Health professional-delivered obesity prevention interventions during the first 1,000 days: A systematic review of external validity reporting

Hennessy, Marita; Heary, Caroline; Laws, Rachel; Rhoon, Luke Van; Toomey, Elaine; Wolstenholme, Hazel; Byrne, Molly

doi:10.12688/hrbopenres.12924.1

Cited by 7 publications

(6 citation statements)

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“…Early life childhood obesity prevention interventions delivered by health professionals show some evidence of effectiveness, particularly in relation to behavioural outcomes [17]. The acceptability of such interventions by parents and health professionals is poorly reported [18]. Research is required to understand how to support and engage parents, and how to support practitioners to support parents [16].…”

Section: Introductionmentioning

confidence: 99%

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Hennessy

Byrne

Laws

et al. 2020

IJERPH

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The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.

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Section: Introductionmentioning

confidence: 99%

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Hennessy

Byrne

Laws

et al. 2020

IJERPH

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“…Hennessy et al conducted a systematic review of more than 39 interventions in early childhood by using the RE-AIM framework to assess their generalizability. 42 The review demonstrated a greater need for in-depth reporting of external validity that could ultimately affect scale-up efforts. Similarly, another review conducted by McGoey et al demonstrated that adoption, implementation, and maintenance were underreported and that interventions should account for RE-AIM constructs for better generalizability .21 In our effort to prepare the PWMI for dissemination, we have incorporated all five constructs of RE-AIM into our Implementation Research Logic Model to facilitate a more integrated evaluation.…”

Section: Discussionmentioning

confidence: 99%

Planned Evaluation of the Healthy Weight Clinic Pediatric Weight Management and Implementation: Massachusetts-CORD 3.0

et al. 2021

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Background: Despite evidence that offering multidisciplinary treatment for children with obesity is effective, access to evidencebased pediatric weight management interventions (PWMIs) is limited. The Healthy Weight Clinic PWMI is a multidisciplinary approach in primary care that improves BMI among children with a BMI ‡ 85th percentile.Objective: To describe the method by which we will evaluate the adoption, acceptability, and feasibility of integrating and implementing a multidisciplinary Healthy Weight Clinic (HWC) into primary care.Design/Methods: We used the Consolidated Framework for Implementation Research (CFIR) domains and constructs to inform our implementation strategies. We will use a Type III hybrid effectiveness-implementation design to test our implementation strategies and improvement in BMI. Sources of data collection will include qualitative interviews with patient caregivers, HWC staff and surveys with HWC staff, patient caregivers, and electronic health record data. Our outcomes are guided by the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework.Results: We identified all five CFIR domains as integral for successful implementation. Some strategies to address barriers within these domains include online self-paced training modules for the HWC staff, a virtual learning collaborative, and engagement of site leadership. Outcomes will be measured at the patient and pilot site levels, and they will include patients reached, patient health outcomes such as BMI and quality of life, level of adoption, acceptability, feasibility, and sustainability of the PWMI.Conclusion: Our use of implementation science frameworks in the planning of Healthy Weight Clinic PWMI could create a sustainable and effective program for dissemination.

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“…Family and parental-child influences are important for establishing healthy early life nutrition and movement behaviors (2)(3)(4)(5). Early childhood family-based behavior change interventions are an important avenue for supporting optimal nutrition and movement behaviors; such interventions have been shown to reduce obesity risk behaviors in children aged 0-5 years (6)(7)(8). While there is evidence about what works in controlled research studies, few interventions progress to implementation at scale (9,10).…”

Section: Introductionmentioning

confidence: 99%

Mapping intervention components from a randomized controlled trial to scale-up of an early life nutrition and movement intervention: The INFANT program

Marshall

Johnson²,

Hesketh³

et al. 2023

Front. Public Health

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IntroductionEarly life parent-focused interventions can effectively improve infant and child nutrition and movement (physical activity and sedentary behavior) as well as parents' health behaviors. Scale-up of such interventions to real-world settings is essential for population-wide benefits. When progressing to scale-up, intervention components may be modified to reflect contextual factors and promote feasibility of scale-up. The INFANT program, an efficacious early life nutrition and movement behavioral intervention began as a randomized controlled trial (RCT), was modified after a small-scale translation, and is currently being scaled-up in Victoria, Australia. This study mapped and compared discrete intervention components of both the original RCT and the scaled-up version of INFANT to examine modifications for scaling up.MethodsDiscrete intervention components, specifically the target behaviors (child-related and parent-related behaviors), delivery features and behavior change techniques (BCTs) from the RCT and the scaled-up program were coded and mapped using established frameworks and taxonomies. Publications and unpublished materials (e.g., facilitator notes, handouts, videos, app) were coded. Coding was performed independently in duplicate, with final coding validated in a meeting with interventionists. Interventionists reported the rationale for modifications made.ResultsThe INFANT RCT and scaled-up version targeted the same obesity prevention-related nutrition and movement behaviors. Key modified delivery features at scale-up included reduced number of sessions, a broader range of professionals facilitating groups, the addition of a mobile app for parents replacing hard-copy materials and tangible tools (e.g., pedometers), and broadening of content (e.g., early feeding, updated 24-h movement guidelines). BCTs used across the RCT and scale-up sessions were unchanged. However, the BCTs identified in the between-session support materials were almost double for the scale-up compared with the RCT, primarily due to the reduced number of sessions and the app's capacity to include more content.ConclusionsINFANT is one of few early life nutrition and movement behavioral interventions being delivered at scale. With INFANT as an example, this study provides critical understanding about what and why intervention components were altered as the RCT was scaled-up. Unpacking these intervention modifications provides important insights for scale-up feasibility, outcome effects, and how to optimize implementation strategies for population-level benefits.

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Health professional-delivered obesity prevention interventions during the first 1,000 days: A systematic review of external validity reporting

Cited by 7 publications

References 80 publications

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Planned Evaluation of the Healthy Weight Clinic Pediatric Weight Management and Implementation: Massachusetts-CORD 3.0

Mapping intervention components from a randomized controlled trial to scale-up of an early life nutrition and movement intervention: The INFANT program

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