Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis.

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childhood obesity 91 Title: The International Journal of Behavioral Nutrition and Physical ActivityFamily-based childhood obesity prevention interventions: a systematic review and quantitative content analysisTayla AshAlen AgaronovTa’Loria
childhood obesity 754 strategy in this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to
childhood obesity 1064 searched the PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral
childhood obesity 2637 inform future decision-making around the design and funding of family-based interventions to prevent childhood obesity .Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0571-2)
childhood obesity 3870 scientists, clinicians, and practitioners are working hard to devise and test interventions to prevent childhood obesity and reduce associated disparities [[2], [9]].One category of interventions to prevent childhood obesity
childhood obesity 3974 childhood obesity and reduce associated disparities [[2], [9]].One category of interventions to prevent childhood obesity that has grown considerably in recent years is family-based interventions. This was in part due to a
childhood obesity 4208 reports published in 2007, including an Institute of Medicine (IOM) report on the recent progress of childhood obesity prevention [[10]] and a report from a committee of experts representing 15 professional organizations
childhood obesity 4426 organizations appointed to make evidence-based recommendations for the prevention, assessment, and treatment of childhood obesity [[11], [12]]. In both reports, parents are described as integral targets in interventions, given their
childhood obesity 5028 of these reports, there has been a proliferation of family-based interventions to prevent and treat childhood obesity as documented in at least five published reviews of this literature in the past decade [[20]–[24]].
childhood obesity 5595 as well as those where few or no studies exist, thereby highlighting knowledge gaps. With a focus on childhood obesity interventions, pertinent questions to address include: whether interventions have continued to focus
childhood obesity 6390 ethical reasons, from a pragmatic viewpoint, it is difficult to identify best practices to prevent childhood obesity in vulnerable populations when few interventions have focused on that population [[38], [39]].The goal
childhood obesity 6577 population [[38], [39]].The goal of this study is to profile family-based interventions to prevent childhood obesity published since 2008 to identify gaps in intervention design and methodology. In particular, we use
childhood obesity 7040 Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify family-based childhood obesity prevention interventions that were written in English and published between January 1, 2008 and December
childhood obesity 7546 eligible studies, we conducted a quantitative content analysis to profile recent interventions for childhood obesity prevention. Content analysis, originally used in communication sciences but increasingly utilized in
childhood obesity 7915 research team has previously employed this technique to survey observational studies on parenting and childhood obesity published between 2009 and 2015 [[41], [42]].Search strategy and initial screeningWith the help of a
childhood obesity 9426 studies. In a recent systematic review of family-based interventions for the treatment and prevention of childhood obesity , more than 80% of eligible studies were published since 2008 [[43]]. Thus, a start date of 2008 appropriately
childhood obesity 10270 human subjects, did not target children, were observational studies, were not relevant to the topic of childhood obesity (e.g. papers about Anorexia Nervosa), or included special clinical populations.Fig. 1PRISMA flow diagram
childhood obesity 10445 clinical populations.Fig. 1PRISMA flow diagram for identifying and screening eligible family-based childhood obesity prevention interventionsApplication of eligibility criteriaThree authors (TA, AA, TY) and one research
childhood obesity 10817 applying the aforementioned exclusion criteria. Eligible studies included family-based interventions for childhood obesity prevention published since 2008. We defined family-based interventions as those involving active and
childhood obesity 21496 was 85 interventions with published outcome data.Table 1Intervention characteristics of family-based childhood obesity prevention interventions published from 2008 to 2015 (n = 119)n (%)Geographic Region Unites States66
childhood obesity 28567 10 years of age.Table 2Age of target child, setting, and behavioral domains targeted of family-based childhood obesity prevention interventions published 2008–2015 (n = 119)Age of target childaSettingan (%)Bx DomaAll
childhood obesity 31427 families identifying as Hispanic/Latino (n = 40, 47%).Table 3Sample characteristics for family-based childhood obesity prevention interventions published from 2008 to 2015 (n = 85)an (%)Representation of underserved populationsb Low
childhood obesity 33086 Indigenous (n = 1, 2%).Fig. 2Inclusion and representation for racial/ethnic groups in U.S. family-based childhood obesity prevention interventions (n = 50)Few studies included non-traditional families; less than a third
childhood obesity 34154 use theory (see Additional file 3: Table S1).DiscussionParents are important agents of change in the childhood obesity epidemic [[20], [22], [48], [49]]. This study used rigorous systematic methods to conduct a quantitative
childhood obesity 34421 interventions to prevent childhood published between 2008 and 2015 to profile the field of recent family-based childhood obesity prevention interventions and identify knowledge gaps. We identified gaps in both intervention content
