Table 2 Summary details of community level studies included in the review

Kain et al 2004 [36]

Non-randomised cluster controlled trial; 6 month follow-up; Final sample = 3086; Quality = Strong

5 Schools, Chile; 10.6 years; 47% girls

Reduction and prevention of obesity in low SES children

Nutrition and physical activity intervention; Prevention: nutrition education (children and parents), extra time in PE lessons, encouragement of PA during daily recess, healthy snacks in vending machines (voluntary), incentives for healthy eating and sports equipment for schools

Targeted: Low SES schools (35% children receiving School Lunch Program)

BMI z score (boys)

↓

+ (boys)

Triceps skinfold (boys)

↔

Waist circumference (boys)

↔

BMI z score (girls)

↔

Triceps skinfold (girls)

↔

Waist circumference (girls)

↔

Jansen et al 2011 [37]

Cluster RCT; 8 month follow-up; Final sample = 2416; Quality = Strong

20 Schools, The Netherlands; 6-12 years; 51% girls

Weight reduction and prevention of obesity in low SES children

Nutrition and physical activity intervention; Prevention: nutrition, activity living and healthy lifestyle education, 3 PE lessons per week and voluntary additional after-school sport and play activities

Targeted: Low income inner-city, multi-ethnic schools

Children 6-9 years:

+ (6-9 years)

BMI

↔

Waist circumference

↓

Prevalence overweight

↓

Children 9-12 years:

BMI

↔

Waist circumference

↔

Prevalence overweight

↔

Nemet et al 2011 [38]

Cluster RCT; 1 year follow-up; Final sample = 297; Quality = Strong

11 Kindergartens, Israel; 4.2-6.5 years; 45% girls

Prevention of obesity

Nutrition and physical activity intervention; Prevention: Nutrition education classes and flyers for parents; exercise sessions and songs related to topic of nutrition and exercise

Targeted: kindergarten in low SES communities

BMI (boys)

↓

+ (boys)

BMI% (boys

↓

BMI (girls)

↔

BMI% (girls)

↔

Bingham 2002 [39]

Cluster RCT; 1 year follow-up; Final sample = 985; Quality = Strong

12 schools, USA; 8-10 years; 51% girls

CVD risk factor reduction

Nutrition and physical activity intervention; Prevention: CVD risk factor reduction intervention – education (including nutrition and physical activity) and physical activity sessions

Universal: SES was not found to be a moderator of the intervention effect

Skinfold thickness

↓

0

Simon et al 2008 [40]

Randomised cluster trial; 48 month follow-up; Final sample = 732; Quality = Strong

8 schools, Eastern France; 11-12 years; 50% girls

Increase physical activity by changing attitudes, promoting the social support of parents and teachers, making the environment more supportive of physical activities

Physical activity intervention; Prevention: physical activity education and increased physical activity classes, ‘cycling to school’ days and sports events

Universal: no differences in results by parental occupation

BMI

↓

0

Physical activity

↑

TV/video use

↓

Bellows 2007 [41]

Cluster RCT; 18 week follow-up; Final sample = 201; Quality = Strong

4 Head Start centres, USA; 3-5 years; 46% girls

Prevent obesity

Nutrition and physical activity intervention; Prevention: Food Friends Get Movin’ with Mighty Moves^TM intervention – physical activity sessions and nutrition education

Targeted: low-income, ethnic minority preschoolers

BMI z score

↔

0

de Meij et al 2011 [42]

Cluster non-randomised control trial; 20 month follow-up; Final sample = 2064; Quality = Strong

19 schools, The Netherlands; 6-12 years; 50% girls

To increase physical activity among children living in socially and economically deprived areas

Physical activity intervention; Prevention: physical activity education and exercise sessions

Targeted: majority of pupils low SES

BMI

↔

0

Waist circumference

↔

Organised sport participation

↑

Physical activity

↔

Fitness

↔

Herrick et al 2012 [43]

Cluster non-randomised controlled trial; 5 month follow-up; Final sample = 98; Quality = Strong

6 schools, USA; 10-11 years; 55% girls

Increase physical activity levels

Physical activity intervention; Prevention: after-school physical education sessions; self-management education

