. 2025 Feb 5;22(1):14.

doi: 10.1186/s12966-025-01708-9.

Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

Brittany J Johnson¹, Paul M Chadwick², Samantha Pryde³, Anna Lene Seidler⁴, Kylie E Hunter⁴, Mason Aberoumand⁴, Jonathan G Williams⁴, Hei In Lau³, Sol Libesman⁴, Jannik Aagerup⁴, Angie Barba⁴, Louise A Baur⁵, Samantha Morgillo³, Lee Sanders⁶, Sarah Taki^{7

8}, Kylie D Hesketh⁹, Karen Campbell⁹, Alexandra Manson³, Alison Hayes⁸, Angela Webster⁴, Charles Wood¹⁰, Denise A O'Connor¹¹, Karen Matvienko-Sikar¹², Kristy Robledo⁴, Lisa Askie⁴, Luke Wolfenden¹³, Rachael Taylor¹⁴, H Shonna Yin¹⁵, Vicki Brown¹⁶, Alexander Fiks¹⁷, Alison Ventura¹⁸, Ata Ghaderi¹⁹, Barry J Taylor¹⁴, Cathleen Stough²⁰, Christine Helle²¹, Cristina Palacios²², Eliana M Perrin²³, Elizabeth Reifsnider²⁴, Finn Rasmussen²⁵, Ian M Paul²⁶, Jennifer S Savage²⁷, Jessica Thomson²⁸, Jinan Banna²⁹, Junilla Larsen³⁰, Kaumudi Joshipura³¹, Ken K Ong³², Levie Karssen³⁰, Li Ming Wen^{7

8}, Márcia Vitolo³³, Margrethe Røed²¹, Maria Bryant³⁴, Maribel Campos Rivera³⁵, Mary Jo Messito³⁶, Natalia Golova³⁷, Nina Cecilie Øverby²¹, Rachel Gross³⁸, Rajalakshmi Lakshman³², Rebecca Byrne³⁹, Russell L Rothman⁴⁰, Sharleen O'Reilly⁴¹, Stephanie Anzman-Frasca⁴², Vera Verbestel⁴³, Claudio Maffeis⁴⁴, Kayla de la Haye⁴⁵, Sarah-Jeanne Salvy⁴⁶, Seema Mihrshahi⁴⁷, Janani Ramachandran⁴⁸, Paola Seffrin Baratto⁴⁹, Rebecca K Golley³; TOPCHILD Collaboration

Collaborators, Affiliations

Collaborators

TOPCHILD Collaboration:
Anne-Louise Heath, David McCormick, Katie Angotti, Kim Roberts, Julia Valmorbida, David Nguyen, Nipun Shrestha, Chris Rissel, David Espinoza, Ian Marschner, Lucinda Bell, Lukas Staub, Michelle Sue-See, Peter Godolphin, Wendy Smith, Alison Karasz, Amanda Thompson, Ana Maria Linares, Ana Perez Exposito, Carolina González Acero, Cindy-Lee Dennis, David McCormick, Deborah Jacobvitz, Elizabeth Widen, Emily Oken, Eric Hodges, Eva Corpeleijn, Heather Wasser, Hein Raat, Hongping Xia, Ken Ong, Lene Kierkegaard, Logan Manikam, Lynne Daniels, Maribel Campos Rivera, Michael Goran, Priyanka Patil, Pujitha Wickramasinghe, Tiffany Rybak, Trine Pedersen, Shannon Whaley, Vasana Kiridana, Vera Verbeste