childhood obesity 36718 strategies in high-risk communities and fails to fully address noted health disparities.Family-based childhood obesity prevention interventions have focused heavily on children 2–10 years of age, despite the robust evidence
childhood obesity 37135 changing energy-balance behaviors later on. While it has been established that prenatal life influences childhood obesity risk, the low number of interventions beginning in the prenatal period, in particular, may be due to
childhood obesity 38562 with findings from a content analysis by Gicevic et al. on observational research on parenting and childhood obesity published over a similar time frame [[41]]. The majority of studies were conducted in developed countries;
childhood obesity 39922 include this information because it is included in prior reviews of family-based interventions for childhood obesity prevention published in the past 10 years [[20]–[24], [60]]. Although systematic reviews can identify
childhood obesity 41029 limitations, this study used a novel approach to synthesize and profile the recent literature on family-based childhood obesity prevention interventions. Results demonstrate the current emphasis in interventions, and lack of adequate
childhood obesity 41412 better understand the influence of these characteristics when designing and implementing family-based childhood obesity prevention interventions. The results of this study can be used to inform decision-making around intervention
childhood obesity 41839 populations.Additional filesAdditional file 1:Full search strategy for PubMed database to identify eligible family-based childhood obesity prevention interventions published between 2008 and 2015. (DOCX 135 kb)Additional file 2:List of eligible
childhood obesity 42030 135 kb)Additional file 2:List of eligible articles published between 2008 and 2015 detailing a family-based childhood obesity prevention intervention. (DOCX 210 kb)Additional file 3: Table S1.Intervention characteristics of family-based
childhood obesity 42160 intervention. (DOCX 210 kb)Additional file 3: Table S1.Intervention characteristics of family-based childhood obesity prevention interventions separating studies with evaluations from protocols. (DOCX 116 kb
obesity 101 Title: The International Journal of Behavioral Nutrition and Physical ActivityFamily-based childhood obesity prevention interventions: a systematic review and quantitative content analysisTayla AshAlen AgaronovTa’Loria
obesity 461 (collection): /2017AbstractBackgroundA wide range of interventions has been implemented and tested to prevent obesity in children. Given parents’ influence and control over children’s energy-balance behaviors, including
obesity 764 this effort. The objective of this study was to profile the field of recent family-based childhood obesity prevention interventions by employing systematic review and quantitative content analysis methods to
obesity 1074 PubMed, PsycIFO, and CINAHL databases to identify eligible interventions aimed at preventing childhood obesity with an active family component published between 2008 and 2015. Characteristics of study design, behavioral
obesity 2178 highly represented.ConclusionsThe limited number of interventions targeting diverse populations and obesity risk behaviors beyond diet and physical activity inhibit the development of comprehensive, tailored
obesity 2647 future decision-making around the design and funding of family-based interventions to prevent childhood obesity .Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0571-2)
obesity 2847 (doi:10.1186/s12966-017-0571-2) contains supplementary material, which is available to authorized users.BackgroundChildhood obesity continues to be a pervasive global public health issue as children worldwide are significantly heavier
obesity 3033 are significantly heavier than prior generations [[1]]. Over the past few decades, the prevalence of obesity among children and adolescents has risen by 47% [[2]]. Increases have been seen in both developed and
obesity 3279 prevalence estimates of 23 and 13%, respectively [[2]]. Despite evidence of a plateau in the rates of obesity , at least among young children in developed countries, current levels are still too high, posing short-
obesity 3690 widening in some countries [[5]–[8]]. Given the extensive disease burden, treatment resistance of obesity , and lack of signs of attenuation for rates in the developing world, scientists, clinicians, and practitioners
obesity 3880 clinicians, and practitioners are working hard to devise and test interventions to prevent childhood obesity and reduce associated disparities [[2], [9]].One category of interventions to prevent childhood obesity
obesity 3984 obesity and reduce associated disparities [[2], [9]].One category of interventions to prevent childhood obesity that has grown considerably in recent years is family-based interventions. This was in part due to a
obesity 4218 published in 2007, including an Institute of Medicine (IOM) report on the recent progress of childhood obesity prevention [[10]] and a report from a committee of experts representing 15 professional organizations
obesity 4436 appointed to make evidence-based recommendations for the prevention, assessment, and treatment of childhood obesity [[11], [12]]. In both reports, parents are described as integral targets in interventions, given their
obesity 5038 reports, there has been a proliferation of family-based interventions to prevent and treat childhood obesity as documented in at least five published reviews of this literature in the past decade [[20]–[24]].
