title: A systematic review of the effectiveness of whole-of-community interventions by socioeconomic position.
abstract: Whole-of-community (WOC) interventions have led to modest reductions in population weight gain. Whether they exhibit differential effectiveness by socioeconomic position (SEP) remains unknown. We aimed to summarize evidence of differential effectiveness of WOC interventions by SEP. Electronic databases and grey literature were searched to identify studies that evaluated the effectiveness of a WOC intervention on behavioural change measures, energy balance behaviours and/or anthropometric outcomes according to any measure of SEP. Interventions were assessed for the following characteristics: structural changes to the environment, number of settings the intervention acted in, presence of community engagement and whether equity was considered in its design. Ten studies were included. Nine reported a greater or equal effect among low SEP groups compared with high SEP groups. These studies commonly featured interventions that incorporated structural changes to the environment, acted across more than three settings and/or employed community engagement. Conclusions did not change when excluding low-quality studies (n = 4). WOC interventions represent an effective and equitable approach for the reduction of population weight. Structural components, a larger number of settings and community engagement were common in equitable WOC interventions and should be considered in the design of future WOC interventions.
authors.affiliation: Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Boelsen-Robinson
authors.affiliation: Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Peeters
authors.affiliation: Deakin Population Health, Deakin University, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Beauchamp
authors.affiliation: Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Chung
authors.affiliation: Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Gearon
authors.affiliation: Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.|Department of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Backholer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003153:Community Health Services / Q000458:organization & administration*; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D011634:Public Health; D012111:Residence Characteristics; D040242:Risk Reduction Behavior; D012959:Socioeconomic Factors; D015430:Weight Gain
keywords: Equity; obesity; socioeconomic; whole of community