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Evidence base for primary prevention of obesity in children and adolescents

Evidenzbasierung von Primärprävention der Adipositas bei Kindern und Jugendlichen

  • Leitthema
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Abstract

Effective interventions to prevent obesity in children have never been more necessary. There have been over 30 published reviews and meta-analyses on such interventions (randomized and controlled trials) since 2008. In summary, interventions which involve the whole community (community-based) in complex interventions (promoting healthy eating, reduction in sedentary behaviours and increase in physical activity) that target environments and upstream determinants appear to be more effective. In this article the strengths and weaknesses of community-based complex interventions which aim to prevent obesity in children will be discussed and a selection of recent and ongoing interventions that are shaping the evidence-base in this field will be highlighted (beyond those reported in other papers in this supplement: KOPS, CHILT, TigerKids, IDEFICS and TrinkFit). This paper reviews the challenges and opportunities associated with designing and evaluating community-based complex interventions and initiatives. These include a) design issues (strengths and weaknesses of different types of evidence), b) measurement of (effectiveness) outcomes, c) development of interventions (pilot work, planning frameworks and underpinning theories), d) partnership working and community engagement and e) health inequalities.

Zusammenfassung

Noch nie waren effektive Interventionen zur Prävention von Adipositas von Kindern so nötig wie jetzt. Seit 2008 wurden mehr als 30 Reviews und Metaanalysen zu Adipositasinterventionen (randomisierte und kontrollierte Studien) publiziert. Insgesamt lässt sich feststellen, dass solche Präventionsprogramme besonders effektiv zu sein scheinen, die die ganze Gemeinde (gemeindebasiert) in komplexe Interventionen (Förderung von gesunder Ernährung, Verringerung von sitzenden Tätigkeiten und Erhöhung körperlicher Aktivität) einbeziehen und zudem die Umgebung sowie vorgelagerte Determinanten adressieren. Dieser Beitrag zeigt die Stärken und die Schwächen von gemeindebasierten komplexen Interventionen zur Prävention von Adipositas in Kindern auf. Zudem wird eine Auswahl von jüngeren und noch andauernden Interventionen hervorgehoben, die die Evidenzbasis auf diesem Gebiet schärfen. (Dabei werden andere Beispiele aufgezeigt als diejenigen, die schon in diesem Heft vorgestellt werden: KOPS, CHILT, TigerKids, IDEFICS und TrinkFit.) Dieser Beitrag diskutiert die Herausforderungen und Möglichkeiten bei Design und Evaluation von gemeindebasierten komplexen Interventionen und Initiativen. Dazu gehören a) Designaspekte (Stärken und Schwächen verschiedener Typen der Evidenz), b) Messung der (effektivitätsbezogenen) Endpunkte, c) Entwicklung der Intervention (Vorarbeiten, Planungsrahmen und zugrunde liegende Theorien), d) Aufbau von Partnerschaften und Engagement in der Gemeinde und e) gesundheitliche Ungleichheiten.

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The corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Obesity Research Group (ORB), Durham University, Durham, UK

    F. Hillier, C. Pedley & C. Summerbell

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  1. F. Hillier
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  2. C. Pedley
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  3. C. Summerbell
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Correspondence to C. Summerbell.

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Hillier, F., Pedley, C. & Summerbell, C. Evidence base for primary prevention of obesity in children and adolescents. Bundesgesundheitsbl. 54, 259–264 (2011). https://doi.org/10.1007/s00103-010-1227-4

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