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. 2021 Jan 9;18(1):10.
doi: 10.1186/s12966-020-01074-8.

Process evaluations of early childhood obesity prevention interventions delivered via telephone or text messages: a systematic review

Mahalakshmi Ekambareshwar  1   2 , Swathi Ekambareshwar  3 , Seema Mihrshahi  4   5 , Li Ming Wen  6   4   7 , Louise A Baur  6   4   8 , Rachel Laws  4   9 , Sarah Taki  4   7 , Chris Rissel  6   4
Affiliations

Process evaluations of early childhood obesity prevention interventions delivered via telephone or text messages: a systematic review

Mahalakshmi Ekambareshwar et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Increasingly, public health interventions are delivered via telephone and/or text messages. Recent systematic reviews of early childhood obesity prevention interventions have not adequately reported on the way interventions are delivered and the experiences/perceptions of stakeholders. We aimed to summarise the literature in early childhood obesity prevention interventions delivered via telephone or text messages for evidence of application of process evaluation primarily to evaluate stakeholders' acceptability of interventions.

Methods: A systematic search of major electronic databases was carried out using the Population, Intervention, Comparison, Outcomes framework. Studies were included if interventions were delivered via telephone/text messages; aimed at changing caregivers' behaviours to prevent early childhood obesity; with one or more outcomes related to early obesity risk factors such as breastfeeding, solid feeding, tummy time, sleep and settling, physical activity and screen time; published from inception to May 2020. All eligible studies were independently assessed by two reviewers using the Cochrane Collaboration tool for assessing risk of bias. Qualitative studies were assessed using the Consolidated Criteria for Reporting Qualitative Research and Standards for Reporting Qualitative Research tools.

Results: Twenty-four studies were eligible, and the overall risk of bias was low. Eight studies (33%) had evidence of process evaluation that examined participants' perceptions of interventions. Participants appreciated the convenience of receiving interventions via telephone or text messages. 63% of all studies in this review showed improvement in one or more behaviours related to childhood obesity prevention. Participants were likely to modify behaviours if they received information from a credible source such as from health professionals.

Conclusion: There is limited reporting of stakeholders' experiences in early obesity prevention studies delivered by telephone or text messages. Only one-third of studies examined participants' acceptability and the potential for delivery of childhood obesity prevention interventions conveniently using this mode of delivery. Interventions delivered remotely via telephone or text messages have the potential to reach equal or a greater number of participants than those delivered via face-to-face methods. Future research should build in process evaluation alongside effectiveness measurements to provide important insight into intervention reach, acceptability and to inform scale up.

Trial registration: PROSPERO registration: CRD42019108658.

Keywords: Antenatal/postnatal women; Apps; Caregivers; Childhood obesity prevention; Early childhood; Process evaluation; SMS; Systematic review; Telephone; Text messages.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart screening of literature search and eligibility
Fig. 2
Fig. 2
Risk of bias assessment of eligible studies (N = 24)
See this image and copyright information in PMC

References

    1. Wen LM, Rissel C, Baur LA, Hayes AJ, Xu H, Whelan A, et al. A 3-arm randomised controlled trial of communicating healthy beginnings advice by telephone (CHAT) to mothers with infants to prevent childhood obesity. BMC Public Health. 2017;17(1):79. doi: 10.1186/s12889-016-4005-x. - DOI - PMC - PubMed
    1. Wen LM, Baur LA, Rissel C, Wardle K, Alperstein G, Simpson JM. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial). BMC Public Health. 2007;7 PubMed PMID: WOS:000247035500001. - PMC - PubMed
    1. Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial. BMC Public Health. 2008;8(1):103. doi: 10.1186/1471-2458-8-103. - DOI - PMC - PubMed
    1. Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, et al. The NOURISH randomised control trial: Positive feeding practices and food preferences in early childhood - A primary prevention program for childhood obesity. BMC Public Health. 2009;9(1):387. doi: 10.1186/1471-2458-9-387. - DOI - PMC - PubMed
    1. Hussain T, Smith P, Yee LM. Mobile phone–based behavioral interventions in pregnancy to promote maternal and fetal health in high-income countries: systematic review. JMIR mHealth uHealth. 2020;8(5):e15111. doi: 10.2196/15111. - DOI - PMC - PubMed

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