Systematic review of paediatric weight management interventions delivered in the home setting

Abstract

To increase their accessibility, paediatric weight management interventions are increasingly designed to be delivered in the home setting by trained staff. This systematic review summarizes the available evidence for interventions featuring home visitation and identifies key gaps in the literature. PubMed, CINAHL, Cochrane and PsycINFO were searched for intervention studies that reported change in objectively measured adiposity outcomes in youth ages 2-18 years. Studies published between 1 January 1995 and 12 February 2016 were analysed. Of 15 eligible studies, nine reported that interventions with home visitation were either superior to a control/comparison condition or achieved significant within-subjects reductions in adiposity. Interventions in which professional staff (e.g. dietitians and exercise trainers) conducted home visits tended to be more efficacious than those delivered by paraprofessional or community-based staff, as were interventions with more frequent contact. Most studies were judged to have low or unclear risk of bias across various domains. As most studies compared interventions with home visits with less intensive and qualitatively different approaches, it remains unclear whether home visitation per se enhances weight loss efficacy. Overall, paediatric weight management interventions that feature home visitation are promising, but the incremental benefit of the home visitation treatment modality remains to be rigorously evaluated. © 2016 World Obesity.

A Novel Home‐Based Intervention for Child and Adolescent Obesity: The Results of the Whānau Pakari Randomized Controlled Trial

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Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review

“…Of the 213 RCTs in this review, only 4 (2%) explicitly reported that a lack of fathers was a limitation of the study. The silence on this issue is also evident in many recent reviews of family- and parent-based interventions targeting pediatric obesity prevention 59–62 and treatment, 63–65 which have failed to highlight the absence of fathers as an important area to address in future research. Notably, in a recent scientific summary of important research gaps relating to specifically parent-based interventions for childhood obesity treatment, the American Heart Association identified the need to increase the involvement of grandparents, siblings, and cousins in future efforts, but the issue of father involvement was not addressed.…”

Families’ perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers

“…Home visit programmes are well established in other areas of health service delivery, such as medication adherence for seniors and pre‐partum and post‐partum care for mothers, as stand‐alone initiatives or as an adjunct to clinical care . In addition, paediatric weight management and prevention interventions are increasingly being designed to be delivered in patient's homes . Home visits may increase the accessibility of treatment by addressing time and transportation barriers and increasing how much intervention is received .…”