Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control

Research output: Contribution to journalReview article

Abstract

Context: The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. Evidence acquistion: The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes. The studies were analyzed in 2017–2018. Interventions were classified by environmental focus (food/beverage, physical activity, or both) and stratified by setting (school, community, both). Risk of bias was evaluated for each study. Evidence synthesis: Of 33 natural experiments, most (73%) took place in the school setting only. The most common environmental focus in any setting was food/beverage (48%). All four studies that focused on both food/beverage and physical activity in schools demonstrated decreased prevalence of overweight/obesity or BMI z-score by 0.04–0.17. BMI decreased in all four studies in both school and community settings. The largest effect size was a decrease in BMI z-score of 0.5, but most were <0.25. The risk of bias was high for most (76%) studies. Most (63%) of the eight studies with low/medium risk of bias took place in the school setting focused on the food/beverage environment; effects on BMI were mixed. Conclusions: Natural experiments evaluating school-based policies focusing on both the food/beverage and physical activity environments (versus targeting only one) consistently showed improvement in BMI. However, most studies had high risk of bias, highlighting the need for improved methods for evaluation of natural experiments for childhood obesity prevention.

Original languageEnglish (US)
Pages (from-to)147-158
Number of pages12
JournalAmerican Journal of Preventive Medicine
Volume56
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Pediatric Obesity
Food and Beverages
Population Control
Public Policy
PubMed
Obesity
Medicine

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control. / Bramante, Carolyn T.; Thornton, Rachel Johnson; Bennett, Wendy; Zhang, Allen; Wilson, Renee; Bass, Eric B; Tseng, Eva.

In: American Journal of Preventive Medicine, Vol. 56, No. 1, 01.01.2019, p. 147-158.

Research output: Contribution to journalReview article

@article{2a83c70470254932a8858d5182e27597,
title = "Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control",
abstract = "Context: The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. Evidence acquistion: The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes. The studies were analyzed in 2017–2018. Interventions were classified by environmental focus (food/beverage, physical activity, or both) and stratified by setting (school, community, both). Risk of bias was evaluated for each study. Evidence synthesis: Of 33 natural experiments, most (73{\%}) took place in the school setting only. The most common environmental focus in any setting was food/beverage (48{\%}). All four studies that focused on both food/beverage and physical activity in schools demonstrated decreased prevalence of overweight/obesity or BMI z-score by 0.04–0.17. BMI decreased in all four studies in both school and community settings. The largest effect size was a decrease in BMI z-score of 0.5, but most were <0.25. The risk of bias was high for most (76{\%}) studies. Most (63{\%}) of the eight studies with low/medium risk of bias took place in the school setting focused on the food/beverage environment; effects on BMI were mixed. Conclusions: Natural experiments evaluating school-based policies focusing on both the food/beverage and physical activity environments (versus targeting only one) consistently showed improvement in BMI. However, most studies had high risk of bias, highlighting the need for improved methods for evaluation of natural experiments for childhood obesity prevention.",
author = "Bramante, {Carolyn T.} and Thornton, {Rachel Johnson} and Wendy Bennett and Allen Zhang and Renee Wilson and Bass, {Eric B} and Eva Tseng",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.amepre.2018.08.023",
language = "English (US)",
volume = "56",
pages = "147--158",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Systematic Review of Natural Experiments for Childhood Obesity Prevention and Control

AU - Bramante, Carolyn T.

AU - Thornton, Rachel Johnson

AU - Bennett, Wendy

AU - Zhang, Allen

AU - Wilson, Renee

AU - Bass, Eric B

AU - Tseng, Eva

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Context: The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. Evidence acquistion: The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes. The studies were analyzed in 2017–2018. Interventions were classified by environmental focus (food/beverage, physical activity, or both) and stratified by setting (school, community, both). Risk of bias was evaluated for each study. Evidence synthesis: Of 33 natural experiments, most (73%) took place in the school setting only. The most common environmental focus in any setting was food/beverage (48%). All four studies that focused on both food/beverage and physical activity in schools demonstrated decreased prevalence of overweight/obesity or BMI z-score by 0.04–0.17. BMI decreased in all four studies in both school and community settings. The largest effect size was a decrease in BMI z-score of 0.5, but most were <0.25. The risk of bias was high for most (76%) studies. Most (63%) of the eight studies with low/medium risk of bias took place in the school setting focused on the food/beverage environment; effects on BMI were mixed. Conclusions: Natural experiments evaluating school-based policies focusing on both the food/beverage and physical activity environments (versus targeting only one) consistently showed improvement in BMI. However, most studies had high risk of bias, highlighting the need for improved methods for evaluation of natural experiments for childhood obesity prevention.

AB - Context: The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention. Evidence acquistion: The search included PubMed, CINAHL, PsycINFO, and EconLit from 2000 to 2017 for policies evaluated by natural experiments reporting childhood BMI outcomes. The studies were analyzed in 2017–2018. Interventions were classified by environmental focus (food/beverage, physical activity, or both) and stratified by setting (school, community, both). Risk of bias was evaluated for each study. Evidence synthesis: Of 33 natural experiments, most (73%) took place in the school setting only. The most common environmental focus in any setting was food/beverage (48%). All four studies that focused on both food/beverage and physical activity in schools demonstrated decreased prevalence of overweight/obesity or BMI z-score by 0.04–0.17. BMI decreased in all four studies in both school and community settings. The largest effect size was a decrease in BMI z-score of 0.5, but most were <0.25. The risk of bias was high for most (76%) studies. Most (63%) of the eight studies with low/medium risk of bias took place in the school setting focused on the food/beverage environment; effects on BMI were mixed. Conclusions: Natural experiments evaluating school-based policies focusing on both the food/beverage and physical activity environments (versus targeting only one) consistently showed improvement in BMI. However, most studies had high risk of bias, highlighting the need for improved methods for evaluation of natural experiments for childhood obesity prevention.

UR - http://www.scopus.com/inward/record.url?scp=85057829398&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057829398&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2018.08.023

DO - 10.1016/j.amepre.2018.08.023

M3 - Review article

C2 - 30573143

AN - SCOPUS:85057829398

VL - 56

SP - 147

EP - 158

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 1

ER -