Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 May 6;20(Suppl 2):52.
doi: 10.1186/s12902-020-0526-5.

Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component

Christina-Paulina Lambrinou  1 , Odysseas Androutsos  2 , Eva Karaglani  1 , Greet Cardon  3 , Nele Huys  3 , Katja Wikström  4 , Jemina Kivelä  4 , Winne Ko  5 , Ernest Karuranga  5 , Kaloyan Tsochev  6 , Violeta Iotova  6 , Roumyana Dimova  7 , Pilar De Miguel-Etayo  8   9 , Esther M González-Gil  8   9   10 , Hajnalka Tamás  11 , Zoltán Jancsó  11 , Stavros Liatis  12 , Konstantinos Makrilakis  12 , Yannis Manios  13 ; Feel4Diabetes-study group
Collaborators, Affiliations
Review

Effective strategies for childhood obesity prevention via school based, family involved interventions: a critical review for the development of the Feel4Diabetes-study school based component

Christina-Paulina Lambrinou et al. BMC Endocr Disord. .

Abstract

Background: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies.

Methods: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019.

Results: From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups.

Conclusions: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.

Keywords: Families; Obesity prevention; Primary school children; School based intervention; Type 2 diabetes prevention.

PubMed Disclaimer

Conflict of interest statement

Two co-authors are members of the editorial board (Associate Editor - Odysseas Androutsos, Section Editor- Stavros Liatis) of this journal. The authors declare that they have no further competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the publication identification process. Effective strategies in childhood obesity prevention interventions at the primary-school setting: A narrative review for the development of the Feel4Diabetes-study intervention
See this image and copyright information in PMC

References

    1. Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5:4–85. doi: 10.1111/j.1467-789X.2004.00133.x. - DOI - PubMed
    1. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. Jama. 2010;303(3):242–249. doi: 10.1001/jama.2009.2012. - DOI - PubMed
    1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in us youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018;319(16):1723–1725. doi: 10.1001/jama.2018.3060. - DOI - PMC - PubMed
    1. Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatr Obes. 2006;1(1):26–32. doi: 10.1080/17477160600586614. - DOI - PubMed
    1. Manios Y, Androutsos O, Katsarou C, Vampouli EA, Kulaga Z, Gurzkowska B, et al. Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families: the ToyBox study. Nutrition. 2018;55–56:192–198. doi: 10.1016/j.nut.2018.05.007. - DOI - PubMed