Affiliations

¹ College of Nursing and Health Sciences, Flinders University, Caring Futures Institute, Adelaide, Australia. brittany.johnson@flinders.edu.au.
² Centre for Behaviour Change, University College London, London, UK.
³ College of Nursing and Health Sciences, Flinders University, Caring Futures Institute, Adelaide, Australia.
⁴ National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Camperdown, Australia.
⁵ Sydney Medical School, The University of Sydney, Camperdown, Australia.
⁶ Pediatrics and Health Policy, Stanford University, Stanford, USA.
⁷ Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, Australia.
⁸ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
⁹ Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
¹⁰ Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
¹¹ School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
¹² School of Public Health, University College Cork, Cork, Ireland.
¹³ School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.
¹⁴ University of Otago, Dunedin, New Zealand.
¹⁵ Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, USA.
¹⁶ Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
¹⁷ Clinical Futures and Department of Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
¹⁸ Department of Kinesiology and Public Health, Bailey College of Science and Math, California Polytechnic State University, San Luis Obispo, USA.
¹⁹ Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Solna, Sweden.
²⁰ Department of Psychology, University of Cincinnati, Cincinnati, USA.
²¹ Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.
²² Department of Dietetics and Nutrition, Florida International University, Miami, USA.
²³ Department of Pediatrics, School of Medicine and School of Nursing, Johns Hopkins University, Baltimore, USA.
²⁴ Arizona State University, Tempe, USA.
²⁵ Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
²⁶ Penn State College of Medicine, Hershey, USA.
²⁷ The Center for Childhood Obesity Research, Department of Nutritional Sciences at The Pennsylvania State University, University Park, USA.
²⁸ US Department of Agriculture, Agricultural Research Service, Maryland, USA.
²⁹ University of Hawaii, Manoa, USA.
³⁰ Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
³¹ Harvard Chan School of Public Health, Ahmedabad University School of Public Health, Boston, USA.
³² Medical Research Centre Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
³³ Medical Sciences Campus, University of Puetro Rico, San Juan, Puerto Rico.
³⁴ University of York, York, UK.
³⁵ COHeAL University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
³⁶ New York University Grossman School of Medicine, New York, USA.
³⁷ Hasbro Children's Hospital, Warren Alpert School of Medicine of Brown University, Providence, USA.
³⁸ Department of Pediatrics, Department of Population Health, NYU Grossman School of Medicine, New York, USA.
³⁹ School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
⁴⁰ Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, USA.
⁴¹ School of Agriculture and Food Science, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland.
⁴² Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA.
⁴³ Faculty of Health, Medicine and Life Sciences, Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM) and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
⁴⁴ Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy.
⁴⁵ Department of Preventive Medicine, University of Southern California, Los Angeles, USA.
⁴⁶ Cedars-Sinai Medical Center, Los Angeles, USA.
⁴⁷ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia.
⁴⁸ Children's Hospital of Philadelphia, Philadelphia, USA.
⁴⁹ Graduate Program in Pediatrics, Child and Adolescent Health, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

PMID: 39910407
PMCID: PMC11796048
DOI: 10.1186/s12966-025-01708-9

Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

Brittany J Johnson et al. Int J Behav Nutr Phys Act. 2025.

. 2025 Feb 5;22(1):14.

doi: 10.1186/s12966-025-01708-9.

Authors

Collaborators

TOPCHILD Collaboration:
Anne-Louise Heath, David McCormick, Katie Angotti, Kim Roberts, Julia Valmorbida, David Nguyen, Nipun Shrestha, Chris Rissel, David Espinoza, Ian Marschner, Lucinda Bell, Lukas Staub, Michelle Sue-See, Peter Godolphin, Wendy Smith, Alison Karasz, Amanda Thompson, Ana Maria Linares, Ana Perez Exposito, Carolina González Acero, Cindy-Lee Dennis, David McCormick, Deborah Jacobvitz, Elizabeth Widen, Emily Oken, Eric Hodges, Eva Corpeleijn, Heather Wasser, Hein Raat, Hongping Xia, Ken Ong, Lene Kierkegaard, Logan Manikam, Lynne Daniels, Maribel Campos Rivera, Michael Goran, Priyanka Patil, Pujitha Wickramasinghe, Tiffany Rybak, Trine Pedersen, Shannon Whaley, Vasana Kiridana, Vera Verbeste

