The dose of behavioral interventions to prevent and treat childhood obesity: a systematic review and meta-regression
Year: 2017
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: A better understanding of the optimal "dose" of behavioral interventions to affect change in weight-related outcomes is a critical topic for childhood obesity intervention research. The objective of this review was to quantify the relationship between dose and outcome in behavioral trials targeting childhood obesity to guide future intervention development. METHODS: A systematic review and meta-regression included randomized controlled trials published between 1990 and June 2017 that tested a behavioral intervention for obesity among children 2-18 years old. Searches were conducted among PubMed (Web-based), Cumulative Index to Nursing and Allied Health Literature (EBSCO platform), PsycINFO (Ovid platform) and EMBASE (Ovid Platform). Two coders independently reviewed and abstracted each included study. Dose was extracted as intended intervention duration, number of sessions, and length of sessions. Standardized effect sizes were calculated from change in weight-related outcome (e.g., BMI-Z score). RESULTS: Of the 258 studies identified, 133 had sufficient data to be included in the meta-regression. Average intended total contact (# sessions x length of sessions) was 27.7 (SD 32.2) hours and average duration was 26.0 (SD 23.4) weeks. When controlling for study covariates, a random-effects meta-regression revealed no significant association between contact hours, intended duration or their interaction and effect size. CONCLUSIONS: This systematic review identified wide variation in the dose of behavioral interventions to prevent and treat pediatric obesity, but was unable to detect a clear relationship between dose and weight-related outcomes. There is insufficient evidence to provide quantitative guidance for future intervention development. One limitation of this review was the ability to uniformly quantify dose due to a wide range of reporting strategies. Future trials should report dose intended, delivered, and received to facilitate quantitative evaluation of optimal dose. TRIAL REGISTRATIONS: The protocol was registered on PROSPERO (Registration # CRD42016036124 ).
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,177
Funders: National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Diabetes and Digestive and Kidney Diseases, Office of Behavioral and Social Sciences Research, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: TARGETING OBESITY AND BLOOD PRESSURE IN URBAN YOUTH, University of Minnesota Clinical and Translational Science Institute (UMN CTSI), GROW Baby: Improving Maternal Gestational Weight Gain and Infant Growth in the Growing Right Onto Wellness (GROW) Trial, Multiple Chronic Conditions_Interdisciplinary Nurse Scientist Training, Childhood Obesity Prevention and Treatment Research Coordinating Unit, G4523881014, Growing Right Onto Wellness (GROW): Changing Early Childhood BMI Trajectories, Linking Primary Care, Communities and Families to Prevent Obesity Among Preschool, G7955088541, Vanderbilt Center for Diabetes Translation Research, Nutrition Obesity Research Center (NORC), Clinic, Family & Community Collaboration to Treat Overweight and Obese Children
OpenAlex ID: W2768727694