title: A systematic review of the effectiveness of individual, community and societal-level interventions at reducing socio-economic inequalities in obesity among adults.
abstract: BACKGROUND
  Socioeconomic inequalities in obesity are well established in high-income countries. There is a lack of evidence of the types of intervention that are effective in reducing these inequalities among adults.
  
  
  OBJECTIVE
  To systematically review studies of the effectiveness of individual, community and societal interventions in reducing socio-economic inequalities in obesity among adults.
  
  
  METHODS
  Nine electronic databases were searched from start date to October 2012 along with website and grey literature searches. The review examined the best available international evidence (both experimental and observational) of interventions at an individual, community and societal level that might reduce inequalities in obesity among adults (aged 18 years or over) in any setting and country. Studies were included if they reported a body fatness-related outcome and if they included a measure of socio-economic status. Data extraction and quality appraisal were conducted using established mechanisms and narrative synthesis was conducted.
  
  
  RESULTS
  The 'best available' international evidence was provided by 20 studies. At the individual level, there was evidence of the effectiveness of primary care delivered tailored weight loss programmes among deprived groups. Community based behavioural weight loss interventions and community diet clubs (including workplace ones) also had some evidence of effectiveness-at least in the short term. Societal level evaluations were few, low quality and inconclusive. Further, there was little evidence of long term effectiveness, and few studies of men or outside the USA. However, there was no evidence to suggest that interventions increase inequalities.
  
  
  CONCLUSIONS
  The best available international evidence suggests that some individual and community-based interventions may be effective in reducing socio-economic inequalities in obesity among adults in the short term. Further research is required particularly of more complex, multi-faceted and societal-level interventions.
authors.affiliation: 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [3] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: F C
authors.initials: FC
authors.lastname: Hillier-Brown
authors.affiliation: 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Bambra
authors.affiliation: 1] Department of Geography, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: J-M
authors.initials: JM
authors.lastname: Cairns
authors.affiliation: Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kasim
authors.affiliation: 1] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: H J
authors.initials: HJ
authors.lastname: Moore
authors.affiliation: 1] School of Medicine, Pharmacy and Health, Wolfson Research Institute, Durham University Queen's Campus, Stockton-on-Tees, UK [2] Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees, UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Summerbell
mesh_terms: D000328:Adult; D003153:Community Health Services; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000592:standards / Q000706:statistics & numerical data; D019049:Developed Countries; D055317:Evidence-Based Practice; D006293:Health Promotion / Q000458:organization & administration* / Q000592:standards; D054625:Healthcare Disparities; D006801:Humans; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D064887:Observational Studies as Topic; D011204:Poverty Areas; D015397:Program Evaluation; D011634:Public Health; D016032:Randomized Controlled Trials as Topic; D012923:Social Class; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000458:organization & administration* / Q000592:standards