"Prevention" via publichealthevidence in Google Reader

Developing parent involvement in a school-based child obesity prevention intervention: a qualitative study and process evaluation

2012-05-18T13:57:52Z

Background

Little is known about the effectiveness of parent involvement in school-based obesity prevention interventions.

Methods

A qualitative study with parents of children aged 9–10 years was conducted to identify possible methods to involve them in a school-based obesity prevention intervention, followed by a process evaluation of homework and school newsletters to involve parents.

Results

Qualitative study: parents supported the use of homework and school newsletters to involve them and overcome the main barriers of their work and time. Process evaluation: Ten homeworks and inserts for the school newsletter about the obesity prevention intervention were developed and delivered. The majority of homeworks were given out (73%), completed by children (84%) and recalled by parents (60–68%). The majority of homeworks were enjoyed by parents and children. All the schools put information about the project in the newsletter and this was recalled by parents. Most parents felt the homeworks were a practical way of involving them.

Conclusions

Homeworks are routinely given to children and provide a means of engaging potentially all parents if parental support is required. Homeworks which are novel, fun and involve activities and social contact are enjoyed by parents and children and may increase awareness of healthy diet and physical activity.

Falls prevention: new approaches to integrated falls prevention services

2012-05-10T09:57:48Z

This briefing shares the learning and recommendations from a workshop for members held by the NHS Confederation and the Ambulance Service Network on falls prevention strategies for the older population. It intends to help the NHS and local government think about new approaches to the commissioning and provision of comprehensive, integrated falls prevention services. It shows that a focus on prevention and early intervention through joint working has benefits for the whole health and social care system, and that not taking action may soon become unaffordable.

