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

1
The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK
2
Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
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Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
4
Cochrane UK Methods Support Unit, Editorial & Methods Department, London SW1Y 4QX, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(24), 13395; https://doi.org/10.3390/ijerph182413395
Received: 2 November 2021 / Revised: 10 December 2021 / Accepted: 14 December 2021 / Published: 20 December 2021
(This article belongs to the Section Children's Health)
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. View Full-Text
Keywords: childhood obesity; primary school; realist synthesis childhood obesity; primary school; realist synthesis
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MDPI and ACS Style

Ijaz, S.; Nobles, J.; Johnson, L.; Moore, T.; Savović, J.; Jago, R. Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective. Int. J. Environ. Res. Public Health 2021, 18, 13395. https://doi.org/10.3390/ijerph182413395

AMA Style

Ijaz S, Nobles J, Johnson L, Moore T, Savović J, Jago R. Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective. International Journal of Environmental Research and Public Health. 2021; 18(24):13395. https://doi.org/10.3390/ijerph182413395

Chicago/Turabian Style

Ijaz, Sharea, James Nobles, Laura Johnson, Theresa Moore, Jelena Savović, and Russell Jago. 2021. "Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective" International Journal of Environmental Research and Public Health 18, no. 24: 13395. https://doi.org/10.3390/ijerph182413395

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