Table 2 Scope of literature by category. Category 2: Evaluation of a specific health based obesity prevention intervention: LITERATURE REVIEWS
From: Obesity prevention and the role of hospital and community-based health services: a scoping review
Study (type, author, year) | Clinical focus | Summary of review | Main findings and limitations | 5As focus (Ask, Assess, Advise/Agree, Assist, Arrange) |
|---|---|---|---|---|
Review Smith et al. 2008 [18] | Adults (pregnancy) | Review of outcomes associated with maternal obesity in pregnancy 54 articles | Describes consequences of obesity in pregnancy; psychological implications (mainly descriptive); Interventions: community based (info, groups etc) inconclusive. Individualised: not significant numbers and no long term outcomes Makes recommendations re: implications for practice- quite broad | Not specifically highlighted by review |
Cochrane review Flodgren et al. 2010 [19] | Health professional change | Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in o/o adults (RCTs) 6 RCTS- 246 health professionals and 1324 o/o pts | Limited evidence on how to organise care to include prevention None of the studies evaluated strategies aimed at changing health professionals attitudes or beliefs | N/A focused on changing health professionals behaviour |
Review of reviews Kremers et al. 2010 [20] | Adults | Lit review of interventions targeting prevention of overweight and obesity in adults Looked at 46 studies evaluating interventions aimed at preventing obesity. Interventions looked at setting and target group | More success amongst programmes targeting weight loss than at preventing CV disease or improving general health status | N/A- review focussed on service specifically designed for weight management, not process for people to get into programmes |
Synthesis review Kirk et al. 2012 [21] | Adults | Synthesis of obesity management evidence Systematic reviews and meta-analysis | - Highlights the value of multi-component interventions that are delivered over the longer term, and reinforces the role of health care professionals. - Currently, few health professionals are advising their patients about weight management in general, even as the prevalence of obesity increases. | Focussed on interventions i.e. Assist and arrange |
Review Vuori et al. 2013 [22] USA | Physical activity in health services | Literature review (2000–2013) of ‘exercise training’ counselling delivered in health services | Health benefits to physical activity but advice re: increasing is not routinely incorporated into health encounters Focuses on physical activity in isolation, not how it can link to other lifestyle changes such as diet | N/A Focussed on outcomes not process of providing advice |
Systematic review Kushner and Ryan 2014 [23] | Clinical guidelines for adults | Systematic review to describe best practice for assessment and lifestyle management of obesity | Best practice for assessment lifestyle management of obesity is - Screen all adults for overweight, with full medical history - Offer weight loss via lifestyle change support for people with BMI > 30 Does not discuss issues relating to factors such as health literacy or how to support people with reduced capacity to make lifestyle changes Does not discuss any system issues with implementation | Ask Assess (not health literacy) Advise/ agree Assist Arrange |
Cochrane review Mastellos 2014 [5] | Adults | Transtheoretical model stages of change Looking at Dietary and physical exercise modification in weight loss management for overweight and obese adults 3 RCT studies, 2971 participants | Inconclusive that this model leads to sustained weight loss. The model focuses on 5 stages of change. However, did show changes to behaviour such as improved diet and physical activity. Studies didn’t tend to focus on other outcomes e.g. QoL or rates of illness | N/A- looked at outcomes of specific interventions |