Emergency contraception: coil 99.9% effective

2012-05-09T17:30:00Z

“The coil is a much more effective form of emergency contraception than the morning-after pill,” the Metro has reported. The coil, medically known as an intrauterine device or IUD, is often used as a form of long-term contraception, but it can also be implanted after sex to provide emergency protection against pregnancy. IUDs are in the news as researchers have today published findings on how effectively they prevent pregnancy in women who have them implanted after unprotected sex. Drawing on data from 43 previous studies, the review found women who had an IUD fitted after having unprotected sex had a pregnancy rate of 0.09% – the equivalent of less than 1 pregnancy out of every 1,000 IUDs inserted. Another way of saying this is that 99.91% of women who used an IUD as emergency contraception did not become pregnant. The study was mainly based on findings relating to IUDs containing copper, rather than all-plastic devices, and the data came largely from Chinese studies. As a consequence, the results may not reflect the effectiveness of other types of coil or use of the IUD in the UK. Also, the research did not directly compare the coil to the effectiveness of emergency contraceptive pills, or examine how easily women could obtain an emergency coil following unprotected sex. These will both be important factors for women deciding which option to use. Where did the story come from? The study was led by researchers from the University of Princeton USA in collaboration with researchers based in South Africa, China and the UK. It was funded by a grant from Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the researchers declared that they had no conflicts of interest. The study was published in the peer-reviewed medical journal Human Reproduction. Some news coverage of this research suggested women should “forget morning-after pills” as a form of emergency contraception, which is somewhat irresponsible as they remain an effective form of emergency contraception for some women. Also, emergency contraceptive pills may be a more practical and accessible option at times. Women seeking emergency contraception should be informed about the full range of options available to them to help them make a decision about the most appropriate method for them. What kind of research was this? This research was a systematic review investigating how effective intrauterine devices are at preventing pregnancy when used for emergency contraception. An intrauterine device (IUD) or ‘the coil’ is a form of birth control that is placed in the uterus of a woman to prevent pregnancy. An IUD is made of copper and plastic and works by physically preventing sperm from fertilising the egg. They can also prevent any fertilised eggs from implanting in the womb. Some devices, known as intrauterine systems, also release hormones that prevent fertilisation, but these were not included in this review and are not recommended for emergency contraception. A systematic review seeks to identify and summarise all known literature published on a specific topic. It is an effective way of summarising a large body of research to answer a specific research question. It should also be noted that the study did not directly compare the use of IUDs with the use of the morning after pill, nor did it compare how easily women could access either option after unprotected sex. This means we cannot tell which is a more viable option for women seeking emergency contraception, or say that one is intrinsically ‘better’ than the other based on the study’s results alone. What did the research involve? The researchers performed searches of research databases to gather all relevant published studies on women being given an IUD after seeking emergency contraception. Studies were only included if clear information was available on whether the emergency contraception was effective and whether or not the women became pregnant. Only studies published in English or Chinese were included. The authors state that research published in Chinese was included because there is a high volume of contraceptive research taking place in China. Those studies that met the inclusion criteria were analysed in more detail and data were extracted from them by two reviewers working independently of one another, which is intended to reduce errors and bias during data selection. The authors then described the results from the individual studies. The researchers then used a simple method to pool the results of the different studies. During this process they combined the number of women seeking contraception and the number who became pregnant from across all the studies, which was intended to estimate the overall effectiveness of IUDs at preventing pregnancy. What were the basic results? The researchers included 42 studies that provided data on the effectiveness of IUDs in women seeking emergency contraception. These represented studies conducted in six countries between 1979 and 2011, and included 7,034 women using eight different types of IUD. Nearly all the IUDs were devices containing small amounts of copper, and only a small number of plastic-only IUDs were included, in the older pre-1985 studies. Most of the study data came from research based in China. The main finding was that, out of the total 7,034 IUD insertions after unprotected sex, there were 10 recorded pregnancies. This gave a combined IUD failure rate (failure to prevent pregnancy) of 0.14% (95% CI 0.08 to 0.25%). The authors commented that a study in Egypt gave a “surprisingly high” failure rate of 2%, which was vastly different from all the other studies. If this single atypical study was excluded the combined failure rate of using an IUD fell to 0.09% (95%CI 0.04 to 0.19%). This rate means that less than one woman in every 1,000 would fall pregnant using the IUD as an emergency contraceptive. Another way of saying this is that 99.91% of women who used an IUD as emergency contraception did not become pregnant. The maximum length of time from intercourse to IUD insertion ranged from two days to 10 or more days. Most of the insertions (74% of the studies) occurred within five days of intercourse. However, the studies did not include sufficient detail about the delay between intercourse and insertion of IUD for the researchers to analyse accurately how the effectiveness of the IUD was affected by any delay. How did the researchers interpret the results? The researchers conclude that “IUDs are a highly effective method of emergency contraception, with a failure rate of less than one per thousand”. In discussing the different types of IUD they concluded that use of a copper IUD “is by far the most effective emergency contraception option” compared with the non-copper alternatives. Conclusion This systematic review of IUD use in emergency contraception provides useful estimates of pregnancy rates following insertion after unprotected sex. To assess the issue it drew upon studies in several different countries, although the studies were primarily carried out in China. The results of the study suggest that IUDs are a highly effective form of emergency contraception, with a very low failure rate of around 0.09%. It should be noted that the research primarily estimates how likely it is that a woman would become pregnant after having unprotected sex and having an IUD fitted. It does not, however, tell us important related factors such as how available IUDs are after unprotected sex, nor does it confirm that they are necessarily a better option than emergency contraceptive pills. For example, women can obtain emergency contraceptive pills from specially trained pharmacists, whereas an IUD needs to be fitted by a trained clinician. This is not to say that either is better or more practical, rather that there are particular considerations to take into account with each form or contraception beyond overall failure rate. The research also has some limitations, which should be considered when interpreting the results. For example, most of the results included in the review related to the copper coil and some were older devices, so the overall failure rate of 0.09% may not accurately represent the failure rate of newer IUDs or ones that contain hormones (known as intrauterine systems). More data on these devices are needed to establish whether they have a similar failure rate leading to pregnancy as the copper options included in the review. Similarly, most of the data feeding into the 0.09% figure come from studies based in China. Hence, this overall estimate best reflects copper IUD use in Chinese women. The effectiveness in other countries and for other IUDs is less certain based on this study alone. Also, the research originally set out to assess the effectiveness of IUDs in detail so the researchers could see how many days had elapsed between unprotected sex and insertion of the IUD. However, the studies they identified did not contain sufficient detail for this to be possible. Hence, the combined IUD failure rate represents all cases together regardless of the time between intercourse and insertion of IUD. It is likely that the time between unprotected sex and insertion of the IUD directly influences the effectiveness of the contraceptive device, but this review was unable to analyse this. The recommended maximum interval after unprotected sex is 120 hours (five days) for most currently marketed devices. As research was restricted to studies published in English or Chinese, this will exclude potentially informative research in other languages. The results of these excluded studies may have influenced the conclusions of this review had they been included. When discussing their research the authors highlight recent studies exploring attitudes towards IUDs, which identified several potential barriers to a greater use of IUDs as emergency contraception. These included the waiting time (not being able to get a coil on the day emergency contraception is requested), low levels of awareness and understanding among patients, and a lack of understanding among healthcare providers. The results of this study, which show that IUDs are a highly effective option, may renew efforts to increase awareness of IUDs as an emergency contraceptive option. On this note, a spokeswoman for the Family Planning Association is quoted in the Metro as calling for more women to be offered the IUD routinely as a method of contraception. The Metro’s headline suggesting that women should “forget morning-after pills” is somewhat irresponsible, as morning after pills remain an acceptable and effective method of emergency contraception for some women. A previous systematic review carried out by the Cochrane collaboration in 2008 concluded that drugs (such as the morning after pill) and copper IUDs were both effective and safe methods of emergency contraception. The risks of sexually transmitted diseases associated with unprotected sex are well known and the coil, whether used as a standard contraceptive or an emergency contraceptive, does not reduce these risks. Analysis by Bazian Links To The Headlines Forget morning-after pills, the coil is far more reliable. Metro, May 9 2012 Coil 'could be a more effective form of emergency contraception than the Morning-after pill'. Daily Mail, May 9 2012 Links To Science Cleland K, Zhu H, Goldstuck N, et al. The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience. Human Reproduction, Published online May 8 2012

