The IDEFICS intervention trial to prevent childhood obesity: design and study methods

Pigeot, Iris; Baranowski, Tom; Henauw, Stefaan De

doi:10.1111/obr.12345

Cited by 36 publications

(35 citation statements)

References 32 publications

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“…The process data suggested that elements of the intervention were not delivered as planned . There were substantial differences across countries in intervention components, called Best Practices, which were designed to meet culture‐specific needs and strengths . However, the results from the study combined with the generally inconclusive, mixed or null findings in many other obesity prevention programmes for children caution us to rethink our foundations.…”

Section: Discussionmentioning

confidence: 99%

Should the IDEFICS outcomes have been expected?

Baranowski

Lytle

2015

Obesity Reviews

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SummaryThe Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study evaluated with a large sample a comprehensive carefully planned obesity prevention intervention targeting multiple levels of influence that were culturally adapted to the situations in eight European countries. Despite the great effort and attention to detail, the IDEFICS study did not achieve its targeted adiposity or behaviour change objectives. Should we be surprised that the IDEFICS trial did not have its intended effects? We think not, and would have been surprised if it did. Recent research has revealed the lack of consistent meaningful relationships between several apparently obesogenic behaviours and adiposity, weak or no relationships among behavioural change procedures, mediating variables and targeted behaviours and inadequate attention to moderating effects. Future obesity prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and the interrelationships with biological factors. While systems modelling has been proposed as providing the solution, important less complex identification of new constructs, new relationships and community interventions are still needed, both to find innovative solutions and to provide input into the systems models. We should question results from cross-sectional studies and be satisfied only with longitudinal or experimental tests of relationships.

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Section: Discussionmentioning

confidence: 99%

Should the IDEFICS outcomes have been expected?

Baranowski

Lytle

2015

Obesity Reviews

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“…A follow‐up examination, T 1 , was completed during the academic year 2009–2010. For more details on the intervention design see .…”

Section: Methodsmentioning

confidence: 99%

Impact of a community based health‐promotion programme in 2‐ to 9‐year‐old children in Europe on markers of the metabolic syndrome, the IDEFICS study

et al. 2015

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Summary Introduction One objective of ‘Identification and prevention of Dietary‐and lifestyle‐induced health EFfects In Children and infantS’, the IDEFICS study, was to implement a community‐oriented childhood obesity prevention intervention in eight European countries. Objective To assess the effect of an obesity primary prevention programme on metabolic markers. Methods The study had a non‐randomized cluster‐experimental design. In each country, children were recruited from distinct communities serving as intervention and control regions. Health examinations were done during 2007–2008 before the intervention (T0) and during 2009–2010 (T1). Children with results available from T0 and T1 on blood pressure, waist circumference and at least one blood‐marker (fasting glucose, insulin, HOMA‐IR, HbA1c, HDL‐ and LDL‐cholesterol, triglycerides, C‐reactive protein) were included. A metabolic syndrome (MetS) score was calculated. Results A total of 7,406 children (age 2–9.9 years) of the 16,228 participating at T0 provided the necessary data. No effect of the intervention was seen on insulin, HOMA‐IR, CRP or the MetS score. Overall fasting glucose increased less in the intervention than in the control region, a pattern driven by three of the eight countries and more pronounced in children of parents with low education. Overall, HbA1c and waist circumference increased more and blood pressure less in the intervention regions. Conclusion We observed no convincing effect of the intervention on markers of the metabolic syndrome. We identified diverse patterns of change for several markers of uncertain relation to the intervention. © 2015 World Obesity

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“…Historically, behavioral theories have largely focused on complex intra- (e.g., autonomy, self-efficacy) and inter- (e.g., peer social support) personal processes mediating youth physical activity behaviors [6–10]. More recently, the introduction of social-ecological models has expanded the targets of interventions to multiple levels of the environments and settings where youth spend a majority of their time [11–13]. …”

Section: Introductionmentioning

confidence: 99%

The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion

Beets

Okely

Weaver

et al. 2016

Int J Behav Nutr Phys Act

160

147

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BackgroundPhysical activity interventions targeting children and adolescents (≤18 years) often focus on complex intra- and inter-personal behavioral constructs, social-ecological frameworks, or some combination of both. Recently published meta-analytical reviews and large-scale randomized controlled trials have demonstrated that these intervention approaches have largely produced minimal or no improvements in young people’s physical activity levels.DiscussionIn this paper, we propose that the main reason for previous studies’ limited effects is that fundamental mechanisms that lead to change in youth physical activity have often been overlooked or misunderstood. Evidence from observational and experimental studies is presented to support the development of a new theory positing that the primary mechanisms of change in many youth physical activity interventions are approaches that fall into one of the following three categories: (a) the expansion of opportunities for youth to be active by the inclusion of a new occasion to be active, (b) the extension of an existing physical activity opportunity by increasing the amount of time allocated for that opportunity, and/or (c) the enhancement of existing physical activity opportunities through strategies designed to increase physical activity above routine practice. Their application and considerations for intervention design and interpretation are presented.SummaryThe utility of these mechanisms, referred to as the Theory of Expanded, Extended, and Enhanced Opportunities (TEO), is demonstrated in their parsimony, logical appeal, support with empirical evidence, and the direct and immediate application to numerous settings and contexts. The TEO offers a new way to understand youth physical activity behaviors and provides a common taxonomy by which interventionists can identify appropriate targets for interventions across different settings and contexts. We believe the formalization of the TEO concepts will propel them to the forefront in the design of future intervention studies and through their use, lead to a greater impact on youth activity behaviors than what has been demonstrated in previous studies.

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The IDEFICS intervention trial to prevent childhood obesity: design and study methods

Cited by 36 publications

References 32 publications

Should the IDEFICS outcomes have been expected?

Should the IDEFICS outcomes have been expected?

Impact of a community based health‐promotion programme in 2‐ to 9‐year‐old children in Europe on markers of the metabolic syndrome, the IDEFICS study

The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion

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