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Review
. 2020 Dec 31:21:101299.
doi: 10.1016/j.pmedr.2020.101299. eCollection 2021 Mar.

Family-based lifestyle interventions: What makes them successful? A systematic literature review

Anne Arnason  1 , Nayeli Langarica  1 , Lara R Dugas  2 , Nallely Mora  2 , Amy Luke  2 , Talar Markossian  2
Affiliations
Review

Family-based lifestyle interventions: What makes them successful? A systematic literature review

Anne Arnason et al. Prev Med Rep. .

Abstract

Nearly one in five young people in the United States has obesity, putting one-fifth of America's children at higher risk of having chronic health conditions and of having obesity into adulthood. Family-based lifestyle interventions (FBLI) have been proposed as effective mechanisms to improve the health through health education and the adoption of healthier behaviors. The aim of this review is to identify and summarize effective intervention activities and lessons learned that organizations can adopt when planning health promotion interventions for families, and to assess the effect of family-based lifestyle interventions on BMI z-score. A systematic review on lifestyle health-promotion interventions for families was conducted following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statements. Inclusion criteria were: duration ≥12 weeks and inclusion of family members. Summary data about the assessment tools, intervention strategies, and outcomes in parents and children were extracted and compared for all studies. A meta-analysis of BMI z-score change was conducted. Thirty-four articles were included in this review. Frequent strategies used were delivering education and training on healthy habits and well-being (94%), engaging community in the planning and implementation phases (80.6%) and providing reminders and feedback (47.2%). BMI z-score mean differences were reported in 40 cohorts and included in a meta-analysis, with no statistically significant differences between groups. The findings of this systematic review and meta-analysis indicate that components of a successful family lifestyle intervention program include duration between six to twelve months and delivery in a community setting. Other key factors include constructing a multidisciplinary team, using a mentor/role model approach, and reinforcing messaging with technology.

Keywords: Behavioral; Family-based lifestyle; Nutrition; Obesity; Systematic review.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of the systematic review and meta-analysis according to the PRISMA guidelines.
Fig. 2
Fig. 2
Intervention setting characteristics varied across the studies. Panels A-C: Pie charts depict the intervention characteristics by number of interventions or cohorts. Panel D: There were common techniques used by different interventionalists, shown in this bar graph as the number of interventions that contained each component, with the most common being delivering education and training.
Fig. 3
Fig. 3
Forest plot displaying a random-effects meta-analysis of the effect of family lifestyle intervention on BMI z-score change.
Fig. 4
Fig. 4
Forest plot displaying a random-effects meta-analysis of the effect of family lifestyle intervention on BMI z-score change. Results are stratified by delivery of intervention setting subgroup.
Fig. 5
Fig. 5
Forest plot displaying a random-effects meta-analysis of the effect of family lifestyle intervention on BMI z-score change. Results are stratified by population age subgroup.
Fig. 6
Fig. 6
Forest plot displaying a random-effects meta-analysis of the effect of family lifestyle intervention on BMI z-score change. Results are stratified by population intervention time group. (3 to < 6 months, 6 to < 12 months, 12 ≥ months).
See this image and copyright information in PMC

References

    1. American Dietetic A. Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight. J. Am. Diet. Assoc. 2006;106(6):925–945. - PubMed
    1. Amini M., Djazayery A., Majdzadeh R., Taghdisi M.-H., Sadrzadeh-Yeganeh H., Abdollahi Z., Hosseinpour-Niazi N., Chamari M., Nourmohammadi M. A School-Based Intervention to Reduce Excess Weight in Overweight and Obese Primary School Students. Biol. Res. Nurs. 2016;18(5):531–540. - PubMed
    1. Arredondo E.M. Is parenting style related to children's healthy eating and physical activity in Latino families? Health Educ. Res. 2006;21(6):862–871. - PubMed
    1. Bacardi-Gascon M., Perez-Morales M.E., Jimenez-Cruz A. A six month randomized school intervention and an 18-month follow-up intervention to prevent childhood obesity in Mexican elementary schools. Nutr. Hosp. 2012;27(3):755–762. - PubMed
    1. Cawley J., Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J. Health Econ. 2012;31(1):219–230. - PubMed

Further reading

    1. Finkelstein E.A., Trogdon J.G., Cohen J.W., Dietz W. Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Aff. (Millwood) 2009;28(Supplement 1):w822–w831. - PubMed
    1. Ward W.L., Shaffer L.A., Testa E.G. Pediatric Psychologists' Collaboration in a National Pediatric Obesity Initiative: A Case Study in Interprofessional Collaboration. J. Clin. Psychol. Med. Settings. 2018;25(4):367–389. - PubMed

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