Methods. Two reviewers independently reviewed each article for eligibility. For each study, one
reviewer extracted the data and a second reviewer verified the accuracy. Both reviewers assessed
the risk of bias for each study. Together, the reviewers graded the strength of the evidence (SOE)
supporting interventions—diet, physical activity, or both—in each setting for the outcomes of
interest. We quantitatively pooled the results of studies that were sufficiently similar. Only
experimental studies with followup of at least 1 year (6 months for studies in school settings)
were included. We abstracted data on comparisons of intervention versus control.
Results. We identified 34,545 unique citations and included 131 articles describing 124
interventional studies. The majority of the interventions (104 studies) were school based,
although many of them included components delivered in other settings. Most were conducted in
the United States and in the past decade. Results of four studies were pooled for BMI and four
for BMI z-score in the school-only setting; results of five school-home studies were pooled for
BMI. Other studies tested interventions delivered at home (n=6), in primary care (n=1), in
childcare (n=4), and in the community (n=9). Six studies tested consumer health informatics
interventions. For obesity prevention, the following settings and interventions showed benefit:
school-based—diet or physical activity interventions (SOE moderate); school-based with a home
component—physical activity interventions (SOE high) and both diet and physical activity (SOE
moderate); school-based with home and community components—diet and physical activity
interventions (SOE high); school-based with a community component—diet and physical
activity interventions (SOE moderate); community with a school component—diet and physical
activity interventions (SOE moderate). The strength of the evidence is either low or insufficient
for the remainder of the interventions and settings.
Conclusions. The evidence is moderate about the effectiveness of school-based interventions for
childhood obesity prevention. Physical activity interventions in a school-based setting with a
family component or diet and physical activity interventions in a school-based setting with home
Methods. Two reviewers independently reviewed each article for eligibility. For each study, one
reviewer extracted the data and a second reviewer verified the accuracy. Both reviewers assessed
the risk of bias for each study. Together, the reviewers graded the strength of the evidence (SOE)
supporting interventions—diet, physical activity, or both—in each setting for the outcomes of
interest. We quantitatively pooled the results of studies that were sufficiently similar. Only
experimental studies with followup of at least 1 year (6 months for studies in school settings)
were included. We abstracted data on comparisons of intervention versus control.
Results. We identified 34,545 unique citations and included 131 articles describing 124
interventional studies. The majority of the interventions (104 studies) were school based,
although many of them included components delivered in other settings. Most were conducted in
the United States and in the past decade. Results of four studies were pooled for BMI and four
for BMI z-score in the school-only setting; results of five school-home studies were pooled for
BMI. Other studies tested interventions delivered at home (n=6), in primary care (n=1), in
childcare (n=4), and in the community (n=9). Six studies tested consumer health informatics
interventions. For obesity prevention, the following settings and interventions showed benefit:
school-based—diet or physical activity interventions (SOE moderate); school-based with a home
component—physical activity interventions (SOE high) and both diet and physical activity (SOE
moderate); school-based with home and community components—diet and physical activity
interventions (SOE high); school-based with a community component—diet and physical
activity interventions (SOE moderate); community with a school component—diet and physical
activity interventions (SOE moderate). The strength of the evidence is either low or insufficient
for the remainder of the interventions and settings.
Conclusions. The evidence is moderate about the effectiveness of school-based interventions for
childhood obesity prevention. Physical activity interventions in a school-based setting with a
family component or diet and physical activity interventions in a school-based setting with home
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