The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

Abstract

BackgroundChildren from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families.MethodsSearches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity.ResultsThirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery.ConclusionThere is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required.Trial registrationPROSPERO Registration no: CRD42013006536.

A Review of the Relationship Between Socioeconomic Position and the Early-Life Predictors of Obesity

“…Our own systematic review on this topic found that few of the obesityprevention interventions targeting pre-school children from low SEP environments were high quality. Those conducted in children from 0 to 2 had a positive impact on diet quality, but few reported later impacts on weight change, while interventions in 3-5-year old children had mixed results, with the successful interventions being more intensive [143]. That review also suggested that for breastfeeding outcomes and the timing of the introduction of solid food, anticipatory guidance approaches (proactively supporting and advising parents about issues and how to manage them before they occur) show particular promise in low SEP families [143].…”

Multi-site trial using short mobile messages (SMS) to improve infant weight in low-income minorities: Development, implementation, lessons learned and future applications

“…A recent systematic review of interventions to prevent obesity in socioeconomically disadvantaged children (0–5 years) revealed that of the 6 studies identified that recruited children before age 2 with anthropometric outcomes, only 1 had a small effect on BMI. 15 The authors note that most studies use intensive face-to-face interventions, and that future research should explore the feasibility, acceptability and effectiveness of low-cost delivery modes such as use of mobile phone based interventions. 15 According to data collected from July to December 2016 through the National Health Interview Survey, 66.3% of adults considered “poor” according to the U.S. Census Bureau’s poverty thresholds lived in wireless-only households.…”

Parental feeding behaviour and motivations regarding pre-school age children: A thematic synthesis of qualitative studies

“…Focus on building practical skills (e.g. cooking), social networking, progressive rewards, links to community resources and the use of behaviour change strategies (including self-monitoring and goal setting) has been endorsed in the context of obesity prevention among low SES families (Laws et al, 2014) and these techniques also hold considerable promise in the area of general nutrition education. New technologies such as apps which can be loaded onto mobile devices (e.g.…”