The effect of Public Health/Pediatric Obesity interventions on socioeconomic inequalities in childhood obesity: A scoping review

Abstract

SummaryChildhood obesity has a strong social gradient. This scoping review aims to synthesize the evidence on the impact on inequalities of non‐targeted interventions to reduce the prevalence of childhood and adolescent obesity in high‐income countries. We updated a review by Hillier‐Brown, searching up to 31 December 2017 on MEDLINE, Embase, The Cochrane Library, CINAHL, and PsycINFO, with no limitations on study design. Fifty‐eight studies describing 51 interventions were included: 31 randomized clinical trials and 27 non‐randomized trials, with sample sizes from 67 to 2,700,880 subjects. The majority were implemented in the school setting at a community level; the others were in health services or general population setting and targeting individuals or the system. Twenty‐nine interventions proved to be effective overall; seven others had an effect only in a subgroup, while 15 proved not to be effective. All types of included interventions can increase inequalities. Moreover, some interventions had opposite effects based on the socioeconomic characteristics. Any kind of intervention can reduce equity. Consequences are difficult to predict based on intervention construct. Complex interventions acting on multiple targets, settings, and risk factors are more effective and have a lower risk of increasing inequalities.

Un programa de prevención temprana de la obesidad: “HaViSa UC” (2009-2019)

“…Una consideración necesaria es que los programas de prevención no incrementen las disparidades, es decir, que favorezcan especialmente a los grupos que presentan menores factores de riesgo y, por tanto, menor prevalencia de obesidad 45 . La respuesta homogénea en los últimos tres años de los tres centros en nuestra muestra, con diferente representación socioeconómica, es un indicador indirecto de ausencia de este efecto.…”

Obesity prevention in the early years: A mapping study of national policies in England from a behavioural science perspective

“…This is likely to be challenging for many families but particularly difficult in families from lower SES backgrounds; this may act to further widen the health inequalities apparent with obesity [30]. A recent review indicated that all intervention types risk widening health inequalities but complex interventions which are targeted at multiple levels (systems, community, individual) and in multiple settings (school, health, population) appear to have less negative effects, and fiscal measures may even bring benefits [31]. Successive UK governments' policies highlight obesity as a serious problem; however there is a political tension between state and individual responsibility.…”

Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review

“…Though this might be included in other categories, it is listed separately due to the considerable attention it has gained in previous research. [33][34][35][36][37][38][39] These school-level determinants were examined for their impact on numerous health outcomes. The outcomes most often focused on include alcohol consumption, smoking and substance use, 20 29-31 40 eating behaviour and obesity, 35 36 38 41 42 behavioural and conduct problems, 20 31 43 or physical activity and sedentary behaviours.…”

“…These school-level determinants were examined for their impact on numerous health outcomes. The outcomes most often focused on include alcohol consumption, smoking and substance use, 20 29–31 40 eating behaviour and obesity, 35 36 38 41 42 behavioural and conduct problems, 20 31 43 or physical activity and sedentary behaviours. 33 34 37 39 41 …”