Family‐based models for childhood‐obesity intervention: a systematic review of randomized controlled trials

Abstract

Effective interventions are needed to address the growing epidemic of childhood obesity. In the past 35 years, family-based approach has gradually developed as a preferred intervention. This review aimed to examine the methodological rigour and treatment effectiveness of family-based interventions according to intervention types and theoretical orientations. A total of 15 randomized controlled trials (RCTs) of family-based lifestyle interventions for children and adolescents aged 2-19 years were included. The adapted Methodological Quality Rating Scales (MQRS) and a four-grade qualitative scoring scheme were adopted to evaluate the methodological rigour and the effectiveness of treatment, respectively. The average MQRS score was 7.93 out of 14 points. Ten of the 15 RCTs had well aligned their research questions with appropriate research methods. The overall short-term outcome of the15 RCTs were satisfactory with an average score of 3.1. Family-based interventions rooted in behaviour theory achieved better results than those theoretically connected to family systems theory in terms of treatment effectiveness. Results suggest future studies to improve the methodological design and continue to explore the potential of the family systems approach.

Randomised controlled trial evaluating the effectiveness and cost-effectiveness of ‘Families for Health’, a family-based childhood obesity treatment intervention delivered in a community setting for ages 6 to 11 years

“…16 Family-based interventions rooted in behaviour theory have been shown to achieve better treatment effectiveness than those rooted in family systems theory. 17 A recent review of published studies 18 investigating family-based childhood obesity interventions in the UK included 10 studies. The majority of programmes reviewed lasted 12 weeks, with only three studies providing follow-up data at 12 months or longer.…”

Childhood Obesity Prevention: Does Policy Meet Research? Evidence-Based Reflections upon the Spanish Case

“…[35][36][37][38][39][40][41][42][43] In addition, particularly at young ages, habit changes do not directly depend on children but rather on the adults in their environment, principally parents, but also other relatives, neighbors, teachers, and canteen educators. As expected, family involvement emerges as a crucial aspect [36][37][38][39][40][41][42][43][44][45][46][47][48] although a remaining major question concerns how they should be involved. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Public policies against childhood obesity at European level As we can observe in Table 2, actions against childhood obesity have been undertaken from all institutional levels: the WHO, the WHO Regional Office for Europe, the EU Commission and the Spanish government has developed wide-range policies aiming at offering an integral solution to the dramatic rise of obesity rates.…”

A Systematic Review of Pediatric Obesity and Family Communication Through the Lens of Addiction Literature

“…34 Parent-only interventions have proven as successful as those including children, 35 and there is increasing interest in parenting skills to support healthy lifestyle changes. 36 Traditional behavior modification approaches, such as stimulus control, self-monitoring, and goal setting, are also used in a family setting.…”

“…37 Broader familybased approaches, including family therapy, are being considered as family systems theory and other approaches are incorporated into interventions. 34,38 As researchers and clinicians work toward concretely defining family-based treatment of pediatric obesity, it is important to look more closely at the family unit and the relationships of individuals involved in treatment. The circumplex model of family functioning, 39 which states that communication facilitates balance within the family unit, highlights the importance of exploring family communication within a family-based treatment structure.…”