Table 1 Summary of twenty studies reporting the relationship of CT programs with body weight, body mass index, overweight, and obesity
Country | Program | Type | Year (s) | Study population | Study design | Methods | Total (n) | Program (n) | Control (n) | Duration of exposure | Findings | Reference |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Children and adolescents | ||||||||||||
Brazil | Bolsa Família | CCT | 2006–2007 | Children < 5 y; 6 largest municipalities in Maranhāo state; overall prevalence overweight 6.7% | Cross-sectional | State of Maranhāo Health Care Study 2006–2007 data; multivariable logistic regression | 1214 | not stated | not stated | not stated | Overweight Treatment prevalence ratio (95% CI) 1.0 (0.5, 1.7) (P = 0.91) | 13 |
Brazil | Bolsa Família | CCT | 2013 | Children 7–16 y; beneficiaries of National School Meals Program in Guariba, Sāo Paulo state | Cross-sectional | Crude chi-square analyses | 409 | 160 | 249 | not stated | Overweight Treatment: 21.9% Control: 23.3% Obese Treatment: 16.9% Control: 28.9% (P < 0.05) | 14 |
Brazil | Bolsa Família | CCT | not stated | Children 9 y; 4th graders in Belo Horizonte, Minas Gerais state | Cross-sectional | Data from larger project on food and nutrition education; two-stage cluster sampling; crude chi-square analyses | 319 | 118 | 201 | not stated | Overweight Treatment: 36.3% Control: 30.7% (P = 0.59) | 15 |
Brazil | Bolsa Família | CCT | 2008–2009 | Adolescents 10–19 y in Northeast region and Southeast region | Cross-sectional | Family Budget Survey 2008–2009 data; propensity score matching used to identify controls; average treatment effect on the treated (ATT) | 4408 | 1858 (Northeast) 346 (Southeast) | 1858 (Northeast) 346 (Southeast) | not stated | Overweight Northeast region: ATT 0.015 (SE 0.015) (n.s.) Southeast region: ATT -0.042 (SE 0.036) (P < 0.05) | 16 |
Colombia | Familias en Acción | CCT | 2002–2006 | Children 2–6 y | Longitudinal | Program evaluation data from 2002–2003 and 2005–2006; difference-in-difference (DD) impact estimates calculated | 2874 | 1290 | 1584 | 3–4 years | Overweight Treatment OR 1.30 (95% CI 0.83, 2.03) (n.s.) Obese Treatment OR 0.56 (95% CI 0.20, 1.53) (n.s.) | 17 |
Peru | Juntos | CCT | 2002–2006 | Children 7–8 y | Longitudinal; non-participants vs participants < 2 y duration vs participants ≥ 2 y duration | Young Lives Study data; propensity score matching used to identify controls; average treatment effect on the treated (ATT); results described for treatment ≥ 2 y | 338 | 169 | 169 | > 2 years | Overweight baseline Treatment: 37.5% Control: 37.9% (P = 0.91) follow-up Treatment: 16.6% Control: 24.9% (P = 0.06) Stratified by sex, overweight in girls: ATT -0.22 pp, 95% CI -42.5, -2.7 pp (P = 0.03) overweight in boys: n.s., ATT not stated | 18 |
Dominican Republic | Solidaridad | CCT | 2010 | Children < 5 y | Cross-sectional | Social Protection Survey 2010 data; propensity score matching used to identify controls; average treatment effect on the treated (ATT) | 2358 | 1179 | 1179 | not stated | Overweight and obesity ATT -7.0 to -8.7 pp (P < 0.05) | 19 |
Japan | Jido teate | UCT | 2016 | Children, grades 1, 5, 8 | Cross-sectional | Kochi Child Health Impact of Living Difficulty Study 2016 data; propensity score matching used to identify controls; multivariable logistic regression | 434 | 217 | 217 | not stated | Overweight Treatment: OR 0.51 (95% CI 0.29, 0.91) (P = 0.024) | 20 |
South Africa | Child Support Grant | UCT | 2012 | Children, 5–14 y | Cross-sectional | National Income Dynamics Study, wave 3 data; crude chi-square | 6951 | 5227 | 1724 | not stated | Overweight Treatment: 14.8% Control: 18.0% Obese Treatment: 8.6% Control: 11.8% (P < 0.001) | 21 |
Mexico | Oportunidades | CCT | 1998–2003 | Adolescents, 15–21 y, rural areas | Longitudinal | Analysis took advantage of random phase-in of CCT; fuzzy regression discontinuity design; effect of CCT on outcomes calculated as local average treatment effect (LATE); program duration averaged 4 y | 2036 | not stated | not stated | not stated | Overweight LATE Women -0.137 (0.302) Men 0.069 (0.055) Obesity LATE Women -0.322 (0.157)* Men 0.132 (0.163) (*P < 0.01) | 22 |
USA | Alaska Permanent Fund Dividend (PFD) | UCT | 2009–2011 | Children age 3 y | Longitudinal | Alaska Longitudinal Child Abuse and Neglect Linkage Project data; obesity age 3 y main outcome; | 885 | not stated | not stated | 3 years | For each $1000, OR 0.69 (P < 0.01) for obesity; equivalent to reducing the average probability by 5.2% | 23 |
Country | Program | Type | Year (s) | Study population | Study design | Methods | Total (n) | Program (n) | Control (n) | Findings | Reference | |
