Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis

Abstract

The prevalence of childhood and adolescent obesity has been a major worldwide problem for decades. To stop the number of children and adolescents with overweight or obesity from increasing, numerous interventions focusing on improving children’s weight status have been designed and implemented. This vastly growing body of research on weight-related interventions for children and adolescents has been summarized by several meta-analyses that aim to provide an overview of the effectiveness of these interventions. Yet, the number of meta-analyses is expanding so quickly and overall results differ, making a comprehensive synopsis of the literature difficult. To tackle this problem, a meta- synthesis was conducted to draw informed conclusions about the state of the effectiveness of interventions targeting child and adolescent overweight. The results of the quantitative synthesis of 26 meta-analyses resulted in a standardized mean difference of -0.12 (95%CI: -0.16;-0.08). Several moderator analyses (e.g., gender, age, duration of the intervention, parental involvement) showed that participant and intervention characteristics had little impact on the overall effect size. Overall, the results of this meta-synthesis suggest that interventions result in statistically significant effects albeit of relatively little clinical relevance.

Biobehavioural approaches to prevention and treatment: A call for implementation science in obesity research

“…In particular, much progress has been made in biobehavioural prevention and treatment strategies for pregnant women, infants, and children. [57][58][59][60][61][62][63][64][65][66][67][68] However, much work remains for groups with complex psychosocial risk factors. [69][70][71][72][73][74] When heterogeneous responses are acknowledged, the community of researchers and clinicians may address potential prevention and treatment targets; and these factors would ideally be included in future studies to inform precision obesity medicine.…”

Aim2Be an mHealth intervention for children with overweight and obesity: Study protocol for a randomized controlled trial

“…Currently, the accepted standard of care for the management of childhood obesity is to provide in-person family-based multidisciplinary interventions that target lifestyle behaviours (e.g., diet, physical activity, and sedentary behaviours) and behavioural strategies at both the individual and familial levels (10,11). While such strategies are efficacious at decreasing weight or Body Mass Index (BMI) z-score (10,11), their effects are modest, not sustained, and high attrition is a common problem (12)(13)(14)(15)(16). In a German study that included 21,784 children attending a community weight management program, 76% and 92% of the participants dropped out after six and 24 months, respectively (14).…”

“…Data on the efficacy of mHealth interventions for managing childhood obesity is still emerging (19,20). Importantly, mHealth interventions are ideally suited to: 1) address some of the barriers associated with in-person lifestyle behaviour modification interventions including lack of enthusiasm for in-person meetings, lack of financial resources, inconvenient location, and lack of time (12,15,21,22); 2) emphasize the development of self-regulatory skills (e.g., goal setting, planning, and self-monitoring) that are a hallmark of effective lifestyle behavioural modification interventions (11), as specific app features can be designed to support self-regulatory processes; and 3) improve engagement by incorporating game-design elements without the context of what is traditionally considered a "game" (23). A review by Johnson et al (24) identified that gamification can benefit health and wellbeing interventions, and that behavioural outcomes, in particular physical activity, may be the most ideal targets for gamification.…”

“…With continued advances in wearable or transportable technologies (e.g. smart phones, smart watches, wireless activity trackers and other wireless devices) and the high penetrance of mobile phones use among children (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) year old spend an average of 15 hours per week on a mobile phone (25,26)), there is a need to harness the potential of mHealth lifestyle behaviour modification interventions in the pediatric context, especially interventions targeting children 10 to 17 years of age.…”

Parent, school, and peer factors related to U.S. adolescents’ diet and exercise

“…Identifying the contextual factors strongly associated with these critical outcomes would facilitate the development of interventions targeting those factors, ultimately improving diet and PA. A recent systematic review identified few studies focused on adolescents aged 14-17 and recommended additional studies of this age group (Ash, Agaronov, Young, Aftosmes-Tobio, & Davison, 2017). Although other studies have established the effectiveness of parental involvement in improving adolescent obesity, relatively few studies have implemented parent-focused interventions (Kobes, Kretschmer, Timmerman, & Schreuder, 2018). A Cochrane review determined that most study interventions of behavioral changes occur in healthcare settings with the limited identification of subgroup differences.…”