title: Systematic review of community-based childhood obesity prevention studies.
abstract: OBJECTIVE
  This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries.
  
  
  METHODS
  We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer's data abstraction for completeness and accuracy.
  
  
  RESULTS
  Nine community-based studies were included; 5 randomized controlled trials and 4 non-randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake).
  
  
  CONCLUSIONS
  The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting.
authors.affiliation: Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. sbleich@jhsph.edu
authors.forename: Sara N
authors.initials: SN
authors.lastname: Bleich
authors.forename: Jodi
authors.initials: J
authors.lastname: Segal
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Renee
authors.initials: R
authors.lastname: Wilson
authors.forename: Youfa
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D003430:Cross-Sectional Studies; D019049:Developed Countries; D004038:Diet, Reducing; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States
keywords: childhood obesity; community-based; prevention