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

Laws, Rachel; Campbell, Karen J; van der Pligt, Paige; Russell, Georgina; Ball, Kylie; Lynch, John; Crawford, David; Taylor, Rachael; Askew, Deborah; Denney-Wilson, Elizabeth

doi:10.1186/1471-2458-14-779

Table 3 Summary of studies: focus, design, sample, delivery agent, quality assessment, and outcome

From: 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

Study/Target group/Aim	Focus/outcome measures							Design	N	Age at start	Delivery agent	Follow up	Quality	Outcome
Study/Target group/Aim	BF	PFP	Diet	PA	SB	Anthro	Theory based¹	Design	N	Age at start	Delivery agent	Follow up	Quality	Outcome
Home Based (n = 12)
Edwards et al. (2013), low income young black mothers [36]	√	Delay solids						RCT	248	Antenatally	Doulas	Birth, 6 weeks, 4 m	Low	+BF, +solids
1° Aim: Increase BF and delay early introduction of solids	√	Delay solids						RCT	248	Antenatally	Doulas	Birth, 6 weeks, 4 m	Low	+BF, +solids
Black et al. (2001), USA, low income black adoescents [46]		Delay solids					√	RCT	181	Birth	Trained mentors	3 &12 m	Moderate	+solids
1° Aim: Delay early introduction of solids		Delay solids					√	RCT	181	Birth	Trained mentors	3 &12 m	Moderate	+solids
Wen et al. (2012), Australia, first time mothers disadvantaged Community [37]	√	√	√	√	√	√		RCT	667	Antenatally	Nurses	6,12 & 24 m	High	+ BF, +PFP, +Diet, -PA, +SB, +Anthro
1° Aim: Obesity prevention	√	√	√	√	√	√		RCT	667	Antenatally	Nurses	6,12 & 24 m	High	+ BF, +PFP, +Diet, -PA, +SB, +Anthro
Scheinmann et al. (2010), USA, low income Latino mothers [47]	√	Delay solids						Quasi-experimental	439	Infant < 5 months	Video only	3 & 6 m	Moderate	+solids
														-BF
1° Aim: Delay early introduction of solids														-BF
De Oliveira et al. (2012), Brazil, low income adolescent mothers [38]	√	Delay solids	√					RCT	323	Birth	MD team	1,2,3,4,5 & 6 m	Moderate	+BF, +solids
														+ diet
1° Aim: Delay early introduction of solids														+ diet
Vitola et al. (2012), Brazil, low income mothers [39]	√	√	√			√		RCT	500	Birth	Trained field workers	6,12 m, 3–4 & 7–8 years	Moderate	+BF
Vitola et al. (2012), Brazil, low income mothers [39]														+diet
1° Aim: Improve child diet														-anthro
Johnson et al. (1993), UK, low income area [40]		√	√					RCT	262	<=4 months	Trained volunteers	12 m & 7 years	Moderate	+Diet
Johnson et al. (1993), UK, low income area [40]														+PFP
1° Aim: Improved child development/diet														+PFP
Fitzpatrick et al. (1997), UK, travelling mothers [35]		√	√					Prospective with non equivalent comparison	39	<=4 months	Trained volunteers	12 m	Low	+Diet
Fitzpatrick et al. (1997), UK, travelling mothers [35]														+PFP
1° Aim: Improved child development/diet														+PFP
Watt et al. (2009), UK, low income mothers [41]	√	√	√			√	√	RCT	312	10 weeks age	Trained volunteers	12, 18 m & 4 years	High	-BF, -solids
Watt et al. (2009), UK, low income mothers [41]														+diet, +PFP,
1° Aim: Improve PFP and child diet														-anthro
Harvey-Berino (2003), USA, Native American Toddlers/Pre-school children [49]		√	√	√	√	√		RCT	43	9 months to 3 years	Indigenous peer educators	4 m	Low	+PFP, -anthro, +diet, -PA
1° Aim: Obesity prevention		√	√	√	√	√		RCT	43	9 months to 3 years	Indigenous peer educators	4 m	Low	+PFP, -anthro, +diet, -PA
