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Table 3 Intervention characteristics, children

From: Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review

Author, year (ref) Study designa Intervention group content Comparison group content Intervention group delivery Comparison group delivery Theoretical Basis Cultural Strategies Major Cardio metabolic
Findingsb
Chen 2008 [34] pre-post single arm Tailored educational materials on nutrition, physical activity, and healthy weight maintenance based on baseline assessment of their children’s weight, diet, and physical activity. Parents were instructed to follow the recommendations and share information with their children. NA Mothers were mailed one educational package to their homes. Researchers called parents to ensure mailed materials were understood. NA Ecological Model of Childhood Obesity Prevention (Davison and Birch, 2001) Materials were modified to be compatible with Chinese and Chinese American culture. Researchers were bilingual and bicultural, and information presented to the mothers was in Chinese and English. BMI declined significantly among children who were in the overweight category at baseline (p = 0.01).
Chen 2010 [27] RCT ABC Intervention:In sessions, children spent 15 min on physical activities and 30 min were focused on children’s knowledge regarding nutrition and physical activity and reinforced the notion of self-efficacy regarding food choices and alternatives to high-fat and high-sugar foods and television viewing.
The parent intervention included a workbook, video clips and discussion of techniques.
Wait-list control group participated in data collection activities at the same time as the intervention group. Small group weekly session activities for children, and two small group workshops for parents. Children received a food diary, books, and a weekly packet of materials. After completing the final follow-up assessment, the control group received the ABC study intervention. Social Cognitive Theory (Bandura) Workshops were led by bicultural/bilingual staff. Materials were provided in both Chinese and English. Intervention decreased body mass index and diastolic blood pressure.
Chen 2011 [28] RCT Web-based tailored program including activities to improve nutrition, physical activity, and coping. Web-based general health information related to nutrition, dental care, safety, common dermatology care, and risk-taking behaviors 8 weekly online sessions for adolescents; 3 15 min lessons for parents 8 weekly online sessions for adolescents; 3 15 min lessons for parents Transtheoretical Model–Stages of Change and social cognitive theory. Intervention delivered in English to adolescents and in English and Chinese to parents; Interactive dietary software program (The Wok) tailored to common Chinese foods. Intervention decreased waist-to-hip ratio and diastolic blood pressure
Chen 2013 [29] pre-post with historical comparison group iStart Smart (educational play-based activities teaching self-efficacy, critical thinking, and problem solving skills related to nutrition, physical activity, and coping). Short video clips with hands-on activities to reinforce concepts; Interactive dietary software (The Wok); 60 min exercise classes (basketball, dodge ball, badminton) weekly for 8 sessions; Provided pedometer, activity diary, and books related to physical activity. One 1-h parent workshop to provide reinforcement and social support. Historical control group with weight, height, and blood pressure measured as the same interval as children in iStart Smart. Parents and children met separately for small-group sessions. 8-weekly, 1.5 h sessions for children;a single 1-h parent workshop. NA Social cognitive theory (Bandura 2004) Intervention delivered in English to children and in English and Chinese to parents.; Interactive dietary software program (The Wok) tailored to common Chinese foods Intervention reduced BMI and BP in overweight and obese children, and improved knowledge and self-efficacy related to nutrition.
Chen 2015 [35] pre-post single arm iStart Smart (based on modifications to the ABC program developed previously by the first author and the national We Can! (Ways to Enhance Children’s Activity & Nutrition) program developed by the National Institute of Health) NA Weekly classroom activities combined with 60 min of each class in physical activity for children. Children also received a pedometer, activity diary, and books related to physical activity. They were encouraged to document their pedometer readings and challenge themselves to achieve 10,000 steps a day.
Medical care was integrated into the program through individualized weight management supervised by a pediatrician at scheduled medical visits during the curriculum, and at structured follow-up intervals. The provider advised the family regarding the patient’s risk for CVD in the context of the lifestyle behaviors, laboratory values, and family history.
NA Social cognitive theory (Bandura 2004) Childrens’ intervention sessions were led by a bicultural, bilingual research assistant. The parent workshop was conducted in Cantonese and English and discussed both Chinese and western diets. Average BMI percentile decreased from 94.6 (SD = 7.4) to 93.4(SD = 8.2). Similar reduction of waist/hip ratio and blood pressure were also found at 6 month follow up.
Chen 2016 [36] pre-post single arm Childrens’ weekly workshops included a health curriculum and physical activity. The parent workshops aimed to increase parents’ knowledge and skills regarding healthy food preparation, active lifestyle and maintaining a healthy weight tailored to the needs of each family. The program also included a field trip to a local grocery store. NA The children’s program included 60 min of interactive health curriculum and 60 min of physical activity each week. The parent workshop discussed both Chinese and Western diets and ways to increase physical activity in urban, underresourced communities. NA Social cognitive theory (Bandura 2004) Childrens’ intervention sessions were led by a bicultural, bilingual research assistant. The parent workshop was conducted in Cantonese and English and discussed both Chinese and western diets. Significant reduction of BMI, waist/hip ratio, and systolic blood pressure at 6-month follow-up. In addition, significant improvement of high-density lipoprotein cholesterol and decrease in triglyceride were found at 6-month follow-up.
Chen 2018 [30] RCT Participants (1) used a sensor to track physical activity and diet for six months, (2)reviewed eight online educational modules for three months, and then modules, (3)received tailored, biweekly text messages for three months. Participants (1) used an OmronHJ-105 pedometer and a blank food-and-activity diary to record for three months; (2)reviewed eight online modules related to general adolescent health issues Sequential stages; wearable sensor for 6 months, then reviewed eight online educational modules for three months, and, after completing the modules, received tailored, biweekly text messages for three months Adolescents were asked to track and record physical activity, sedentary activity, and food intake in a diary for three months and were asked to access an online program that consisted of eight modules related to general adolescent health issues Social cognitive theory (Bandura 2004) Materials included concepts and beliefs with regard to promoting balance in health in Chinese and food examples that are consistent with Chinese practices and Western dietary practices. Intervention reduced BMI, sugary beverage, TV and computer time and increased self-efficacy in nutrition and physical activity significantly more than those in the control group.
Sun 2017 [26] RCT Family-centered modules were developed as a tablet-based educational tool adapted from existing programs. These programs contained recommendations (5 servings fruits and vegetables, 4 cups water, 3 servings dairy, 2 h screen time, 1 h physical activity, 0 sugary drinks) for children and families to achieve a healthy lifestyle.. Weekly mailings of printed health information (e.g., food safety, choking hazards, oral health) Intervention consisted of 8 weekly 30-min, interactive, Cantonese, educational modules delivered via tablet. Six of eight lessons were 10 to 15-min animated short videos in Cantonese, and two lessons were in a talk show format hosted by a bilingual registered dietitian. Weekly mailings over an 8-week period Information–Motivation– Behavior (IMB) model Registered dietitians and health educators wrote lesson scripts in English which were then translated into Chinese by an experienced translator on the research team. Intervention reduced maternal body mass index, waist circumference, and improved maternal eating style and self-efficacy for promoting healthy eating.
  1. aRCT Randomized, controlled trial, bBMI Body mass index