Targeted: largely low-income population

BMI

↔

0

BMI z score

↔

MVPA

↔

Lubans et al 2012 [44]

Cluster RCT; 12 month follow-up; Final sample = 294; Quality = Strong

12 schools, Australia; 13.2 years; 100% girls

Prevention of unhealthy weight gain in low SES adolescent girls

Nutrition and physical activity intervention; Prevention: Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) – nutrition education; exercise sessions; self-monitoring; social support

Targeted: schools in low-income communities

BMI

↔

0

BMI z score

↔

Body fat%

↔

Sichieri et al 2008 [45]

Cluster RCT; 8 month follow-up; Final sample = 927; Quality = Strong

22 schools, Brazil; 10-11 years; 53% girls

Prevention of excess weight gain

Nutrition intervention; Prevention: educational intervention to reduce consumption of sugar-sweetened beverages and encourage water consumption

Targeted: children from low SES families

BMI (overall)

↔

+ (overweight girls)

BMI (overweight girls)

↓

Walter et al 1985 [46]

Cluster RCT; 1 year follow-up; Final sample = 1115; Quality = Strong

22 Schools, USA; 9 years; 49% girls

Prevention of chronic disease risk factors (including obesity)

Nutrition and physical activity intervention; Prevention: “Know Your Body” curriculum focusing on nutrition physical fitness and smoking prevention

Targeted: Children from low income families

Ponderosity index

↔

0

Triceps skinfold thickness

↔

Robinson 1999 [47]

Randomised cluster trial; 6 month follow-up; Final sample = 192; Quality = Strong

2 schools, USA; 8-9 years; 45% girls

Prevent the onset of obesity

Physical activity intervention; Prevention: education course to reduce TV and video game use including a 10 day TV turn off. Home TV usage monitor. Parental education materials

Universal: no differences in results by parental education

BMI

↓

0

Triceps skin fold thickness

↓

Waist circumference

↓

Waist-hip ratio

↓

Kalavainen et al 2007 [48]

RCT; 12 month follow-up; Final sample = 69; Quality = Strong

1 Health care centre, Finland; 7-9 years; 60% girls; Obese

Treatment of obesity

Nutrition and physical activity intervention; Treatment: Family-based group treatment programme – diet and physical activity education and behavioural therapy

Universal: No association between social class and obesity-related outcomes

Weight for height

↓

0

BMI

↓

BMI SDS

↔

Alves et al 2008 [49]

RCT; 6 month follow-up; Final sample = 68; Quality = Strong

Community setting (exact setting unclear), Brazil; 5-10 years; 49% girls; Overweight

Increase physical activity in overweight children to reduce BMI

Physical activity intervention; Treatment: Physical activity sessions 3 times per week

Targeted: Children from a disadvantaged area

BMI

↓

+

Robinson et al 2003 [50]

RCT (pilot); 12 week follow-up; Final sample = 60; Quality = Strong

Community centres and homes, USA; 8-10 years; 100% girls; At risk of obesity

Prevent further weight gain in low SES African American girls

Physical activity intervention; Treatment: Dance classes and TV viewing reduction intervention (GEMS) targeting African American girls at risk of obesity

Targeted: Recruited from low income neighbourhoods

BMI

↔

0

Waist circumference

↔

Willet 1995 [51]

Non-randomised controlled trial; 1 year follow-up; Final sample = 40; Quality = Strong

1 community setting (exact setting unclear), USA; 7-12 years; 100% girls

Prevention of obesity in low income African American girls

Nutrition and physical activity intervention; Prevention: Mother and daughter culturally specific obesity prevention programme (based on the Know Your Body health education curriculum)

Targeted: low SES, African American girls

BMI

↔

0

% overweight

↔

Hamad et al 2011 [52]

RCT; 1 year follow-up; Final sample = 1501; Quality = Strong

Microcredit institution, Republic of Peru; <5 years

To improve the general health of disadvantaged children

Nutrition and physical activity intervention; Prevention: Microcredit loan with the addition of health education sessions to parents

Targeted: children of families receiving microcredit

BMI

↔

0

% overweight

↔