Karanja et al. (2010), USA, American Indian/	√		√			√		Simulated before and after design	205	Antenatally	Community health workers	2 years	Low	?BF, diet NR,
Karanja et al. (2010), USA, American Indian/														-anthro
Native Alaskan [48]
1° Aim: Obesity prevention
Haines et al. (2013), USA, low income racial minority families with preschool children [50]			√	√	√	√		RCT	121	2 to 5 years	Bi-lingual health educators	6 m	Moderate	+anthro
														+ sleep, +SB,
														-family meals, -TV in bedroom
1° Aim: Obesity prevention														-family meals, -TV in bedroom
Primary Health Care (n = 6)
Kavanagh et al. (2008), USA, low income WIC attendees [53]		√				√		RCT	61	3- 10 weeks	Unclear	4 m	Low	-formula feeding,
1° Aim: Improve formula feeding practices and reduce rapid weight gain		√				√		RCT	61	3- 10 weeks	Unclear	4 m	Low	-anthro
Kahn et al. (2007), USA, predominantly low income Hispanic WIC attendees [54]		√					√	RCT	48	18-30 months	Nutritionist	2 m	Low	+bottle weaning
1° Aim: Bottle weaning		√					√	RCT	48	18-30 months	Nutritionist	2 m	Low	+bottle weaning
Klohe-Lehman et al. (2007), USA, low income WIC attendees [57]			√	√		√	√	Before and after	235	1-3 years	Dietitian	2& 6 m	Low	+diet, +PA
														-anthro
1° Aim: Improve diet and PA of mothers and children														-anthro
Davison et al. (2011), USA, WIC attendees aged 2–5 years [56]				√	√			Quasi-experimental	880	2-5 years	WIC clinic staff	1 year	Low	+SB, +PA
1° Aim: Increase child PA and reduce SB				√	√			Quasi-experimental	880	2-5 years	WIC clinic staff	1 year	Low	+SB, +PA
McGarvey et al. (2004), WIC attendees 2–4 years [55]		√	√	√	√		√	Quasi-experimental	336	2-4 years	WIC nutritionist	1 year	Low	+PFP
1° Aim: Improve child diet and PA, reduce SB		√	√	√	√		√	Quasi-experimental	336	2-4 years	WIC nutritionist	1 year	Low	+PFP
French et al. (2012), USA, low income families [51]		√	√		√	√		Cluster RCT	292	<2 months age	Primary care staff	12 m	Moderate	+ diet, -PFPs
French et al. (2012), USA, low income families [51]														+ SB, -anthro
1° Aim: Improve PFP and child diet														+ SB, -anthro
Preschool (n = 7)
Niederer et al. (2012), Switzerland, Preschools with high migrant population [59]			√	√	√	√	√	Cluster RCT	652 (213 parents with low education)	5-6 years	Health educators and preschool teachers	1 year	High	-anthro, diet NR, PA NR, SB NR
1° Aim: Improve aerobic fitness and obesity prevention			√	√	√	√	√	Cluster RCT	652 (213 parents with low education)	5-6 years	Health educators and preschool teachers	1 year	High	-anthro, diet NR, PA NR, SB NR
Jouret et al. (2009), France, Preschools [58]			√	√	√	√		Cluster RCT	79 kindergartens, 1663 children	2.5-5 years	Dietitian and education aide	2 years	Moderate	+Anthro
1° Aim: Obesity prevention			√	√	√	√		Cluster RCT	79 kindergartens, 1663 children	2.5-5 years	Dietitian and education aide	2 years	Moderate	+Anthro
Fitzgibbon et al. (2005), USA, Black preschool children [62]			√	√	√	√	√	Cluster RCT	12 preschools, 409 children	3-5 years	Trained child educators	2 years	Moderate	+Anthro -diet,
														-PA
1° Aim: Obesity prevention														-PA
Fitzgibbon et al. (2006), USA, Latino preschool children [63]			√	√	√	√	√	Cluster RCT	12 preschools,	3-5 years	Trained child educators	2 years	Moderate	-anthro, -diet,