Affiliations

¹ College of Nursing and Health Sciences, Flinders University, Caring Futures Institute, Adelaide, Australia. brittany.johnson@flinders.edu.au.
² Centre for Behaviour Change, University College London, London, UK.
³ College of Nursing and Health Sciences, Flinders University, Caring Futures Institute, Adelaide, Australia.
⁴ National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Camperdown, Australia.
⁵ Sydney Medical School, The University of Sydney, Camperdown, Australia.
⁶ Pediatrics and Health Policy, Stanford University, Stanford, USA.
⁷ Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, Australia.
⁸ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
⁹ Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
¹⁰ Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
¹¹ School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
¹² School of Public Health, University College Cork, Cork, Ireland.
¹³ School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.
¹⁴ University of Otago, Dunedin, New Zealand.
¹⁵ Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, USA.
¹⁶ Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
¹⁷ Clinical Futures and Department of Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
¹⁸ Department of Kinesiology and Public Health, Bailey College of Science and Math, California Polytechnic State University, San Luis Obispo, USA.
¹⁹ Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Solna, Sweden.
²⁰ Department of Psychology, University of Cincinnati, Cincinnati, USA.
²¹ Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.
²² Department of Dietetics and Nutrition, Florida International University, Miami, USA.
²³ Department of Pediatrics, School of Medicine and School of Nursing, Johns Hopkins University, Baltimore, USA.
²⁴ Arizona State University, Tempe, USA.
²⁵ Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
²⁶ Penn State College of Medicine, Hershey, USA.
²⁷ The Center for Childhood Obesity Research, Department of Nutritional Sciences at The Pennsylvania State University, University Park, USA.
²⁸ US Department of Agriculture, Agricultural Research Service, Maryland, USA.
²⁹ University of Hawaii, Manoa, USA.
³⁰ Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
³¹ Harvard Chan School of Public Health, Ahmedabad University School of Public Health, Boston, USA.
³² Medical Research Centre Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
³³ Medical Sciences Campus, University of Puetro Rico, San Juan, Puerto Rico.
³⁴ University of York, York, UK.
³⁵ COHeAL University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
³⁶ New York University Grossman School of Medicine, New York, USA.
³⁷ Hasbro Children's Hospital, Warren Alpert School of Medicine of Brown University, Providence, USA.
³⁸ Department of Pediatrics, Department of Population Health, NYU Grossman School of Medicine, New York, USA.
³⁹ School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
⁴⁰ Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, USA.
⁴¹ School of Agriculture and Food Science, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland.
⁴² Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA.
⁴³ Faculty of Health, Medicine and Life Sciences, Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM) and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
⁴⁴ Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy.
⁴⁵ Department of Preventive Medicine, University of Southern California, Los Angeles, USA.
⁴⁶ Cedars-Sinai Medical Center, Los Angeles, USA.
⁴⁷ Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia.
⁴⁸ Children's Hospital of Philadelphia, Philadelphia, USA.
⁴⁹ Graduate Program in Pediatrics, Child and Adolescent Health, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

PMID: 39910407
PMCID: PMC11796048
DOI: 10.1186/s12966-025-01708-9

Abstract

Background: Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) systematically characterise the target behaviours, delivery features, and Behaviour Change Techniques (BCTs) used in interventions in the international Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration, and 2) explore similarities and differences in BCTs used in interventions by target behaviour domains.

Methods: Annual systematic searches were performed in MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, and two clinical trial registries, from inception to February 2023. Trialists from eligible randomised controlled trials of parent-focused, behavioural early obesity prevention interventions shared unpublished intervention materials. Standardised approaches were used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials. Validation meetings confirmed coding with trialists. Narrative syntheses were performed.

Results: Thirty-two trials reporting 37 active intervention arms were included. Interventions targeted a range of behaviours. The most frequent combination was targeting all parental behaviour domains (infant [milk] feeding, food provision and parent feeding, movement, sleep health; n[intervention arms] = 15/37). Delivery features varied considerably. Most interventions were delivered by a health professional (n = 26/36), included facilitator training (n = 31/36), and were interactive (n = 28/36). Overall, 49 of 93 unique BCTs were coded to at least one target behaviour domain. The most frequently coded BCTs were: Instruction on how to perform a behaviour (n[intervention arms, separated by domain] = 102), Behavioural practice and rehearsal (n = 85), Information about health consequences (n = 85), Social support (unspecified) (n = 84), and Credible source (n = 77). Similar BCTs were often used for each target behaviour domain.

Conclusions: Our study provides the most comprehensive description of the behaviour change content of complex interventions targeting early childhood obesity prevention available to date. Our analysis revealed that interventions targeted multiple behaviour domains, with significant variation in delivery features. Despite the diverse range of BCTs coded, five BCTs were consistently identified across domains, though certain BCTs were more prevalent in specific domains. These findings can be used to examine effectiveness of components and inform intervention development and evaluation in future trials.

Trial registration: PROSPERO registration no. CRD42020177408.

Keywords: Behaviour change techniques; Diet; Infant feeding; Infants; Intervention components; Movement; Sleep.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethics approval was obtained from University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1) to perform secondary analyses. Consent for publication: Not applicable. Competing interests: Authors listed as Trial Representatives in the acknowledgements are investigators of eligible trials, however these authors were not involved in the screening, data extraction, initial coding of the interventions, analysis or drafting of the manuscript. AKV currently has an investigator-initiated research grant from Bobbie Baby, Inc. LS is advisor to Medeloop, Inc.

Figures

**Fig. 1**
PRISMA flowchart showing search results of the TOPCHILD Collaboration

**Fig. 2**
Frequency of combinations of target parental behaviour domains coded in early child obesity prevention interventions (N = 37)^a. ^aThe x-axis details the possible combinations of the four target parental behaviour domains, with the dots indicating the domain is present in that combination. The y-axis indicates the number of interventions that targeted that combination of domains. Zeros represent that no intervention targeted the combination of domains

See this image and copyright information in PMC

References

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Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

Collaborators

Affiliations

Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical