Abstract
Background: This systematic review identifies programs, policies, and built-environment changes targeting prevention and control of adult obesity and evaluates their effectiveness. Methods: We searched PubMed, CINAHL, PsycINFO, and EconLit from January 2000 to March 2018. We included natural experiment studies evaluating a program, policy, or built-environment change targeting adult obesity and reporting weight/body mass index (BMI). Studies were categorized by primary intervention target: physical activity/built environment, food/beverage, messaging, or multiple. Two reviewers independently assessed the risk of bias for each study using the Effective Public Health Practice Project tool. Results: Of 158 natural experiments targeting obesity, 17 reported adult weight/BMI outcomes. Four of 9 studies reporting on physical activity/built environment demonstrated reduced weight/BMI, although effect sizes were small with low strength of evidence and high risk of bias. None of the 5 studies targeting the food/beverage environment decreased weight/BMI; strength of evidence was low, and 2 studies were rated high risk of bias. Discussion: We identified few natural experiments reporting on the effectiveness of programs, policies, and built-environment changes on adult obesity. Overall, we found no evidence that policies intending to promote physical activity and healthy eating had beneficial effects on weight/BMI and most studies had a high risk of bias. Limitations include few studies met our inclusion criteria; excluded studies in children and those not reporting on weight/BMI outcomes; weight/BMI reporting was very heterogeneous. More high-quality research, including natural experiments studies, is critical for informing the population-level effectiveness of obesity prevention and control initiatives in adults.
| Original language | English (US) |
|---|---|
| Journal | Journal of General Internal Medicine |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- obesity
- prevention
- systematic reviews
ASJC Scopus subject areas
- Internal Medicine
Cite this
Effectiveness of Policies and Programs to Combat Adult Obesity : a Systematic Review. / Tseng, Eva; Zhang, Allen; Shogbesan, Oluwaseun; Gudzune, Kimberly A; Wilson, Renee; Kharrazi, Hadi H K; Cheskin, Lawrence J; Bass, Eric B; Bennett, Wendy.
In: Journal of General Internal Medicine, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effectiveness of Policies and Programs to Combat Adult Obesity
T2 - a Systematic Review
AU - Tseng, Eva
AU - Zhang, Allen
AU - Shogbesan, Oluwaseun
AU - Gudzune, Kimberly A
AU - Wilson, Renee
AU - Kharrazi, Hadi H K
AU - Cheskin, Lawrence J
AU - Bass, Eric B
AU - Bennett, Wendy
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: This systematic review identifies programs, policies, and built-environment changes targeting prevention and control of adult obesity and evaluates their effectiveness. Methods: We searched PubMed, CINAHL, PsycINFO, and EconLit from January 2000 to March 2018. We included natural experiment studies evaluating a program, policy, or built-environment change targeting adult obesity and reporting weight/body mass index (BMI). Studies were categorized by primary intervention target: physical activity/built environment, food/beverage, messaging, or multiple. Two reviewers independently assessed the risk of bias for each study using the Effective Public Health Practice Project tool. Results: Of 158 natural experiments targeting obesity, 17 reported adult weight/BMI outcomes. Four of 9 studies reporting on physical activity/built environment demonstrated reduced weight/BMI, although effect sizes were small with low strength of evidence and high risk of bias. None of the 5 studies targeting the food/beverage environment decreased weight/BMI; strength of evidence was low, and 2 studies were rated high risk of bias. Discussion: We identified few natural experiments reporting on the effectiveness of programs, policies, and built-environment changes on adult obesity. Overall, we found no evidence that policies intending to promote physical activity and healthy eating had beneficial effects on weight/BMI and most studies had a high risk of bias. Limitations include few studies met our inclusion criteria; excluded studies in children and those not reporting on weight/BMI outcomes; weight/BMI reporting was very heterogeneous. More high-quality research, including natural experiments studies, is critical for informing the population-level effectiveness of obesity prevention and control initiatives in adults.
AB - Background: This systematic review identifies programs, policies, and built-environment changes targeting prevention and control of adult obesity and evaluates their effectiveness. Methods: We searched PubMed, CINAHL, PsycINFO, and EconLit from January 2000 to March 2018. We included natural experiment studies evaluating a program, policy, or built-environment change targeting adult obesity and reporting weight/body mass index (BMI). Studies were categorized by primary intervention target: physical activity/built environment, food/beverage, messaging, or multiple. Two reviewers independently assessed the risk of bias for each study using the Effective Public Health Practice Project tool. Results: Of 158 natural experiments targeting obesity, 17 reported adult weight/BMI outcomes. Four of 9 studies reporting on physical activity/built environment demonstrated reduced weight/BMI, although effect sizes were small with low strength of evidence and high risk of bias. None of the 5 studies targeting the food/beverage environment decreased weight/BMI; strength of evidence was low, and 2 studies were rated high risk of bias. Discussion: We identified few natural experiments reporting on the effectiveness of programs, policies, and built-environment changes on adult obesity. Overall, we found no evidence that policies intending to promote physical activity and healthy eating had beneficial effects on weight/BMI and most studies had a high risk of bias. Limitations include few studies met our inclusion criteria; excluded studies in children and those not reporting on weight/BMI outcomes; weight/BMI reporting was very heterogeneous. More high-quality research, including natural experiments studies, is critical for informing the population-level effectiveness of obesity prevention and control initiatives in adults.
KW - obesity
KW - prevention
KW - systematic reviews
UR - http://www.scopus.com/inward/record.url?scp=85053553505&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053553505&partnerID=8YFLogxK
U2 - 10.1007/s11606-018-4619-z
DO - 10.1007/s11606-018-4619-z
M3 - Article
C2 - 30206789
AN - SCOPUS:85053553505
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
ER -