Authors' objectives

To identify and review published interventions aimed at the prevention of weight gain.

Searching

MEDLINE (1966 to the present), EMBASE (1980 to present), PsycLIT (1974 to present), Cochrane Library, Current Contents (Life Sciences), ERIC, HealthStar and Social Science Citation Index were searched. Full details of searches were provided in tables in the article. Reference lists of all papers were checked manually, authors of included papers were contacted and asked to provide references of any published interventions that met the inclusion criteria. The search strategy was limited to articles published in English.

Study selection

Assessment of study quality

Quality was not formally assessed, although factors relating to the methodological quality of studies were discussed in the'Results' section.

Data extraction

Data on the following were extracted from studies onto standardised data collection forms by the first author: behaviour targeted for change, characteristics of participants, study design, underlying theoretical model, modes of delivery and study outcomes. Three reviewers independently validated one-third of the data extraction (not clear whether each validated one third, or whether one third was validated between them), and any disagreements were resolved by discussion.

Methods of synthesis

Results of the review

Eleven publications describing nine distinct interventions, five in junior schools (aged 6-13 years) and four in the wider community. Five studies were randomised controlled trials and four were non-randomised trials.

Three of the five interventions that measured diet and physical activity by self report found positive changes. Effects on observed weight were mixed, with two studies finding no significant differences between intervention and control group, two studies reporting less weight gain in the intervention group and one study finding less weight gain only in subgroups, the other four studies did not report on the effect on weight.

Authors' conclusions

Interventions to prevent weight gain exhibited various degrees of effectiveness. Definite statements about the elements of the interventions that were associated with increased effect size cannot be made as only one of the five studies that involved an RCT design reported a significant effect on weight. This intervention involved a correspondence programme and a mix of behaviour change methods including goal setting, self monitoring and contingencies.

CRD commentary

A reasonable review of the area. A thorough literature search was conducted. However, only published studies were included and the review was limited to English language papers thus the results may be subject to publication bias. Inclusion criteria are clearly defined and the authors provide methodological details on how the review was conducted. Study details are well described in tables and a narrative summary is presented which appears appropriate in view of the heterogeneous nature of the interventions and participants included in the different studies. Methodological quality was not formally assessed however the authors do discuss some methodological features of the studies in the text. The authors' conclusions follow from the results presented.

Implications of the review for practice and research

Practice: The authors do not provide any recommendations for practice.

Research: The authors state that 'future interventions might be more effective if they were explicitly based on methods of behaviour change that have been shown to work in other contexts. Effective interventions would be more easily replicated if they were explicitly described. Effectiveness might be more precisely demonstrated if more objective measures of physical activity and diet were used, and if the follow-up was over a longer period'.

Funding

DoH/MRC Nutrition Initiative.

Bibliographic details

Hardeman W, Griffin S, Johnston M, Kinmonth A L, Wareham N J. Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. International Journal of Obesity 2000; 24(2): 131-143. [PubMed: 10702762]

Indexing Status

Subject indexing assigned by NLM

MeSH

Behavior Therapy; Humans; Models, Psychological; Obesity /prevention & control /psychology; Weight Gain

AccessionNumber

12000000517

Database entry date

31/05/2001

Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.