EVIDENCE REVIEW FOR CHILDHOOD OBESITY

Overview: The review of the evidence for policy and environmental strategies to prevent childhood obesity is an effort to develop a replicable review system to evaluate the growing literature for these strategies. Over 2,000 articles from the scientific and grey literature published between January 2000 and May 2009 were identified and systematically reviewed. Guided by the RE-AIM framework, the review included 606 eligible studies across 24 strategies. This novel classification system was used to assess the evidence for effectiveness (e.g., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach – participation or exposure and representativeness) in 142 independent evaluation study groupings and 254 independent associational study groupings. Development of the system included the creation of a framework and process for ongoing reviews; identification of effective (first and second tier), promising, and emerging strategies; and development of products to disseminate the findings to inform researchers, practitioners, and funders in the field. Transtria used a collaborative approach for the review process involving researchers, evaluators, evidence review bodies, practitioners, and policy- or decision-makers working in multiple areas (e g., public health, behavioral medicine, transportation, health economics). 

Purpose: The main objectives of the project were to:

1. Create a systematic annual review process to classify policy and environmental strategies to prevent childhood obesity by level of evidence (i.e., emerging, promising, and effective)..
   
2. Summarize findings using easy to read “evidence maps” that identify effects/associations related to obesity/overweight, physical activity, and nutrition/diet outcomes.
   
3. Classify 24 distinct intervention strategies, based on the effectiveness and impact, into ratings ranging from “effective” (recommended for use) to “promising” to “emerging” (recommended for further testing).
   

Staff, Partners, and Advisors: Click here for a list of all staff, partners and advisors involved in the evidence review project.

Funding Source: The Robert Wood Johnson Foundation

Our Role: Development of a systematic annual literature review process for policy and environmental strategies to prevent obesity in children, including:

• A conceptual framework to organize the review (link)
• An evidence review cycle to illustrate the trajectory from discovery to application (link)
• Operational definitions for policy and environmental strategies (link)
• An evidence typology for classification of policy and environmental strategies (link)
• Search, inventory, and abstraction tools and protocols (link)
• Detailed intervention tables organized by the 24 strategies, tables summarizing effectiveness and impact ratings for the 24 strategies, and evidence maps with visual illustrations of the intervention effects or associations (link)
• Evidence ratings for each of the 24 strategies (link)

Population: Children aged 3-18 years, with special attention to racial and ethnic and lower-income populations at greatest risk for overweight and obesity.

Supporting Documents:

• Publications
• Annual Review of Public Health article (link)
• Complete Reference List — Click here for a list of the 606 peer-reviewed studies abstracted during the review process