Save lives: Clean your hands

2012-05-04T17:10:38Z

New cases of MRSA bloodstream infection have dropped by 41 % and C. difficile by 30% across the NHS in England since 2009/10.

The decrease in MRSA and C. difficile has been achieved thanks to good clinical practice including improved hand hygiene in NHS trusts across the country, helping to prevent healthcare associated infections by providing a clean and safe environment to patients.

The annual World Health Organization (WHO) awareness day, on 5 May, acts as a valuable reminder of how vital good hand hygiene is in the fight against healthcare associated infections.

Good hand hygiene is essential to prevent avoidable healthcare associated infections and the WHO audit tool can help identify ways to improve performance.

Healthcare providers can also register with WHO SAVE LIVES: Clean Your Hands to show their commitment to hand hygiene and have the opportunity to share experiences on this important issue.

Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene

2012-05-04T10:09:10Z

This study evaluates the impact of the Cleanyourhands campaign on rates of hospital procurement of alcohol hand rub and soap; reports trends in selected healthcare associated infections; and investigates the association between infections and procurement.

Research paper

Lifestyle intervention for preventing weight gain in young adults: a systematic review and meta-analysis of RCTs

2012-03-14T07:36:13Z

Summary

Younger generations of Australians are gaining weight faster than their parents. Associated health consequences are likely to ensue unless weight gains are prevented; however, it is unclear how to effectively intervene in this population. Electronic databases for health sciences were searched from April to the end of August 2011. Nine studies were included in the review, eight in the meta-analysis, from 771 abstracts reviewed for eligibility criteria: randomized controlled trials of lifestyle interventions, published in English (1980 onward), aimed at preventing weight gain among healthy subjects 18–35 years. Mean body weight change was the primary outcome. The combined weighted mean change in intervention participants was −0.87 kg (95% CI −1.56, −0.18) and in control participants 0.86 kg (95% CI 0.14, 1.57). Post hoc meta-regression analyses revealed evidence-based interventions of 4 months or longer duration were significantly associated with greater weight loss (−1.62 [95% CI −3.21, −0.04], P = 0.045). The small number, short duration and large heterogeneity of trials means the effectiveness of lifestyle intervention for preventing young adult weight gain remains unclear. Future trials conducted over longer periods with larger samples are urgently required to develop effective programmes that will protect against weight gains in future generations.

