Systematic review on community-based interventions targeting prevention of overweight and obesity in children and adolescents.

Júlia Santamaria, Nikolai Mühlberger, Daniela Schmid, Igor Kuchin, Erica A Suzumura, Nardeen Ayad, Yuli Lily Hsieh, Kieran Tuohy, Michael Laxy, Uwe Siebert, Beate Jahn

Journal: Frontiers in public health 2025;13():1687963

PMID: 41235199

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Abstract

BACKGROUND

With increasing obesity rates, community-based interventions (CBIs) have gained attention as more evidence suggests that the environment has a significant impact on individuals' behaviors. We aimed to conduct a systematic review of CBIs for preventing overweight/obesity in children and adolescents.

SUBJECT AND METHODS

We searched PubMed (January 2011-December 2024) for studies evaluating CBIs for the prevention of overweight and obesity. We included controlled interventional studies that reported weight-related outcomes. The assessment of risks of bias of the included studies was performed using the Cochrane Collaboration tool. Results are reported in systematic evidence tables, including information on main study characteristics and effect sizes.

RESULTS

A total of 2,724 articles were retrieved, of which 37 publications representing 28 projects from seven world regions were included for review. Most of the interventions targeted children. Reported intervention effects ranged from none to small effects. A beneficial intervention effect was observed in 11 out of 16 studies that calculated the intervention effect for BMI z-score and in seven out of nine studies for the prevalence of overweight/obesity. Effect sizes ranged from -0.26 to -0.03 for the BMI z-score and up to an adjusted odds ratio of 0.65 in the intervention group compared to the control group, with respect to the prevalence of overweight/obesity. The risk of bias of the studies was moderate to high.

CONCLUSION

Overall, our study found inconclusive evidence on the benefits of CBIs. While creating health-promoting environments can influence population-wide nutrition and physical activity behaviors by making healthy choices more accessible, methodological challenges exist to accurately capture the true effects of CBIs.

Address: Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria.; Faculty of Life Sciences, Albstadt-Sigmaringen University, Sigmaringen, Germany.; Department of Preventive Medicine, Faculdade de Medicina da Universidade de São Paulo FMUSP, São Paulo, Brazil.; Department of Pediatrics, Washington University, Saint Louis, MO, United States.; Interfaculty Initiative in Health Policy, Harvard University, Cambridge, MA, United States.; Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, United States.; Nutrition and Nutrigenomics Unit, Research and Innovation Cente-Fondazione Edmund Mach, San Michele all'Adige, Italy.; School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom.; Public Health and Prevention, School of Medicine and Health, Technical University of Munich, Munich, Germany.; Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria.; Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, United States.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.; Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

DOI: 10.3389/fpubh.2025.1687963

MeSH Terms: Humans, Adolescent, Child, Pediatric Obesity, Overweight, Health Promotion, Male, Female, Community Health Services