A Systematic Review of Obesity Disparities Research.
BACKGROUND
A review of interventions addressing obesity disparities could reveal gaps in the literature and provide guidance on future research, particularly for populations with a high prevalence of obesity and obesity-related cardiometabolic risk.


METHODS
A systematic review of clinical trials in obesity disparities research that were published in 2011-2016 in PubMed/MEDLINE resulted in 328 peer-reviewed articles. Articles were excluded if they had no BMI, weight, or body composition measure as primary outcome or were foreign (n=201); were epidemiologic or secondary data analyses of clinical trials (n=12); design or protocol papers (n=54); systematic reviews (n=3); or retracted or duplicates (n=9). Forty-nine published trials were summarized and supplemented with a review of ongoing obesity disparities grants being funded by the National, Heart, Lung and Blood Institute.


RESULTS
Of the 49 peer-reviewed trials, 27 targeted adults and 22 children only or parent-child dyads (5 of 22). Interventions were individually focused; mostly in single settings (e.g., school or community); of short duration (mostly ≤12 months); and primarily used behavioral modification (e.g., self-monitoring) strategies. Many of the trials had small sample sizes and moderate to high attrition rates. A meta-analysis of 13 adult trials obtained a pooled intervention effect of BMI -1.31 (95% CI=-2.11, -0.52, p=0.0012). Institutional review identified 140 ongoing obesity-related health disparities grants, but only 19% (n=27) were clinical trials.


CONCLUSIONS
The reviews call for cardiovascular-related obesity disparities research that is long term and includes population research, and multilevel, policy, and environmental, or "whole of community," interventions.
NIH, Bethesda, Maryland. Electronic address: prattc@nhlbi.nih.gov.
Charlotte A
CA
Pratt
NIH, Bethesda, Maryland.
Catherine M
CM
Loria
NIH, Bethesda, Maryland.
Sonia S
SS
Arteaga
NIH, Bethesda, Maryland.
Holly L
HL
Nicastro
NIH, Bethesda, Maryland.
Maria
M
Lopez-Class
NIH, Bethesda, Maryland.
Janet M
JM
de Jesus
NIH, Bethesda, Maryland.
Pothur
P
Srinivas
NIH, Bethesda, Maryland.
Christine
C
Maric-Bilkan
NIH, Bethesda, Maryland.
Lisa
L
Schwartz Longacre
NIH, Bethesda, Maryland.
Josephine E A
JEA
Boyington
NIH, Bethesda, Maryland.
Abera
A
Wouhib
NIH, Bethesda, Maryland.
Nara
N
Gavini
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002986:Clinical Trials as Topic; D054624:Health Status Disparities; D006801:Humans; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D012107:Research Design / Q000706:statistics & numerical data; D012574:Schools / Q000706:statistics & numerical data; D061217:Weight Reduction Programs / Q000379:methods* / Q000706:statistics & numerical data