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Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding
Brittany J Johnson1, Paul M Chadwick2, Samantha Pryde3
1College of Nursing and Health Sciences, Flinders University, Caring Futures Institute, Adelaide, Australia. brittany.johnson@flinders.edu.au.
Insights
This study analyzed early childhood obesity prevention interventions, finding they often target multiple parent behaviors like feeding and sleep. Five key behavior change techniques were consistently used across different intervention areas.
Area of Science:
- Public Health
- Behavioral Science
- Pediatrics
Background:
- Early childhood obesity prevention interventions vary widely in their approaches to modifying parental behaviors.
- These interventions target domains such as infant feeding, food provision, physical activity, and sleep health.
- A systematic characterization of these interventions' components is needed.
Purpose of the Study:
- To systematically characterize target behaviors, delivery features, and Behavior Change Techniques (BCTs) in early childhood obesity prevention interventions within the TOPCHILD Collaboration.
- To explore similarities and differences in BCTs employed across various target behavior domains.
Main Methods:
- Conducted annual systematic searches of multiple databases and trial registries up to February 2023.
- Collected unpublished intervention materials from eligible randomized controlled trials of parent-focused interventions.
- Used standardized coding for target behaviors, delivery features, and BCTs, with validation meetings involving trialists.
Main Results:
- Included 32 trials (37 intervention arms), with most targeting all parental behavior domains (feeding, movement, sleep).
- Interventions commonly delivered by health professionals, included facilitator training, and were interactive.
- 49 unique BCTs were identified; frequently used BCTs included instruction, practice, information on consequences, social support, and credible source.
Conclusions:
- This study offers a comprehensive description of the behavior change content in early childhood obesity prevention interventions.
- Interventions targeted multiple behavior domains with diverse delivery features.
- Five BCTs were consistently used across domains, informing future intervention development and evaluation.
Background:
Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) systematically characterise the target behaviours, delivery features, and Behaviour Change Techniques (BCTs) used in interventions in the international Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration, and 2) explore similarities and differences in BCTs used in interventions by target behaviour domains.
Methods:
Annual systematic searches were performed in MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, and two clinical trial registries, from inception to February 2023. Trialists from eligible randomised controlled trials of parent-focused, behavioural early obesity prevention interventions shared unpublished intervention materials. Standardised approaches were used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials. Validation meetings confirmed coding with trialists. Narrative syntheses were performed.
Results:
Thirty-two trials reporting 37 active intervention arms were included. Interventions targeted a range of behaviours. The most frequent combination was targeting all parental behaviour domains (infant [milk] feeding, food provision and parent feeding, movement, sleep health; n[intervention arms] = 15/37). Delivery features varied considerably. Most interventions were delivered by a health professional (n = 26/36), included facilitator training (n = 31/36), and were interactive (n = 28/36). Overall, 49 of 93 unique BCTs were coded to at least one target behaviour domain. The most frequently coded BCTs were: Instruction on how to perform a behaviour (n[intervention arms, separated by domain] = 102), Behavioural practice and rehearsal (n = 85), Information about health consequences (n = 85), Social support (unspecified) (n = 84), and Credible source (n = 77). Similar BCTs were often used for each target behaviour domain.
Conclusions:
Our study provides the most comprehensive description of the behaviour change content of complex interventions targeting early childhood obesity prevention available to date. Our analysis revealed that interventions targeted multiple behaviour domains, with significant variation in delivery features. Despite the diverse range of BCTs coded, five BCTs were consistently identified across domains, though certain BCTs were more prevalent in specific domains. These findings can be used to examine effectiveness of components and inform intervention development and evaluation in future trials.
Trial Registration:
PROSPERO registration no. CRD42020177408.
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