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.

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Available from: Dong-Chul Seo
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    • "Additionally, successful programs often include family involvement, behavioral monitoring , environmental changes and longer-term interven- tions[8,10,14]. National experts have recommended that programs improve the family's ability to support children's weight-related behavior change[11]; however , including parents in childhood obesity trials can be challenging[10]. Family-based approaches for childhood obesity prevention interventions have increased over the past several decades and those rooted in behavior theory appear to have more successful outcomes for overweight youth[15]. "
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    • "Similar to what was mentioned earlier regarding interventions to reduce sedentary behaviour, community-based obesity prevention programmes have been recommended, particularly the inclusion of culturally tailored strategies (effect size −0.93–3.28, mean effect size 0.30;Seo & Sa 2010;Stevens 2010), and these may draw on the concepts of social norms and social support. Not surprisingly, authoritative parenting has been associated with lower BMI (Gerards et al. 2011), and this parenting style has been promoted as an effective strategy for the prevention and management of obesity in adolescence (Regber et al. 2007;Kitzman-Ulrich et al. 2010;Sleddens et al. 2011). "
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    • "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]. "
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