@article{3104461,
    title = "Effective strategies for childhood obesity prevention via school based, family involved interventions: A critical review for the development of the Feel4Diabetes-study school based component",
    author = "Lambrinou, C.-P. and Androutsos, O. and Karaglani, E. and Cardon, G. and Huys, N. and Wikström, K. and Kivelä, J. and Ko, W. and Karuranga, E. and Tsochev, K. and Iotova, V. and Dimova, R. and De Miguel-Etayo, P. and M. González-Gil, E. and Tamás, H. and Jancsó, Z. and Liatis, S. and Makrilakis, K. and Manios, Y. and Cardon, G. and Lindström, J. and Schwarz, P. and Makrilakis, K. and Annemans, L. and Garamendi, I. and Karatzi, K. and Androutsos, O. and Moschonis, G. and Kanellakis, S. and Mavrogianni, C. and Tsoutsoulopoulou, K. and Katsarou, C. and Karaglani, E. and Qira, I. and Skoufas, E. and Maragkopoulou, K. and Tsiafitsa, A. and Sotiropoulou, I. and Tsolakos, M. and Argyri, E. and Nikolaou, M. and Vampouli, E.-A. and Filippou, C. and Apergi, K. and Filippou, A. and Katerina, G. and Dimitriadis, E. and Lindström, J. and Laatikainen, T. and Wikström, K. and Hovi, P. and Kivelä, J. and Valve, P. and Levälahti, E. and Virtanen, E. and Cardon, G. and Van Stappen, V. and Huys, N. and Annemans, L. and Willems, R. and Shadid, S. and Schwarz, P. and Timpel, P. and Makrilakis, K. and Liatis, S. and Dafoulas, G. and Lambrinou, C.-P. and Giannopoulou, A. and Rabemananjara, L. and De Sabata, M.S. and Ko, W. and Garamendi, I. and Moreno, L. and Civeira, F. and Bueno, G. and De Miguel-Etayo, P. and Gonzalez-Gil, E.Mª. and Miguel-Berges, M.L. and Giménez-Legarre, N. and Flores-Barrantes, P. and Ayala-Marín, A.M. and Seral-Cortés, M. and Baila-Rueda, L. and Cenarro, A. and Jarauta, E. and Mateo-Gallego, R. and Iotova, V. and Tankova, T. and Usheva, N. and Tsochev, K. and Chakarova, N. and Galcheva, S. and Dimova, R. and Bocheva, Y. and Radkova, Z. and Marinova, V. and Bazdarska, Y. and Stefanova, T. and Rurik, I. and Ungvari, T. and Jancsó, Z. and Nánási, A. and Kolozsvári, L. and Semánova, C. and Bíró, É. and Antal, E. and Radó, S. and Martinez, R. and Tong, M.",
    journal = "BMC Endocrine Disorders",
    year = "2020",
    volume = "20",
    publisher = "BioMed Central Ltd.",
    issn = "1472-6823",
    doi = "10.1186/s12902-020-0526-5",
    keywords = "behavior change;  child;  childhood obesity;  community program;  elementary student;  family service;  health education;  health promotion;  healthy diet;  home environment;  human;  non insulin dependent diabetes mellitus;  parent;  physical activity;  physical education;  Review;  school health service;  school teacher;  social marketing;  socioeconomics;  vulnerable population;  body mass;  body weight;  childhood obesity;  family;  health promotion;  kinesiotherapy;  lifestyle;  meta analysis (topic);  obesity;  prognosis;  school, Body Mass Index;  Body Weight;  Diet, Healthy;  Exercise Therapy;  Family;  Health Promotion;  Humans;  Life Style;  Meta-Analysis as Topic;  Overweight;  Pediatric Obesity;  Prognosis;  Schools",
    abstract = "Background: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. Methods: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. Results: From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. Conclusions: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives. © 2020 The Author(s)."
}