EPODE approach for childhood obesity prevention: methods, progress and international development

2011-11-23T06:46:09Z

Summary

Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. ‘Ensemble Prévenons l'ObésitéDes Enfants’ (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity.

At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input – drawing on the evidence-base – together with evaluation of the programme.

Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge.

A web-based computer-tailored smoking prevention programme for primary school children: Intervention design and study protocol

2012-04-10T00:00:00Z

Background: Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking.Methods & DesignThis paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled 'Fun without Smokes'. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils' smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the 'Fun without Smokes' website. The main outcome measures will be ever smoking and the utilisation of the 'Fun without Smokes' website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up.DiscussionThe present study protocol describes the purpose, intervention design and study protocol of 'Fun without Smokes'. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only.Trial RegistrationDutch Trial Register NTR3116

Infection: prevention and control of healthcare-associated infections in primary and community care

2012-03-30T11:14:55Z

This guideline provides a blueprint for the infection prevention and control precautions that should be applied by everyone involved in the care of people who are having treatment or care either in their own home or elsewhere in the community (for example, in a care home, a GP surgery, health centre, school or prison and by the ambulance service) where NHS healthcare is provided or commissioned.

Alcohol strategy

2012-03-23T11:49:53Z

This strategy sets out Government proposals to crack down on binge drinking culture, cut down on alcohol fuelled violence and disorder and slash the number of people drinking to damaging levels. It includes commitments to introduce a minimum unit price for alcohol; consult on a ban on the sale of multi-buy alcohol discounting; introduce stronger powers for local areas to control the density of licensed premises; and pilot innovative sobriety schemes to challenge alcohol-related offending.

Ban on cheap booze 'to cut binge drinking'