Adults | ||||||||||||
Peru | Juntos | CCT | 2007–2013 | Mothers | Cross-sectional | Demographic and Health Survey data collected annually 2007–2013; individual and district level analyses; propensity score matching used to identify controls; generalized linear models | 5143 individual 24,242 district | not stated | not stated | not stated | Overweight Individual level analysis Prevalence ratio 1.06 (95% CI 0.98, 1.15), (P = 0.17) District level analysis Prevalence ratio 0.94 (95% CI 0.90, 0.98), (P < 0.001) | 24 |
Mexico | Non-contributory pension | UCT | 2007–2008 | Adults > 70 y, rural areas, 7 states | Longitudinal | Adults with 11 months exposure to treatment; discontinuity regression approach; 4023 adults | 4023 | not stated | not stated | 11 months | BMI Treatment -0.059 kg/m2 (P = 0.48) | 25 |
Mexico | Non-contributory pension | UCT | 2008–2009 | Adults > 70 y in Yucatan state | Longitudinal | Valladolid city, treatment group; Motul city, control group; difference-in-difference (DD) impact estimates calculated | 1650 | 1146 | 504 | 6 months | DD of means (SEM) BMI 0.111 (0.120) (n.s.) Overweight -0.037 (0.025) (n.s.) Obese 0.020 (0.018) (n.s.) | 26 |
Mexico | Oportunidades | CCT | 2002, 2005–2006, 2009–2012 | Adults, representative sample of Mexican population at national, rural–urban, and regional level | Longitudinal | Mexican Family Life Survey data; CCT participants (235 stayed in program, 192 left program) and non-participants; propensity score matching used to identify controls; triple difference-in-difference (DDD) impact estimates calculated; average treatment effect on the treated (ATT) | 7131 | 427 | 6704 | variable, up to 10 years | BMI DDD estimate ATT -1.43 kg/m2 (P < 0.05) | 27 |
Colombia | Familias en Acción | CCT | 2002, 2006 | Women ≥ 18 y | Longitudinal | Surveys conducted in 2002 and 2006; difference-in-difference (DD) impact estimates calculated | 2073 | 1238 | 835 | 4 years | BMI Treatment β = 0.25 (95% CI 0.03, 0.47 (P = 0.03) Overweight Treatment OR 1.06 (95% CI 0.90, 1.26) (P = 0.46) Obesity Treatment OR 1.27 (95% CI 1.03, 1.57) (P = 0.03) | 28 |
Mexico | Oportunidades | CCT | 2003 | Adults from rural areas of 7 states | Cross-sectional | Adults receiving CCT for 3.5–5 y compared with newly recruited control group; propensity score matching used to identify controls; ordinary least squares regression | 6343 | 5280 | 1063 | not stated | Overweight Treatment: 59.24% Control: 63.04% (P = 0.03) Obesity Treatment: 20.28% Control: 25.31% (P < 0.001) | 29 |
Mexico | Oportunidades | CCT | 2003–2005 | Women, 18–49 y, from rural communities in southern and eastern Mexico | Longitudinal | Community randomized controlled intervention trial in 235 communities; CT vs food basket vs control; 23 month duration; difference-in-difference (DD) impact estimates calculated | 1507 | 786 | 721 | mean 14 months | Body weight DD estimate (SEM) 0.4 (0.2) (P < 0.05) CT vs control Stratified by normal, overweight, and obese categories at baseline, treatment significantly increased body weight only in women already obese at baseline | 30 |
Canada | Universal Child Care Benefit | UCT | 2001–2014 | Adults, aged 25–49 | Cross-sectional | Canadian Community Health Survey data; treatment group with youngest child 1–5 y, control group with youngest child 6–11 y; difference-in-difference (DD) impact estimates calculated | 217,002 | 107,108 | 109,984 | not stated | BMI Mothers Treatment -0.467 kg/m2 (P < 0.01) Fathers Treatment -0.075 kg/m2 (n.s.) Overweight Mothers Treatment -0.054 (P < 0.01) Fathers Treatment 0.007 (n.s.) Obese Mothers Treatment -0.019 (P < 0.05) Fathers Treatment -0.009 (n.s.) | 31 |
Country | Program | Type | Year (s) | Study population | Study design | Methods | Total (n) | Program (n) | Control (n) | Findings | Reference | |
Both children and adults | ||||||||||||
Colombia | Familias en Acción | CCT | 2010 | Children < 5 y; mothers 18–49 y | Cross-sectional | Demographic and Health Survey data; analysis based upon four household (HH) typologies: normal HH, n = 4200 (no stunting or obesity in children, mother normal BMI); underweight HH, n = 1250 (at least 1 child stunted, mother underweight); overweight HH, n = 5085 (at least 1 child obese, mother overweight/obese or normal); dual-burden HH, n = 713 (at least 1 child stunted, mother overweight/obese); 11,248 households in analysis | 11,248 households | not stated | not stated | not stated | Treatment Underweight typology OR 0.8 (95% CI 0.7, 1.0) (P < 0.10) Overweight typology OR 0.9 (95% CI 0.8, 1.0) (P < 0.10) Dual-burden typology OR 0.9 95% CI 0.7, 1.1) (n.s.) | 32 |