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Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective

Childhood obesity is a global public health concern. While evidence from a recent comprehensive Cochrane review indicates school-based interventions can prevent obesity, we still do not know how or for whom these work best. We aimed to identify the contextual and mechanistic factors associated with...

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Autores principales: Ijaz, Sharea, Nobles, James, Johnson, Laura, Moore, Theresa, Savović, Jelena, Jago, Russell
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702173/
https://www.ncbi.nlm.nih.gov/pubmed/34949004
http://dx.doi.org/10.3390/ijerph182413395
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author Ijaz, Sharea
Nobles, James
Johnson, Laura
Moore, Theresa
Savović, Jelena
Jago, Russell
author_facet Ijaz, Sharea
Nobles, James
Johnson, Laura
Moore, Theresa
Savović, Jelena
Jago, Russell
author_sort Ijaz, Sharea
collection PubMed
description Childhood obesity is a global public health concern. While evidence from a recent comprehensive Cochrane review indicates school-based interventions can prevent obesity, we still do not know how or for whom these work best. We aimed to identify the contextual and mechanistic factors associated with obesity prevention interventions implementable in primary schools. A realist synthesis following the Realist And Meta-narrative Evidence Syntheses–Evolving Standards (RAMESES) guidance was with eligible studies from the 2019 Cochrane review on interventions in primary schools. The initial programme theory was developed through expert consensus and stakeholder input and refined with data from included studies to produce a final programme theory including all of the context-mechanism-outcome configurations. We included 24 studies (71 documents) in our synthesis. We found that baseline standardised body mass index (BMIz) affects intervention mechanisms variably as a contextual factor. Girls, older children and those with higher parental education consistently benefitted more from school-based interventions. The key mechanisms associated with beneficial effect were sufficient intervention dose, environmental modification and the intervention components working together as a whole. Education alone was not associated with favourable outcomes. Future interventions should go beyond education and incorporate a sufficient dose to trigger change in BMIz. Contextual factors deserve consideration when commissioning interventions to avoid widening health inequalities.
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spelling pubmed-87021732021-12-24 Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective Ijaz, Sharea Nobles, James Johnson, Laura Moore, Theresa Savović, Jelena Jago, Russell Int J Environ Res Public Health Review Childhood obesity is a global public health concern. While evidence from a recent comprehensive Cochrane review indicates school-based interventions can prevent obesity, we still do not know how or for whom these work best. We aimed to identify the contextual and mechanistic factors associated with obesity prevention interventions implementable in primary schools. A realist synthesis following the Realist And Meta-narrative Evidence Syntheses–Evolving Standards (RAMESES) guidance was with eligible studies from the 2019 Cochrane review on interventions in primary schools. The initial programme theory was developed through expert consensus and stakeholder input and refined with data from included studies to produce a final programme theory including all of the context-mechanism-outcome configurations. We included 24 studies (71 documents) in our synthesis. We found that baseline standardised body mass index (BMIz) affects intervention mechanisms variably as a contextual factor. Girls, older children and those with higher parental education consistently benefitted more from school-based interventions. The key mechanisms associated with beneficial effect were sufficient intervention dose, environmental modification and the intervention components working together as a whole. Education alone was not associated with favourable outcomes. Future interventions should go beyond education and incorporate a sufficient dose to trigger change in BMIz. Contextual factors deserve consideration when commissioning interventions to avoid widening health inequalities. MDPI 2021-12-20 /pmc/articles/PMC8702173/ /pubmed/34949004 http://dx.doi.org/10.3390/ijerph182413395 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Ijaz, Sharea
Nobles, James
Johnson, Laura
Moore, Theresa
Savović, Jelena
Jago, Russell
Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title_full Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title_fullStr Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title_full_unstemmed Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title_short Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective
title_sort preventing childhood obesity in primary schools: a realist review from uk perspective
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702173/
https://www.ncbi.nlm.nih.gov/pubmed/34949004
http://dx.doi.org/10.3390/ijerph182413395
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