Evaluating the success of preconception and pregnancy lifestyle interventions in preventing obesity in children: A scoping review protocol

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Childhood obesity leads to many health problems and needs to be addressed. However, there are mixed results from lifestyle interventions that target the periods of preconception and pregnancy, motivating researchers within the EndObesity project to develop and present a protocol of a scoping review to clarify discrepancies in the literature. The review will consist of six stages. The authors expect that the results, which will be submitted for publication in a journal, will interest researchers, families, and practitioners concerned with optimal child outcomes.

Childhood obesity is a major public health concern, leading to short- and long-term adverse health outcomes for children. There is evidence that lifestyle factors during preconception, pregnancy, and early childhood can increase the risk of childhood obesity. However, results from recent systematic reviews that analyse preventive interventions during preconception and pregnancy have shown mixed results. Interventions, in general, may have limited effects either because of weaknesses in their design or because they are not properly implemented. Therefore, there is need for further evaluation, which could be done through the investigation of process evaluation components (e.g., context, recruitment, reach, dose delivered, dose received, fidelity, or implementation). These components could provide information about limitations in current interventions and help optimise future interventions.

This protocol outlines plans for a future study aiming to summarise and evaluate intervention components and process evaluation components to understand why interventions do not seem to show the desired results of preventing obesity in children. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, a scoping review will be conducted by two researchers using the frameworks of the JBI and Arksey and O’Malley. This framework describes six key stages of conducting a scoping review. Authors of this protocol have already defined the research focus, which was the first stage according to the stated framework.

The next stage of identifying relevant literature will consist of a two-step approach: (1) a systematic search to identify all relevant trials between 1990 and 2020. (2) CLUSTER searches to find linked publications like follow-ups or process evaluations of the eligible trials. For stage three (selection of the studies), the criteria will be pilot-tested by screening a random sample. As part of the fourth stage (charting the data), data will be entered onto specially designed sheets to ensure a standardised way of summarising the details of the interventions. Then, the fifth stage of summarising, synthesising, and reporting the results will consist of a qualitative thematic and/or descriptive analysis on process evaluation components, authors’ interpretations, and intervention complexity. Lastly, the vital sixth stage of integrating expert consultation will follow. A key element at this point is to consult stakeholders and content experts to identify any further studies that should be included and to gather their feedback regarding the findings before submitting the results of this scoping review. Stakeholders’ evidence will be presented in the review’s official publication, hoping to appeal to researchers, families, and practitioners.

This scoping review is being conducted within the European project “EndObesity”, which aims to develop, implement, and evaluate innovative, multi-disciplinary strategies for the prevention of childhood obesity. The project brings together stakeholders from various countries and many experts in different fields. EFCNI participates as a third-party collaborator in the EndObesity project and will take part in the different consultation stages.

Paper of the protocol of the scoping review is available at: PLoS ONE

Full list of authors: Kaat Philippe, Carla Perrotta, Aisling O’Donnell, Fionnuala M. McAuliffe, Catherine M. Phillips.