Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review
Year: 2025
Type: review
Study design: Systematic Review
Abstract: BACKGROUND: Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) systematically characterise the target behaviours, delivery features, and Behaviour Change Techniques (BCTs) used in interventions in the international Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration, and 2) explore similarities and differences in BCTs used in interventions by target behaviour domains. METHODS: Annual systematic searches were performed in MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, and two clinical trial registries, from inception to February 2023. Trialists from eligible randomised controlled trials of parent-focused, behavioural early obesity prevention interventions shared unpublished intervention materials. Standardised approaches were used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials. Validation meetings confirmed coding with trialists. Narrative syntheses were performed. RESULTS: Thirty-two trials reporting 37 active intervention arms were included. Interventions targeted a range of behaviours. The most frequent combination was targeting all parental behaviour domains (infant [milk] feeding, food provision and parent feeding, movement, sleep health; n[intervention arms] = 15/37). Delivery features varied considerably. Most interventions were delivered by a health professional (n = 26/36), included facilitator training (n = 31/36), and were interactive (n = 28/36). Overall, 49 of 93 unique BCTs were coded to at least one target behaviour domain. The most frequently coded BCTs were: Instruction on how to perform a behaviour (n[intervention arms, separated by domain] = 102), Behavioural practice and rehearsal (n = 85), Information about health consequences (n = 85), Social support (unspecified) (n = 84), and Credible source (n = 77). Similar BCTs were often used for each target behaviour domain. CONCLUSIONS: Our study provides the most comprehensive description of the behaviour change content of complex interventions targeting early childhood obesity prevention available to date. Our analysis revealed that interventions targeted multiple behaviour domains, with significant variation in delivery features. Despite the diverse range of BCTs coded, five BCTs were consistently identified across domains, though certain BCTs were more prevalent in specific domains. These findings can be used to examine effectiveness of components and inform intervention development and evaluation in future trials. TRIAL REGISTRATION: PROSPERO registration no. CRD42020177408.
Authors: Brittany J. Johnson, Paul M. Chadwick, Samantha Pryde, Anna Lene Seidler, Kylie E. Hunter, Mason Aberoumand, Jonathan G. Williams, Hei In Lau, Sol Libesman, Jannik Aagerup, Angie Barba, Louise A. Baur, Samantha Morgillo, Lee Sanders, Sarah Taki, Kylie D. Hesketh, Karen Campbell, Alexandra Manson, Alison Hayes, Angela Webster, Charles Wood, Denise A. O’Connor, Karen Matvienko-Sikar, Kristy Robledo, Lisa Askie, Luke Wolfenden, Rachael Taylor, H. Shonna Yin, Vicki Brown, Alexander Fiks, Alison Ventura, Ata Ghaderi, Barry J. Taylor, Cathleen Stough, Christine Helle, Cristina Palacios, Eliana M. Perrin, Elizabeth Reifsnider, Finn Rasmussen, Ian M. Paul, Jennifer S. Savage, Jessica Thomson, Jinan Banna, Junilla Larsen, Kaumudi Joshipura, Ken K. Ong, Levie Karssen, Li Ming Wen, Márcia Vitolo, Margrethe Røed, Maria Bryant, Maribel Campos Rivera, Mary Jo Messito, Natalia Golova, Nina Cecilie Øverby, Rachel Gross, Rajalakshmi Lakshman, Rebecca Byrne, Russell L. Rothman, Sharleen O’Reilly, Stephanie Anzman-Frasca, Vera Verbestel, Claudio Maffeis, Kayla de la Haye, Sarah-Jeanne Salvy, Seema Mihrshahi, Janani Ramachandran, Paola Seffrin Baratto, Rebecca K. Golley, Anne-Louise Heath, David McCormick, Katie Angotti, Kim Roberts, Julia Valmorbida, David Nguyen, Nipun Shrestha, Chris Rissel, David Espinoza, Ian Marschner, Lucinda Bell, Lukas Staub, Michelle Sue-See, Peter Godolphin, Wendy Smith, Alison Karasz, Amanda Thompson, Ana Maria Linares, Ana Perez Exposito, Carolina González Acero, Cindy-Lee Dennis, David McCormick, Deborah Jacobvitz, Elizabeth Widen, Emily Oken, Eric Hodges, Eva Corpeleijn, Heather Wasser, Hein Raat, Hongping Xia, Ken Ong, Lene Kierkegaard, Logan Manikam, Lynne Daniels, Maribel Campos Rivera, Michael Goran, Priyanka Patil, Pujitha Wickramasinghe, Tiffany Rybak, Trine Pedersen, Shannon Whaley, Vasana Kiridana, Vera Verbeste
