Strength of obesity prevention interventions in early care and education settings: A systematic review.
2010-2015; INTERNATIONAL: Given the high levels of obesity in young children, numbers of children in out-of-home care, and data suggesting a link between early care and education (ECE) participation and overweight/obesity, obesity prevention in ECE settings is critical. As the field has progressed, a number of interventions have been reviewed yet there is a need to summarize the data using more sophisticated analyses to answer questions on the effectiveness of interventions. We conducted a systematic review of obesity prevention interventions in center-based ECE settings published between 2010 and 2015. Our goal was to identify promising intervention characteristics associated with successful behavioral and anthropometric outcomes. A rigorous search strategy resulted in 43 interventions that met inclusion criteria. We developed a coding strategy to assess intervention strength, used a validated study quality assessment tool, and presented detailed descriptive information about interventions (e.g., target behaviors, intervention strategies, and mode of delivery). Intervention strength was positively correlated with reporting of positive anthropometric outcomes for physical activity, diet, and combined interventions, and parent engagement components increased the strength of these relationships. Study quality was modestly related to percent successful healthy eating outcomes. Relationships between intervention strength and behavioral outcomes demonstrated negative relationships for all behavioral outcomes. Specific components of intervention strength (number of intervention strategies, potential impact of strategies, frequency of use, and duration of intervention) were correlated with some of the anthropometric and parent engagement outcomes. The review provided tentative evidence that multi-component, multi-level ECE interventions with parental engagement are most likely to be effective with anthropometric outcomes.
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States. Electronic address: dsward@email.unc.edu.
Dianne S
DS
Ward
Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States.
Emily
E
Welker
Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States.
Ashley
A
Choate
Henderson Consulting, Guilford, CT, United States.
Kathryn E
KE
Henderson
Healthy Eating Research, Duke Global Health Institute, Duke University, Durham, NC, United States.
Megan
M
Lott
Department of Nutrition and Food Sciences, University of Rhode Island, South Kingstown, RI, United States.
Alison
A
Tovar
Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States.
Amanda
A
Wilson
Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States.
James F
JF
Sallis
D002654:Child Care; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D010290:Parents
Child care; Child, preschool; Diet, food, and nutrition; Motor activity; Pediatric obesity; Physical activity