obesity 5605 those where few or no studies exist, thereby highlighting knowledge gaps. With a focus on childhood obesity interventions, pertinent questions to address include: whether interventions have continued to focus
obesity 6400 reasons, from a pragmatic viewpoint, it is difficult to identify best practices to prevent childhood obesity in vulnerable populations when few interventions have focused on that population [[38], [39]].The goal
obesity 6587 population [[38], [39]].The goal of this study is to profile family-based interventions to prevent childhood obesity published since 2008 to identify gaps in intervention design and methodology. In particular, we use
obesity 7050 Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify family-based childhood obesity prevention interventions that were written in English and published between January 1, 2008 and December
obesity 7556 studies, we conducted a quantitative content analysis to profile recent interventions for childhood obesity prevention. Content analysis, originally used in communication sciences but increasingly utilized in
obesity 7925 team has previously employed this technique to survey observational studies on parenting and childhood obesity published between 2009 and 2015 [[41], [42]].Search strategy and initial screeningWith the help of a
obesity 8543 home), (2) intervention (e.g. prevention, promotion), (3) children (e.g. child, infant, youth), and (4) obesity (e.g. overweight, body mass) (see Additional file 1 for full search strategy for one database). We searched
obesity 9436 recent systematic review of family-based interventions for the treatment and prevention of childhood obesity , more than 80% of eligible studies were published since 2008 [[43]]. Thus, a start date of 2008 appropriately
obesity 10280 subjects, did not target children, were observational studies, were not relevant to the topic of childhood obesity (e.g. papers about Anorexia Nervosa), or included special clinical populations.Fig. 1PRISMA flow diagram
obesity 10455 populations.Fig. 1PRISMA flow diagram for identifying and screening eligible family-based childhood obesity prevention interventionsApplication of eligibility criteriaThree authors (TA, AA, TY) and one research
obesity 10827 aforementioned exclusion criteria. Eligible studies included family-based interventions for childhood obesity prevention published since 2008. We defined family-based interventions as those involving active and
obesity 11359 parents to a single event, but not involving them in the intervention in an integral way. We defined obesity interventions as those that reported at least one weight-related outcome (weight, body mass index, etc.)