Institutions: Flinders University, Caring Futures Institute, University College London, The University of Sydney, National Health and Medical Research Council, Stanford University, Sydney Local Health District, Deakin University, Duke University, Duke Medical Center, Monash University, University College Cork, University of Newcastle Australia, University of Otago, New York University, Children's Hospital of Philadelphia, University of Pennsylvania, California Polytechnic State University, Karolinska Institutet, University of Cincinnati, University of Agder, Florida International University, Johns Hopkins University, Arizona State University, Pennsylvania State University, Agricultural Research Service, United States Department of Agriculture, University of Hawaiʻi at Mānoa, Radboud University Nijmegen, Harvard University, University of Cambridge, University of Puerto Rico, Medical Sciences Campus, University of York, Brown University, Hasbro Children's Hospital, Queensland University of Technology, Vanderbilt University Medical Center, University College Dublin, University at Buffalo, State University of New York, Maastricht University, Care and Public Health Research Institute, University of Verona, University of Southern California, Cedars-Sinai Medical Center, Macquarie University, Universidade Federal de Ciências da Saúde de Porto Alegre
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,177
Funders: U.S. Department of Agriculture, Hawaii Community Foundation, Patient-Centered Outcomes Research Institute, Children's Trust, W.K. Kellogg Foundation, University of Cincinnati, Hospital Research Foundation, David and Elaine Potter Foundation, Children's Miracle Network Hospitals, National Institute for Health and Care Research, European Commission, Flinders University, Fonds NutsOhra, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Vetenskapsrådet, Forskningsrådet om Hälsa, Arbetsliv och Välfärd, Università degli Studi di Verona, National Institutes of Health, Health Resources and Services Administration, Medical Research Council, National Health and Medical Research Council, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: TOPCHILD (Transforming Obesity Prevention for CHILDren). Looking into the black box of interventions, G1352680067, A Randomized Controlled Trial of an Interactive Non-Stigmatizing Intervention to Prevent Eating Disorder in Youths Through Strengthening of Protective Factors with Potential for Wide Implementation, G1721945061, G1744303664, G2034001405, G2290696482, G2644908011, Early intervention to prevent childhood obesity among a disadvantaged population:, G2944898437, G3549587228, G3636943619, Obesity prevention Phase 2 follow-up and cost-effectiveness analysis, G4289704537, G4294200505, G444796414, G4493575439, Transforming approaches to chronic disease prevention in community settings, A partnership approach linking two randomised controlled trials for optimising early obesity prevention programs for children under 3 years, G5525854376, Implementation Action to prevent Diabetes from Bump 2 Baby (IMPACT DIABETES B2B): a low-resource system of care intervention for appropriate gestational weight gain and improved postnatal outcomes, G6350353692, NHLBI Community Engagement Technical Assistance Center (CETAC), G676540660, G7426176011, IMPlementaion ACTion to prevent DIABETES from Bump 2 Baby (IMPACT DIABETES B2B), Centre of Research Excellence in the Early Prevention of Obesity in Childhood -Translate (EPOCH-Translate), G953086832
OpenAlex ID: W4407181494