2012-03-23T17:40:00Z

The government has unveiled plans for minimum alcohol pricing in England. The proposal suggests a minimum price of 40 pence per unit as part of a wider alcohol strategy to curb health problems and crime associated with binge drinking. It is estimated that each year alcohol causes over 1 million NHS hospitalisations and 1 million violent crimes in England, primarily through binge drinking. Earlier this week NHS figures revealed that deaths from liver disease had risen by 25% in less than a decade, mainly driven by alcohol. The price of most drinks would be unaffected by a 40p threshold, although many super-strength and own-brand products could see large price rises: at present some super-strength lagers and ciders contain 4.5 units per can but sell for less than a pound, equating to less than 20p per unit. Some bottles of ciders could also double in price, as some supermarkets sell them for less than 20p per unit – an equivalent of less than 50p per pint. This is well below the £3-£4 pounds charged in pubs. The strategy has also called for consultation on multi-buy deals offering cheap alcohol in bulk, as well as a "zero tolerance" approach to dealing with drunken behaviour in A&E departments and new legislation over the licensing of pubs and clubs. The strategy is still at a proposal stage but the government hopes to implement it by 2015. What is minimum pricing and why is it being proposed? Minimum pricing per unit of alcohol is when no alcohol is allowed to be sold below a set price per unit. At present, supermarkets and other retailers frequently offer alcohol at discounted prices, with some reportedly offering alcohol at loss-making prices to attract customers. Bringing in a 40p per unit minimum would mostly affect cut-price brands, super-strength drinks and those offered at heavy discounts, but would be unlikely to affect many name brands or drinks in pubs. The government argues that a minimum price for selling alcohol will reduce heavy drinking, which it says accounts for half of all alcohol consumed in this country and is associated with crime and violence. The prime minister, David Cameron, is reported to have said that a 40p minimum price per unit could mean 50,000 fewer crimes each year and 900 fewer alcohol-related deaths annually by the end of the decade. What is a unit? Due to the fact that drinks come in many strengths and sizes, their alcoholic content is expressed in units, which tells you how much pure alcohol a serving contains. One unit is defined as 10ml or 8g of pure alcohol. A drink of alcohol is not the same as a unit: for example, a single pint of premium lager, bitter or cider (5% alcohol by volume) contains about three units. The recommended maximum limit is two-to-three units a day for a woman and three-to-four units a day for a man. The NHS Choices alcohol unit calculator can help you to find out how many units there are in different types and amounts of alcoholic drinks. What price is being proposed? The government has said that it is still consulting on what the minimum price should be, but it has indicated that this could be 40p per unit. A 40p minimum per unit would not affect more expensive wine or a pint of beer bought in a pub. However, the cheaper drinks normally bought from supermarkets and off-licences will be affected, for example: A two-litre bottle of 5% cider currently costing £1.60 from some retailers would increase to £4 minimum. A bottle of cheap 12% strength wine currently costing £3 would increase to £3.60 minimum. An analysis undertaken by The Guardian found that a minimum price could increase the price of more than one-in-five current supermarket drink deals. Over 20% of the drink deals currently on offer by four major supermarkets were priced below 40p per unit, and therefore would not be permitted under the new legislation. What health toll does binge drinking currently have? There’s no denying that binge drinking (usually defined as drinking twice the recommended daily limit on one occasion) is a problem in Britain. The NHS Information Centre reported that in England in 2009, 20% of men surveyed reported binge drinking on at least one day in the past week, as did 13% of women. Binge drinking was highest among the 25-44 age-group for men and the 16-24 age-group for women. Links To The Headlines Minimum alcohol price 'could be higher than 40p per unit'. The Daily Telegraph, March 23 2012 Government to call time on cheap booze with minimum prices which will add £2 to a 12-pack of beer or cider. Daily Mail, March 23 2012 Minimum alcohol price planned for England and Wales. BBC News, March 23 2012 Coalition to set minimum alcohol price. The Guardian, March 23 2012 Minimum price for alcohol to be set. The Daily Telegraph, March 23 2012 Alcohol minimum price plan set out. Channel 4 News, March 23 2012 Shops slam plan to minimum price on alcohol. Sky News, March 23 2012

Evaluation of the bowel cancer awareness pilot

2012-03-21T16:55:02Z

The first regional bowel cancer awareness campaign ran in the East of England and South West in January 2011. The campaign was intended to raise awareness of the symptoms of bowel cancer – loose poo and blood in poo for more than three weeks, and encourage people with these symptoms to see their GP early.

The positive pilot results were used to design the Government’s first ever national cancer campaign to raise awareness of the signs and symptoms of bowel cancer. The evaluation report presents the results of the pilot campaign.

Public awareness of the symptoms of bowel cancer is low. Spotting the signs early and getting medical advice could save people’s lives. The adverts feature real GPs in the ‘Be Clear on Cancer’ bowel cancer campaign. It encourages people who have had symptoms for more than three weeks to see their doctor. The aim is to make people aware of the symptoms of bowel cancer and make it easier for them to discuss this with their GP.

Improving Outcomes: A Strategy for Cancer (January 2011), outlined the direction for improved cancer care and the aim to save an additional 5,000 lives a year by 2014/15 through improving survival rates for cancer in England and to match the European average.

Late diagnosis is considered to be a major reason for England’s poorer survival rates. To tackle this, the Department of Health, working with key stakeholders, established the National Awareness and Early Diagnosis Initiative (NAEDI).

The aim of NAEDI is to achieve earlier diagnosis through a range of actions including raising public awareness of the signs and symptoms of cancer, support GPs to assess patients more effectively and improve GP access to diagnostic tests.

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

2012-03-14T08:57:01Z

Review of the evidence on fall prevention in hospitals

2012-03-05T16:33:00Z

To facilitate the development of a hospital falls prevention resource guide, this paper systematically reviews and documents the existing evidence base for interventions to prevent falls in hospitals and provides an overview of the performance of existing tools with known measurement properties. It also identifies a wide variety of tools for the prevention of falls in hospitals.

