Components of primary care interventions to treat childhood overweight and obesity: a systematic review of effect

• Published in: Obesity reviews 2011-05, Vol.12 (5), p.e219-e235
• Main Authors: Sargent, G.M, Pilotto, L.S, Baur, L.A
• Format: Article
• Language: English
• Subjects: behavior change; Child; childhood obesity; Children; counseling; Delivery of Health Care - methods; Delivery of Health Care - organization & administration; Delivery of Health Care - standards; Diet (effects); Education; Health (care); Health Behavior; health care workers; Health Promotion; healthy diet; Humans; intervention; Intervention component; Medicine; Motivation; Obesity; Obesity - prevention & control; Objectives; overweight; Overweight - prevention & control; paediatric; Patient Education as Topic; Preventive health; primary care; Primary Health Care - methods; Primary Health Care - organization & administration; Primary Health Care - standards; Reviews; systematic review; Weight Loss
• ISSN: 1467-7881; 1467-789X
• DOI: 10.1111/j.1467-789X.2010.00777.x

The primary care setting presents an opportunity for intervention of overweight and obese children but is in need of a feasible model-of-care with demonstrated effectiveness. The aims were to (i) identify controlled interventions that treated childhood overweight or obesity in either a primary care setting or with the involvement of a primary healthcare professional and (ii) examine components of those interventions associated with effective outcomes in order to inform future intervention trials in primary care settings. Major health and medicine databases were searched: MEDLINE, CINAHL, EMBASE, Cochrane Reviews, CENTRAL, DARE, PsychINFO and ERIC. Articles were excluded if they described primary prevention interventions, involved surgical or pharmacological treatment, were published before 1990 or not published in English. Twenty-two papers describing 17 studies were included. Twelve studies reported at least one significant intervention effect. Comparison of these 12 interventions provides evidence for: training for health professionals before intervention delivery; behaviour change options (including healthy diet, activity and sedentary behaviour); effecting behaviour change via a combination of counselling, education, written resources, support and motivation; and tailoring intensity according to whether behavioural, anthropometric or metabolic changes are the priority. These components are practicable to future intervention studies in primary care.