title: A systematic review of the effectiveness of individual, community and societal level interventions at reducing socioeconomic inequalities in obesity amongst children.
abstract: BACKGROUND
  Tackling childhood obesity is one of the major contemporary public health policy challenges and vital in terms of addressing socioeconomic health inequalities.We aimed to systematically review studies of the effectiveness of interventions (individual, community and societal) operating via different approaches (targeted or universal) in reducing socio-economic inequalities in obesity-related outcomes amongst children.
  
  
  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 from interventions that aimed to prevent obesity, treat obesity, or improve obesity-related behaviours (diet and/or physical activity) amongst children (aged 0-18 years) in any setting and country, so long as they provided relevant information and analysis on both socioeconomic status and obesity-related outcomes. Data extraction and quality appraisal were conducted using established mechanisms and narrative synthesis was conducted.
  
  
  RESULTS
  We located 23 studies that provided the 'best available' (strongest methodologically) international evidence. At the individual level (n = 4), there was indicative evidence that screen time reduction and mentoring health promotion interventions could be effective in reducing inequalities in obesity. For the community level interventions (n = 17), evidence was inconclusive - with some studies suggesting that school-based health promotion activities and community-based group-based programmes were effective in reducing obesity - others not. Societal level evaluations were few (n = 1). However, there was no evidence to suggest that any of these intervention types increase inequalities and several studies found that interventions could at least prevent the widening of inequalities in obesity. The majority of studies were from America and were of 6-12 year old children.
  
  
  CONCLUSIONS
  The review has found only limited evidence although some individual and community based interventions may be effective in reducing socio-economic inequalities in obesity-related outcomes amongst children but further research is required, particularly of more complex, societal level interventions and amongst adolescents.
authors.forename: Frances C
authors.initials: FC
authors.lastname: Hillier-Brown
authors.affiliation: Department of Geography, Wolfson Research Institute for Health and Wellbeing, Durham University Queen's Campus, Stockton-on-Tees TS17 6BH, UK. clare.bambra@durham.ac.uk.
authors.forename: Clare L
authors.initials: CL
authors.lastname: Bambra
authors.forename: Joanne-Marie
authors.initials: JM
authors.lastname: Cairns
authors.forename: Adetayo
authors.initials: A
authors.lastname: Kasim
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Moore
authors.forename: Carolyn D
authors.initials: CD
authors.lastname: Summerbell
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D006293:Health Promotion; D054624:Health Status Disparities; D006801:Humans; D063766:Pediatric Obesity / Q000517:prevention & control*
references.citation: Int J Epidemiol. 2010 Apr;39(2):372-7
references.pmid: 19887510
references.citation: Public Health Nutr. 2009 Feb;12(2):197-202
references.pmid: 18559131
references.citation: Int J Obes (Lond). 2011 Jul;35(7):891-8
references.pmid: 20975725
references.citation: J Sch Health. 2012 Oct;82(10):457-61
references.pmid: 22954164
references.citation: PLoS One. 2014 Apr 15;9(4):e94670
references.pmid: 24736389
references.citation: Am J Prev Med. 2013 Jun;44(6):e57-66
references.pmid: 23683991
references.citation: Int J Obes Relat Metab Disord. 2004 Apr;28(4):483-93
references.pmid: 14993915
references.citation: BMJ. 2007 Dec 15;335(7632):1241-3
references.pmid: 18079548
references.citation: Int J Obes (Lond). 2007 Oct;31(10):1500-8
references.pmid: 17438555
references.citation: BMJ. 2011 Oct 13;343:d6195
references.pmid: 21998346
references.citation: Soc Sci Med. 2014 Jul;112:80-7
references.pmid: 24820223
references.citation: Br J Sports Med. 2011 Oct;45(13):1052-7
references.pmid: 21112875
references.citation: BMC Public Health. 2014 Apr 02;14:303
references.pmid: 24690078
references.citation: J Epidemiol Community Health. 2013 Feb;67(2):190-3
references.pmid: 22875078
references.citation: Int J Obes (Lond). 2008 Oct;32(10):1489-98
references.pmid: 18626482
references.citation: Int J Obes (Lond). 2014 Dec;38(12):1483-90
references.pmid: 24813369
references.citation: Int J Pediatr Obes. 2011 Jun;6(2-2):e144-53
references.pmid: 20860432
references.citation: Public Health Nutr. 2010 Oct;13(10A):1693-700
references.pmid: 20883568
references.citation: Arch Pediatr Adolesc Med. 2008 Mar;162(3):239-45
references.pmid: 18316661
references.citation: JAMA. 1999 Oct 27;282(16):1561-7
references.pmid: 10546696
references.citation: BMJ. 2014 May 27;348:g3231
references.pmid: 24865459
references.citation: Int J Pediatr Obes. 2006;1(1):11-25
references.pmid: 17902211
references.citation: Am J Epidemiol. 1985 Nov;122(5):772-81
references.pmid: 4050769
references.citation: Ann Epidemiol. 2012 Oct;22(10):698-704
references.pmid: 22884768
references.citation: Int J Obes (Lond). 2008 Jul;32(7):1060-7
references.pmid: 18542082
references.citation: Obes Facts. 2012;5(5):671-92
references.pmid: 23108336
references.citation: BMC Public Health. 2011 Jan 24;11(1):51
references.pmid: 21261988
references.citation: Obes Rev. 2007 Mar;8 Suppl 1:19-22
references.pmid: 17316296
references.citation: BMJ. 2009 Sep 03;339:b3308
references.pmid: 19729418
references.citation: J Epidemiol Community Health. 2007 Jun;61(6):473-8
references.pmid: 17496254
references.citation: Pediatrics. 2010 Aug;126(2):280-8
references.pmid: 20660556
references.citation: Cochrane Database Syst Rev. 2011 Dec 07;(12):CD001871
references.pmid: 22161367
references.citation: Syst Rev. 2012 Feb 23;1:16
references.pmid: 22587775
references.citation: J Pediatr. 2011 May;158(5):796-801.e1
references.pmid: 21244862
references.citation: Arch Pediatr Adolesc Med. 2011 Aug;165(8):714-22
references.pmid: 21464376
references.citation: Ethn Dis. 2003 Winter;13(1 Suppl 1):S65-77
references.pmid: 12713212
references.citation: Prev Med. 2012 May;54(5):335-40
references.pmid: 22373886
references.citation: Obesity (Silver Spring). 2008 Feb;16(2):275-84
references.pmid: 18239633
references.citation: Int J Pediatr Obes. 2011 Jun;6(2-2):e70-7
references.pmid: 21609245
references.citation: J Epidemiol Community Health. 2009 Jan;63(1):4-11
references.pmid: 18718981
references.citation: Drug Alcohol Depend. 2014 May 1;138:7-16
references.pmid: 24674707
references.citation: Arch Pediatr Adolesc Med. 2012 Sep 1;166(9):821-7
references.pmid: 22566517
references.citation: Cad Saude Publica. 2008;24 Suppl 2:S353-9
references.pmid: 18670715
references.citation: Obes Rev. 2004 May;5 Suppl 1:4-104
references.pmid: 15096099