Evaluation of complex community‐based childhood obesity prevention interventions

Abstract

Selection of study designs and outcome measures compatible with community infrastructure, accompanied by process evaluation, may facilitate successful outcome evaluation.

A Secondary Analysis of the Childhood Obesity Prevention Literature through a Wider Determinants of Health Lens: Implications for Research Funders, Researchers, Policymakers and Practitioners

“…We hope that this analysis prompts policymakers and practitioners to re ect upon the role of the evidence base when designing new policies or approaches. In line with the conclusions of others, the collective ndings would advocate that future efforts (research, policy, and practice) target upstream determinants of the obesogenic system (16,33,48,49).…”

“…The collective ndings suggest that the current efforts of local authorities in England, and the broader international research community that informs practice, predominantly rely on individual agency, and assume that via education, individuals can change their behaviours. As a population-level approach to prevention, this is unlikely to be effective (28), and may indeed have negative consequences for health inequalities (20,(28)(29)(30)(31)(32)(33). Our ndings are paradoxical given the widespread agreement that upstream efforts are required to alter the obesogenic systems in which we live (2,20,31,34).…”

“…In order to move beyond this impasse, alternative research designs may be required to evaluate multifaceted approaches that function within a complex adaptive system (29,33,(44)(45)(46)(47). Signs of this are starting to emerge.…”

“…Signs of this are starting to emerge. Two reviews have synthesised childhood obesity prevention efforts which were evaluated through natural experimental designs, both of which include 33 studies (33,48). Karacabeyli et al (33) synthesised complex community-based interventions and concluded that interventions which target a wide range of determinants across multiple levels of the WDoH were more likely to be effective than single-sector / setting interventions.…”

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

“…Although there is some literature about the development of OW/OB in children dating back to the early 1980s, 8,9 it is mainly in the last 10 to 15 years that the topic has gained increased attention, partly as a basis for designing intervention and prevention programs. [10][11][12][13][14][15][16][17][18][19][20][21] In relation to questions about the etiology of OW/OB, including in childhood, the predominant approach whether from reviews, 22-29 individual research studies, [30][31][32][33][34][35][36][37] or in the design of intervention strategies 38,39 has been one based on correlates, predictors, or risks. These have covered a wide range of factors, including biological determinants (eg, genetic susceptibility and child temperament), an obesogenic environment, children's appetitive traits (eg, eating in the absence of hunger), psychosocial factors (eg, parent feeding styles and practices), ethnic group, cultural and macroenvironmental factors, as well as energy expenditure.…”