									401					-PA, -SB
1° Aim: Obesity prevention									401					-PA, -SB
Fitzgibbon et al. (2011), USA, Black preschool children [64]			√	√	√	√	√	Cluster RCT	18 preschools, 618 children	3-5 years	Classroom teachers	14 weeks	Low	+PA, +SB, -diet, -anthro
1° Aim: Obesity prevention			√	√	√	√	√	Cluster RCT	18 preschools, 618 children	3-5 years	Classroom teachers	14 weeks	Low	+PA, +SB, -diet, -anthro
Fitzgibbon et al. (2013), USA Latino preschool children and their families [61]			√	√	√	√	√	Cluster RCT	4 preschools, 146 children	3-5 years	Bilingual educators	1 year	Low	-anthro, -diet,
														-PA, -SB
1° Aim: Obesity prevention														-PA, -SB
Winter et al. (2013), USA, low income Latino preschool children [66]			√	√	√	√	√	Quasi-experimental	4 preschools, 405 children	3-5 years	Teachers, Promotoras	6 m	Low	-anthro, +PA
1° Aim: Obesity prevention and school readiness			√	√	√	√	√	Quasi-experimental	4 preschools, 405 children	3-5 years	Teachers, Promotoras	6 m	Low	-anthro, +PA
Community setting (n=7)
Horodynski et al. (2004), USA, rural low income carers 1–3 year olds [68]			√					Quasi-experimental	38	1-3 years	Trained paraprofessional	6 m	Moderate	-diet
1° Aim: Improve child diet			√					Quasi-experimental	38	1-3 years	Trained paraprofessional	6 m	Moderate	-diet
Horodynski et al. (2005), USA low income families with toddlers [69]		√	√					Quasi-experimental	135	11-25 months	Peer educator	6 m	Low	-PFP
1° Aim: Improve child diet		√	√					Quasi-experimental	135	11-25 months	Peer educator	6 m	Low	-PFP
Davison et al. (2013), USA, Head start attendees, 2-5 years [67]			√	√	√	√	√	Before and After	154	2-5 years	Trained facilitators	6 m	Low	+diet, +PA,
														+SB, +anthro
1° Aim: Obesity prevention														+SB, +anthro
O’Dwyer et al. (2012), UK, Sure Start attendees, 3–5 years [70]				√	√		√	Cluster RCT	77 families, 79 children	3-4.9 years	Researcher	10 weeks	Moderate	+PA
											Play professionals			+SB
1° Aim: Improve child PA and reduce SB											Play professionals			+SB
Barkin et al. (2012), USA, Latino-American Preschool aged children [71]			√	√	√	√	√	RCT	106	2-6 years	Trained facilitator	3 m	Moderate	+anthro
1° Aim: Obesity prevention			√	√	√	√	√	RCT	106	2-6 years	Trained facilitator	3 m	Moderate	+anthro
Slusser et al. (2012), USA low income Latino parents with 2–4 year olds [73]			√	√		√	√	RCT	160	2-4 years	Bilingual social worker	1 year	Moderate	+anthro
1° Aim: Obesity Prevention			√	√		√	√	RCT	160	2-4 years	Bilingual social worker	1 year	Moderate	+anthro
Bender et al. (2013), USA, low income Mexican parents with 3–5 year olds [72]			√	√		√	√	Before and after	33	3-5 years	Promotoras	15 m	Low	+diet, -anthro
1° Aim: Improve child diet and maternal PA			√	√		√	√	Before and after	33	3-5 years	Promotoras	15 m	Low	+diet, -anthro

BF: breastfeeding, PFP: Parental feeding practices, PA: physical activity, SB: sedentary behaviour, Anthro: anthropometrics, 1°: Primary, ¹theoretical basis of the intervention reported. Low quality: two or more weak ratings; moderate quality: less than four strong and one weak rating, high quality: four strong and no weak ratings, outcomes: +: significant effect, -: no significant effect, NR: not reported.

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ISSN: 1471-2458

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