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Table 2 Characteristics of included studies of prevention or treatment interventions for Māori and Pacific Islander children and adolescents

From: Interventions to prevent or treat childhood obesity in Māori & Pacific Islanders: a systematic review

Authors & CountryDesignParticipants and retentionIntervention CharacteristicsControlOutcome Measure/sMain Findings
   SettingDescriptionDose   
Anderson, C.Y et al. [22] (2017) (NZ)RCT (Treatment)n = 103 (I: n = 69; C: n = 69); aged 5–16 y with overweight/ obesity and comorbidities; 49% female; 45% Māori
Retention: 69% (31% dropout)
Community sporting venues (intervention);
Home (assessments)
“Whānau Pakari Program”
Multidisciplinary program, delivered by a physical activity coordinator, dietitian, and psychologist. Sessions focused on an introduction to sports, making sustainable healthy lifestyle change and dietary education.
12-month, weekly group sessions.
6- and 12-month follow-up with home visits, assessments, and advice
Physical assessments and advice bi-annually for 2 years(1) Anthropometry: BMI SDS change, baseline − 12 mo.
(2) Psychological: quality of life (HR-QOL); psychological characteristics (CBCL);
Cardiometabolic: PA (steps/day; PA intensity); CV fitnessa; glycated hemoglobin; fasting insulin; Behavioural: screen time
No difference in BMI SDS reduction after 12 mo in Māori participants. CV fitness and HR-QOL sig. Improved in Māori participants. Attendance of ≥70% sessions sig. Increased BMI SDS reduction, CV fitness, parent HR-QOL and CBCL score.
Chansavang, Y. et al. [23] (2015) (NZ)Pre/post mixed methods (Treatment)n = 18; “less-active adolescents”, mean age 16.3 y; 78% female; 72% Pacific; 28% Māori
Retention: 89% (11% dropout)
Recreation Centre (after-school)Group-based exercise and lifestyle intervention program. Sessions focused on a variety of physical activities, with dietary and lifestyle education delivered post-session. Text message support was provided, containing health-related quotes.6-week, 3 × 1.5 h per week sessions; follow-up at intervention conclusionNone(1) Cardiometabolic: VO2max; insulin resistance
(2) Cardiometabolic: glycated hemoglobin; fasting plasma glucose; fasting lipid profile; PA levels (IPAQ); Anthropometry: BMI, waist circumference; Behavioural (qualitative): session attendance; comments on program feasibility
Significant improvements in VO2max, systolic BP, weekly vigorous and moderate PA; however, waist circumference sig. Increased. No change in BMI or weight. Feasibility comments were positive, related to sport participation and helpfulness of texts.
Gittelsohn, J. et al. [24] (2010) (USA - Hawaii)Pre/post with control (Prevention)n = 117 (I: n = 64; C: n = 53) child-caregiver pairs; mean child age 9.8 y; 65% Native Hawaiian or Pacific Islander; 50% female (child); 95% female (caregiver)
Retention: 67% (33% dropout)
Five stores in two communities in Oahu and the Big Island. Population size: Oahu (n =
10,506); Big Island (n = 5748)
“Healthy Foods Hawaii”
Increase availability of healthy foods in community stores. Intervention phases targeted: (1) Healthier beverages; (2) Healthier snacks; (3) Healthier condiments; and (4) Healthier meals. Educational and labelling materials were promoted in-store. Cooking demonstrations performed 4–6 times per phase.
Four phases, 6–8 weeks each, with 1–2 week break intervals.Two communities on each island with no intervention(1) Adult caregiver psychosocial factor and food-related behaviours (CIQ); Child psychosocial factors, food-related behaviours and food intake (CCIQ)Mostly no differences overall; however, significant caregiver improvement in perceiving healthy foods as convenient, and significant child improvement in overall dietary score, particularly water and grain consumption.
Maddison, R. et al. [27] (2014) (NZ)RCT (Treatment)n = 251 (I: n = 127; C: n = 124); aged 9–12 years with overweight/ obesity; 43% female; 13% Māori, 53% Pacific
Retention: 95% (5% dropout)
Home environment with complementary digital intervention avenuesSWITCH
Reducing all leisure-based screen-time activities in the home. Three elements offered to families: (1) Behaviour change strategies; (2) Budgeting media time; (3) Activity pack for children.
20 weeks, initial face-to-face, then monthly digital resources. Follow-up at 24 week post-randomisation (4 weeks post-intervention)Usual behaviour(1) Anthropometry: BMI z-score
(2) Anthropometry: BMI, weight (kg), WC, %BF; Cardiometabolic: PA frequency & intensity; Behavioural: total sedentary time (mins), sleep, dietary intake, enjoyment of PA and sedentary behaviour
No significant differences.
Rush, E. et al. [26] (2012) (NZ)RCT (Prevention)n = 926 (I: n = 492; C: n = 434); aged 5–7 y; 51% female; 23% Māori
n = 446 (I: n = 200; C: n = 226); aged 10–12 y; 51% female; 33% Māori
Retention:
Aged 5-7y - 80% (20% dropout)
Aged 10-12y − 57% (43% dropout)
124 primary schoolsProject Energize”
Assignment of a dedicated healthy lifestyle champion - “Energizer” - to each school. Energizers were “agents of change” and integrated physical activity, healthy eating and educational initiatives into daily class activities. Parental nutrition education sessions were delivered.
2 years, no specific dose. Assessments at baseline and 2 years.Schools - no intervention with no restrictions on self-directed initiatives(1) Anthropometry: body composition (BMI; %BF); Cardiometabolic: BP;No significant differences in Māori population.
Rush, R. et al. [25] (2014) (NZ)RCT (Prevention)n = 2959 (I: n = 2474; C: n = 485); aged 6–8 y; 52% female; 36% Māori
n = 3670 (I: n = 2330; C: n = 1340); aged 9-11y; 54% female; 37% Māori
Retention (number of schools): 82% (18% dropout)
193 primary schoolsAs aboveMonths (n) of engagement with each schoolHistorical comparison with 2012 RCT control group [26](1) Cardiometabolic: BP; CV fitnessa; Anthropometry: body composition (BMI; %BF)Overweight/obesity prevalence 31 and 15% lower in younger and older “Energized” children compared to historical comparison, respectively. BMI lower by 3 and 2.4%, respectively. Physical fitness also higher.
  1. NZ New Zealand, RCT Randomised controlled trial, BMI Body mass index, SDS Standard deviation score, HR-QOL Health-related quality of life, CBCL Child behaviour checklist, PA Physical activity, CV Cardiovascular, IPAQ International Physical Activity Questionnaires, BP Blood pressure, CIQ Caregiver Impact Questionnaire, CCIQ Child Customer Impact Questionnaire, SWITCH Screen-Time Weight-loss Intervention Targeting Children at Home, BF Body fat
  2. aAssessed by a 550-m walk/run time trial