Involvement of Fathers in Pediatric Obesity Treatment and Prevention Trials: A Systematic Review
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Philip J Morgan1, Myles D Young2, Adam B Lloyd2
1Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia; philip.morgan@newcastle.edu.au.
Insights
Fathers are significantly underrepresented in pediatric obesity research, with only 6% of single-parent studies including them. Innovative strategies are crucial to enhance father involvement in child obesity prevention and treatment programs.
Area of Science:
- Pediatric Health
- Obesity Research
- Behavioral Science
Background:
- Fathers play a key role in child health outcomes.
- Current pediatric obesity research often overlooks or underutilizes paternal involvement.
Purpose of the Study:
- To systematically review the extent of father involvement in pediatric obesity treatment and prevention programs.
- To identify factors influencing father participation in these interventions.
Main Methods:
- A systematic review of 213 randomized controlled trials (RCTs) published in English peer-reviewed journals.
- Searches across 7 databases using terms related to pediatric participants and obesity outcomes.
- Data extraction focused on parental involvement, specifically father participation.
Main Results:
- Fathers constituted only 6% of parents in RCTs limiting participation to one parent.
- In studies open to both parents, 92% lacked objective data on father involvement.
- Fathers were underrepresented across all study types, with limited acknowledgment of this limitation.
Conclusions:
- Pediatric obesity interventions have largely failed to engage fathers.
- Novel approaches are essential to improve the accessibility and engagement of fathers in these programs.
Context:
Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research.
Objective:
This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years).
Data Sources:
A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*).
Study Selection:
Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study.
Data Extraction:
Two authors independently extracted data using a predefined template.
Results:
The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement.
Limitations:
The review was limited to RCTs published in English peer-reviewed journals over a 10-year period.
Conclusions:
Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers.
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