obesity 11503 at least one weight-related outcome (weight, body mass index, etc.) or which self-identified as an obesity intervention. We defined interventions as preventive if they did not explicitly focus on weight loss
obesity 11673 did not explicitly focus on weight loss or management, or if they did not recruit only children with obesity . The final inclusion criterion was that the intervention was designed with the intent of benefiting
obesity 21506 interventions with published outcome data.Table 1Intervention characteristics of family-based childhood obesity prevention interventions published from 2008 to 2015 (n = 119)n (%)Geographic Region Unites States66
obesity 28577 age.Table 2Age of target child, setting, and behavioral domains targeted of family-based childhood obesity prevention interventions published 2008–2015 (n = 119)Age of target childaSettingan (%)Bx DomaAll
obesity 31437 identifying as Hispanic/Latino (n = 40, 47%).Table 3Sample characteristics for family-based childhood obesity prevention interventions published from 2008 to 2015 (n = 85)an (%)Representation of underserved populationsb Low
obesity 33096 (n = 1, 2%).Fig. 2Inclusion and representation for racial/ethnic groups in U.S. family-based childhood obesity prevention interventions (n = 50)Few studies included non-traditional families; less than a third
obesity 34164 (see Additional file 3: Table S1).DiscussionParents are important agents of change in the childhood obesity epidemic [[20], [22], [48], [49]]. This study used rigorous systematic methods to conduct a quantitative
obesity 34431 prevent childhood published between 2008 and 2015 to profile the field of recent family-based childhood obesity prevention interventions and identify knowledge gaps. We identified gaps in both intervention content
obesity 34996 majority of studies were conducted in developed, or high-income, countries. Given the rapid increase of obesity as a significant public health burden in developing countries, this study demonstrates a need for further
obesity 35190 a need for further intervention efforts in low- and middle-income countries [[50], [51]]. Although obesity rates are lower in low- and middle-income countries than developed countries, two-thirds of people with
obesity 35302 rates are lower in low- and middle-income countries than developed countries, two-thirds of people with obesity worldwide live in developing countries where rates of obesity are increasing [[2]]. The small number
obesity 35364 countries, two-thirds of people with obesity worldwide live in developing countries where rates of obesity are increasing [[2]]. The small number of studies in these geographic regions limits the development
obesity 35556 the development of locally relevant programs and policies aiming to address the growing problem of obesity in these regions.Non-traditional families were underrepresented in interventions. This is concerning
obesity 35741 interventions. This is concerning given that children from non-traditional families have an elevated risk for obesity [[31]–[36]]. The changing nature of family structures, including the increasing number of single-parent
obesity 36176 underrepresented. Racial and ethnic minorities are vulnerable populations who experience elevated risk for obesity [[33], [34]]. Initiatives to fund interventions specifically targeted at racial and ethnic minorities
obesity 36728 in high-risk communities and fails to fully address noted health disparities.Family-based childhood obesity prevention interventions have focused heavily on children 2–10 years of age, despite the robust evidence
obesity 37145 energy-balance behaviors later on. While it has been established that prenatal life influences childhood obesity risk, the low number of interventions beginning in the prenatal period, in particular, may be due to
obesity 37739 emphasis of interventions on diet and physical activity may reflect their relative contribution to obesity risk. However, behavioral risk factors for obesity are interconnected, and thus may be better addressed
obesity 37790 activity may reflect their relative contribution to obesity risk. However, behavioral risk factors for obesity are interconnected, and thus may be better addressed by considering complimentary and supplementary
obesity 38572 findings from a content analysis by Gicevic et al. on observational research on parenting and childhood obesity published over a similar time frame [[41]]. The majority of studies were conducted in developed countries;
obesity 39932 this information because it is included in prior reviews of family-based interventions for childhood obesity prevention published in the past 10 years [[20]–[24], [60]]. Although systematic reviews can identify
obesity 41039 study used a novel approach to synthesize and profile the recent literature on family-based childhood obesity prevention interventions. Results demonstrate the current emphasis in interventions, and lack of adequate
obesity 41422 understand the influence of these characteristics when designing and implementing family-based childhood obesity prevention interventions. The results of this study can be used to inform decision-making around intervention
obesity 41849 filesAdditional file 1:Full search strategy for PubMed database to identify eligible family-based childhood obesity prevention interventions published between 2008 and 2015. (DOCX 135 kb)Additional file 2:List of eligible
obesity 42040 file 2:List of eligible articles published between 2008 and 2015 detailing a family-based childhood obesity prevention intervention. (DOCX 210 kb)Additional file 3: Table S1.Intervention characteristics of family-based
obesity 42170 intervention. (DOCX 210 kb)Additional file 3: Table S1.Intervention characteristics of family-based childhood obesity prevention interventions separating studies with evaluations from protocols. (DOCX 116 kb

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