Annual Act FAST stroke campaign has had a significant impact on patients

2012-02-03T18:30:32Z

Latest figures show that the annual Act FAST stroke campaign has had a significant impact on patients receiving stroke treatment. Last year alone, in the two months after the adverts finished running and people’s awareness of the signs increased, the NHS in England saw a 24 per cent rise in stroke related 999 calls, and a 16 per cent rise in stroke sufferers being seen quicker following the campaign in 2011. With evidence that awareness has improved how quickly patients receive stroke treatment, a campaign launches this week. The adverts aim to get people suffering from stroke to hospital as FAST as possible. The Act FAST campaign will include TV adverts running from February 27 to March 25 and will help people to identify the symptoms of stroke by acting FAST.

Death by indifference: 74 deaths and counting

2012-02-15T12:19:00Z

This report found that although some positive steps have been taken in the NHS, many health professionals are still failing to provide adequate care to people with a learning disability. It highlights the deaths of 74 people with a learning disability in NHS care over the last ten years which could have been avoidable.

8. What do you know about commissioning of public health?

2012-02-13T11:00:39Z

There is increasing emphasis in public policy on public health and its role in preventing illness and promoting the circumstances in which people can lead a fulfilled and healthy life. Reducing the cost of expensive treatment and acute care by preventive strategies and early intervention is particularly important at any time but particularly when budgets are under severe strain.

Pseudomonas aeruginosa bacteria preventing and controlling contamination

2012-02-07T12:18:55Z

This dear colleague letter contains updated advice to assist healthcare providers in preventing and controlling contamination with Pseudomonas aeruginosa bacteria in special care units.

Assessment tools of energy balance-related behaviours used in European obesity prevention strategies: review of studies during preschool

2012-03-01T05:00:00Z

Summary

Valid and reliable measures of energy balance-related behaviours are required when evaluating the effectiveness of public health interventions aiming at prevention of childhood obesity. A structured descriptive review was performed to appraise food intake, physical activity and sedentary behaviour assessment tools used in obesity intervention strategies targeting mainly preschool children across Europe. In total, 25 papers are described, addressing energy balance-related behaviours as study outcomes and targeting individuals or clusters of individuals at school- or home-based environment. Parentally reported food records and 24-h recalls were commonly used to assess food intake. Subjective levels of physical activity and sedentary behaviour were commonly accessed via parentally reported questionnaires. Accelerometry was used to obtain objective measures of physical activity. Insufficient evidence of tool evaluation was provided. When feasible, food records and accelerometry are recommended as the most appropriate methods to assess food intake in young children. Sedentary behaviour could be assessed via questionnaires that include key indicators of sedentarism and are able to differentiate individual practices. The choice of methodology for the assessment of specific intervention effects should be equally balanced between required accuracy levels and feasibility, and be guided by the intervention targets.

Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4–6-year-olds: a systematic review

2012-03-01T05:00:00Z

Summary

The aim of this comprehensive systematic review was to identify the most effective behavioural models and behaviour change strategies, underpinning preschool- and school-based interventions aimed at preventing obesity in 4–6-year-olds. Searching was conducted from April 1995 to April 2010 using MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library. Epidemiological studies relevant to the research question with controlled assignment of participants were included in the review, if they had follow-up periods of 6 months or longer. Outcomes included markers of weight gain; markers of body composition; physical activity behaviour changes and dietary behaviour changes. Twelve studies were included in the review. The most commonly used model was social cognitive theory (SCT)/social learning theory (SLT) either as a single model or in combination with other behavioural models. Studies that used SCT/SLT in the development of the intervention had significant favourable changes in one, or more, outcome measures. In addition, interventions that (i) combined high levels of parental involvement and interactive school-based learning; (ii) targeted physical activity and dietary change; and (iii) included long-term follow-up, appeared most effective. It is suggested that interventions should also be focused on developing children's (and parents') perceived competence at making dietary and physical changes.