relationships between PA behaviors and socioeconomic variables.ResultsChildren experienced increases in active commuting and leisure-time sports activities with increasing child age, whereas mothers experienced temporal declines in active commuting and minimal change in leisure-time sports activity. Sedentary behavior was high for children and mothers over time. Mother-child associations were positive for active commuting and leisure-time sports activities and negative for sedentary behavior (P < 0.05). Maternal education was associated with a greater likelihood of high leisure-time sports activity and high sedentary behavior in mothers but not in children (P < 0.05).ConclusionEfforts to reduce sedentary behavior in Chinese mothers and children are imperative. While increased leisure-time and active commuting activities in children is encouraging, continued PA promotion in children and more intensive efforts to promote leisure-time sports and active commuting in mothers is needed.

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“…In the remaining five trials, the multicomponent intervention was not different from control conditions (Arauz Boudreau, Kurowski, Gonzalez, Dimond, & Oreskovic, 2013;McCallum et al, 2007;Wake et al, 2009), a standard care condition (Hughes et al, 2008), and child-only treatment (Bathrellou et al, 2010). In addition, BWL treatments have been tested in an additional 11 studies of children and adolescents (ages 6-18), with nine of those trials demonstrating the efficacy of the BWL treatment compared to control conditions (Coppins et al, 2011;Jiang, Xia, Greiner, Lian, & Rosenqvist, 2005;Mellin, Slinkard, & Irwin, 1987;Nemet et al, 2005;Nowicka, Hoglund, Pietrobelli, Lissau, & Flodmark, 2008;Reinehr et al, 2010), selfhelp conditions , written dietary advice (Weigel et al, 2008), standard care (Sabet Sarvestani, Jamalfard, Kargar, Kaveh, & Tabatabaee, 2009), and dietary advice usual care (Diaz, EsparzaRomero, Moya-Camarena, Robles-Sardin, & Valencia, 2010) conditions. In this age group, a BWL intervention with family involvement was found to be no different from a combined dietary and physical activity condition or waitlist control condition (Kitzman-Ulrich et al, 2009), and a brief family intervention (Steele et al, 2012).…”

Section: Behavioral Weight Loss Treatment With Family Involvementmentioning

confidence: 99%

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

Altman

Wilfley²

2014

Journal of Clinical Child & Adolescent Psychology

138

149

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Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and metaanalyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided SelfHelp for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.

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Effectiveness of a multi-disciplinary family-based programme for treating childhood obesity (The Family Project)

Abstract: Conflict of InterestThe authors declare that they have no competing interests, financial or non-financial. 2 ABSTRACTBackground / Objectives: To determine if a multi-component family focused

Cited by 23 publications

References 16 publications

Family‐based interventions to increase physical activity in children: a systematic review, meta‐analysis and realist synthesis

Family‐based interventions to increase physical activity in children: a systematic review, meta‐analysis and realist synthesis

Longitudinal, cross-cohort comparison of physical activity patterns in Chinese mothers and children

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

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