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Health professional-delivered obesity prevention interventions during the first 1,000 days: A systematic review of external validity reporting
Hennessy, Marita; Heary, Caroline; Laws, Rachel; Van Rhoon, Luke; Toomey, Elaine; Wolstenholme, Hazel; Byrne, Molly
Background: Childhood obesity prevention interventions delivered by health professionals during the first 1,000 days of life show some evidence of effectiveness, particularly in relation to behavioural outcomes. External validity refers to how generalisable interventions are to populations or settings beyond those in the original study. The degree to which external validity elements are reported in such studies is unclear however. This systematic review aimed to determine the extent to which childhood obesity interventions delivered by health professionals during the first 1,000 days report on elements that can be used to inform generalizability across settings and populations. Methods: Eligible studies meeting study inclusion and exclusion criteria were identified through a systematic review of 11 databases and three trial registers. An assessment tool based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was used to assess the external validity of included studies. It comprised five dimensions: reach and representativeness of individuals, reach and representativeness of settings, implementation and adaptation, outcomes for decision making maintenance and/or institutionalisation. Two authors independently assessed the external validity reporting of 20% of included studies; discrepancies were resolved, and then one completed assessments of the remaining studies. Results: In total, 39 trials involving 46 interventions published between 1999 and 2019 were identified. The majority of studies were randomized controlled trials (n=24). Reporting varied within and between dimensions. External validity elements that were poorly described included: representativeness of individuals and settings, treatment receipt, intervention mechanisms and moderators, cost effectiveness, and intervention sustainability and acceptability. Conclusions: Our review suggests that more emphasis is needed on research designs that consider generalisability, and the reporting of external validity elements in early life childhood obesity prevention interventions. Important gaps in external validity reporting were identified that could facilitate decisions around the translation and scale-up of interventions from research to practice. Ms Marita Hennessy is a PhD Scholar funded by the Health Research Board under SPHeRE/2013/1. The authors thank Ms Jane Mulligan and Ms Rosie Dunne (James Hardiman Library, NUI Galway) for their assistance in developing the search strategies, and Ms Louise Tully (Royal College of Surgeons in Ireland, Dublin) for assisting with the double screening of titles and abstracts for this review.
Keyword(s): External validity; childhood obesity; generalisability; intervention; implementation science; health professional; prevention; replication; systematic review
Publication Date:
2019
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Contributor(s): Health Research Board
Institution: NUI Galway
Publisher(s): Health Research Board
File Format(s): application/pdf
First Indexed: 2019-11-01 06:30:12 Last Updated: 2019-11-01 06:30:12