A Meta-Analysis of Obesity Interventions Among US Minority Children

Department of Applied Health Science, Indiana University, Bloomington, Indiana 47405, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 04/2010; 46(4):309-23. DOI: 10.1016/j.jadohealth.2009.11.202
Source: PubMed


To quantitatively evaluate the efficacy of interventions designed to prevent or treat obesity among U.S. minority children using meta-analytic techniques.
A total of 40 intervention trials involving 10,725 children aged 6-19 years were examined.
Interventions with more components showed a higher mean effect size than those with fewer components: among 32 controlled trials, d = .07 for one-component (n = 6); d = .08 for two-component (n = 15); d = .33 for three-component (n = 10); and d = .71 for four-component (n = 1) interventions. Interventions with parental involvement (n = 22, d = .21) and lifestyle interventions (n = 14, d = .34) showed a greater mean effect size than those without parental involvement (n = 10, d = .05) or lifestyle interventions (n = 18, d = .04), despite the fact that their 90% confidence intervals overlapped. Among uncontrolled trials (n = 8), two-component interventions (n = 5) yielded d = .86 and three-component interventions (n = 3) yielded d = .96.
Evidence indicates that, among U.S. minority children, obesity interventions with three or more components might be more efficacious than those using fewer components. Parental involvement, lifestyle change, culturally-based adaptation, and interactive computer programs seem to show promise in the reduction of obese minority children.

Download full-text


Available from: Dong-Chul Seo,
  • Source
    • "A systematic review of studies among U.S. minority children to control obesity has shown that strategies with three or more interventions (e.g. nutrition advice, sedentary behaviour reduction, medication) were more effective than those with a smaller number of interventions [30]. The stance taken by the Commission on Social Determinants implicitly accepts this by calling for inter-sectoral action with several successful examples [11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.
    Emerging Themes in Epidemiology 01/2011; 8(1):2. DOI:10.1186/1742-7622-8-2 · 2.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Wireless communication using multiple-input multiple-output (MIMO) systems enables increased spectral efficiency and improved reliability for a given total transmit power. We discuss channel phenomenology and space-time turbo coding. Space-time turbo codes combine the advantages of turbo codes with MIMO systems. The performance of receiver options is investigated, including multichannel multiuser detectors (MCMUD) that iteratively employ space-time-frequency adaptive processing, multiuser detection, and joint channel-data estimation. MIMO capacity is a strong function of channel phenomenology, motivating experimental performance evaluation. Results from outdoor experimental data using a 2 bits/s/Hz, 4/spl times/4 space-time turbo code are presented.
    Signals, Systems and Computers, 2002. Conference Record of the Thirty-Sixth Asilomar Conference on; 12/2002
  • [Show abstract] [Hide abstract]
    ABSTRACT: In dilute aqueous solution unimers of copolymer P123 (E21P67E21) associate to form micelles, and in more concentrated solution micelles pack to form high-modulus gels. We are interested in the use of the system as a templating agent in the synthesis of mesoporous materials, and the possibility of determining gel structure, hence mesoporosity, by use of n-, s- or t-butanol. Dynamic light scattering from clear dilute solutions has been used to confirm micellization, visual observation of mobility (tube inversion) to detect gel formation in concentrated solutions, oscillatory rheometry to confirm gel formation and provide values of elastic moduli over a wide temperature range, and small-angle X-ray scattering to determine gel structure. As expected, clear cubic gels (fcc) formed at moderate concentrations and temperatures, e.g. 30 wt.% P123, 20 degrees C, and clear hexagonal gels at higher concentrations and temperatures. The transition on heating from cubic to hexagonal gel involved an intermediate turbid phase in which cubic and hex structures coexisted. Considering cubic gels of 35 wt.% P123 in 5 wt.% butanol/water, those in n-butanol/water had the lowest critical temperatures for gel formation and the highest maximum values for the dynamic elastic modulus (G') of the gels, a result consistent with n-butanol/water being the poorest solvent for P123.
    Journal of Colloid and Interface Science 09/2010; 353(2):482-489. DOI:10.1016/j.jcis.2010.09.061 · 3.37 Impact Factor
Show more