Review article
A Meta-Analysis of Obesity Interventions Among U.S. Minority Children

https://doi.org/10.1016/j.jadohealth.2009.11.202Get rights and content

Abstract

Purpose

To quantitatively evaluate the efficacy of interventions designed to prevent or treat obesity among U.S. minority children using meta-analytic techniques.

Methods

A total of 40 intervention trials involving 10,725 children aged 6–19 years were examined.

Results

Interventions with more components showed a higher mean effect size than those with fewer components: among 32 controlled trials, d = .07 for one-component (n = 6); d = .08 for two-component (n = 15); d = .33 for three-component (n = 10); and d = .71 for four-component (n = 1) interventions. Interventions with parental involvement (n = 22, d = .21) and lifestyle interventions (n = 14, d = .34) showed a greater mean effect size than those without parental involvement (n = 10, d = .05) or lifestyle interventions (n = 18, d = .04), despite the fact that their 90% confidence intervals overlapped. Among uncontrolled trials (n = 8), two-component interventions (n = 5) yielded d = .86 and three-component interventions (n = 3) yielded d = .96.

Conclusions

Evidence indicates that, among U.S. minority children, obesity interventions with three or more components might be more efficacious than those using fewer components. Parental involvement, lifestyle change, culturally-based adaptation, and interactive computer programs seem to show promise in the reduction of obese minority children.

Section snippets

Search strategy

The search consisted of seven online databases: MEDLINE, Academic Search Premier, Educational Resource Information Center (ERIC), Health Source Nursing/Academic Edition, PsycARTICLES, CINAHL Plus with Full Text, and SPORTDiscus. The search terms used were “minority or black or African American or American Indian or Mexican American or Hispanic or Latino or Asian American,” “child or adolescent or youth,” “obesity or overweight,” in combination with “intervention or trial” and various suffixes.

Results

The on-line library database search initially produced 1,544 hits, and a search through a reference lists review yielded 4 additional studies. Of the total, 40 studies [84], [85], [86], [87], [88], [89], [90], [91], [92], [93], [94], [95], [96], [97], [98], [99], [100], [101], [102], [103], [104], [105], [106], [107], [108], [109], [110], [111], [112], [113], [114], [115], [116], [117], [118], [119], [120], [121], [122], [123] were selected in the present meta-analysis. Figure 1 illustrates the

Discussion and Conclusion

Previous research [2], [3], [16], [17] has shown continuing racial/ethnic disparity in the prevalence of childhood obesity. However, no study has reviewed obesity interventions among U.S. minority children. The current review provides the first systematic analysis that focused on the efficacy of obesity interventions among U.S. multiethnic and minority children. Six conclusions could be drawn from this review. First, as hypothesized, interventions addressing three or more components, such as

Summary and Implications

Evidence shows that obesity interventions using three or more components are more efficacious than those that address less, illustrating the importance of applying multiple components to affect obesity risk factors among minority children. Intervention strategies, such as involving parents, changing lifestyles by integrating desired physical activity, and diet changes into participants' daily routines, considering cultural characteristics, and using interactive computer programs, may be

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