Table 1 Scope of literature by category. Category 1: Evaluation of a specific hospital or community health based obesity prevention intervention
From: Obesity prevention and the role of hospital and community-based health services: a scoping review
Study (author, year, country) | Clinical focus | Intervention participants, setting duration | Main findings and limitation | 5As focus (Ask, Assess, Advise/Agree, Assist, Arrange) |
|---|---|---|---|---|
Jackson et al., 2007 [11] United Kingdom | Health visitor (community nurse) | Specialist health visitor intervention aimed at addressing obesity 89 people with BMI > 30 Community health 1 year | - Weight, BMI, BP decreased - Self-reported diet changed (less sugar products, more fruit and vegetable) - Positive feedback from participants - Small numbers and short term follow-up | - Assess - Advise - Assist |
Davis et al. 2008 [12] USA | Medical specialists (nephrology) | Education of doctors on behaviour modification, patient education, health literacy and communication 64 patient interactions observed pre and post education of doctors working in hospital based nephrology clinic Pre and post intervention evaluation | - Doctors communication improved post intervention - Patients increased recall of weight based advice - No assessment if intervention lead to patients making changes recommended. - Small numbers, all in one clinic | - Ask - Assess - Advise |
Mustila et al. 2013 [13] Finland | Maternity- Prenatal care | Non randomised, individual and group counselling for women at risk of gestational diabetes Measures: development of gestational diabetes, gestational weight gain, newborn anthropometry, infant weight gain Interventions commenced at 1—17 weeks gestational weeks, follow up to infant 12 months | - Reduced gestational glucose intolerance, no changes to gestational weight gain, newborn anthropometry or infant weight gain - No long term follow-up to establish impact on childhood obesity or mother’s long-term weight | - Ask - Assess - Advise |
Claesson et al. 2014 [14] Sweden | Maternity- Physical activity benefits during pregnancy | Obese women kept physical activity diaries during pregnancy and answered questionnaires looking at mental health, QoL at weeks 15 and 35 plus 11 wks post 74 physical active, 79 physically inactive | - Physical activity among obese pregnant women provides better psychological well-being and improved quality of life, but does not change weight gain - Self-reported data | - Ask |
McElwaine et al. 2014 [15] Australia | Primary healthcare based nurses and allied health | Practice change intervention to increase PHC nurse and AH provision of preventive care. Non randomised two groups (intervention and control)- interviews with clients to ascertain benefit | - Increase in assessment and advice relating to risk behaviours (Ahn, Smith, & Ory, 2012), but no change in referral rates for intervention or follow-up - Highlights issues with implementation in real world settings | - Ask - Advise - Arrange (refer) |
Bartlem et al. 2016 [16] Australia | Mental health | Trial to get community MH workers to increase preventive care by assessing for risk factors and referring person for intervention 12 month intervention | - Increase in assessment for nutrition risk - No significant change in practice advice or referral | Modified 5As (2As and 1R) - Ask - Advise - Refer |
Wiggers et al. 2017 [17] Australia | Community-based preventative care | Practice change intervention with nursing and allied health community base staff delivering adult services over 12 months, aimed at increasing assessment, brief advice and referral for risk factors Interventions include developing policy and electronic medical record based tool; clinician and manager training; audit and feedback; implementation support | - Assessment enhanced but no significant change to rates of brief advice or referral | Modified 5As (2As and 1R) - Ask - Advise - Refer |