The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

Taghizadeh, Shahnaz; Farhangi, Mahdieh Abbasalizad

doi:10.1186/s12967-020-02640-1

Table 5 Results of subgroup analyses for the effects of childhood obesity policies on childhood BMI-Z_score

From: The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

Group	No. of trial	WMD (95% CI)			P	P_{heterogeneity}	I², %
Total	45	− 0.02	− 0.061	0.021	0.34	< 0.001	99.8
Setting
School	14	− 0.073	− 0.137	− 0.01	0.024	< 0.001	69.4
Community, school, home	7	− 0.08	− 0.202	0.043	0.203	0.773	0
Community, school	13	0.057	− 0.012	0.125	0.105	< 0.001	76.5
School–home	–	–			–	–	–
Community, home	3	− 0.127	− 0.263	0.01	0.068	0.511	0
Community	8	− 0.052	− 0.14	0.036	0.245	< 0.001	100
Target group
Children	34	− 0.028	− 0.074	0.018	0.23	< 0.001	99.8
Parent	1	− 0.18	− 0.345	− 0.015	0.032
Children and parents	6	0.034	− 0.023	0.091	0.242	0.891	0
Children and parents and teachers	4	0.03	− 0.135	0.196	0.719	0.058	59.9
Continent
USA	17	− 0.011	− 0.047	0.025	0.539	0.449	0.4
Europe	6	0.034	− 0.056	0.123	0.46	0.102	45.6
Oceania	21	− 0.032	− 0.09	0.025	0.27	< 0.001	99.9
Asia	1	− 0.1	− 0.155	− 0.045	< 0.001
Intervention content^a
Education only	4	0.053	− 0.149	0.254	0.609	0.007	75.4
Education as curricula	3	0.026	− 0.138	0.19	0.753	0.015	76.4
Education + change in school environment (such as increased PA or changes in school diet)	15	− 0.071	− 0.128	− 0.014	0.015	< 0.001	67
Other community sections	23	− 0.006	− 0.062	0.051	0.841	< 0.001	99.9
Study focus
Diet + PA	44	− 0.017	− 0.059	0.024	0.415	< 0.001	99.8
PA	1	− 0.1	− 0.155	− 0.045	< 0.001
Age-category
< 5 years old	3	0.072	− 0.063	0.208	0.295	< 0.001	100
5–10 years old	24	− 0.069	− 0.137	− 0.001	0.046	< 0.001	78.8
≥ 10 years old	18	0.018	− 0.032	0.067	0.483	< 0.001	67.2
By sample size
≤ 1000	22	0.015	− 0.03	0.06	0.096	< 0.001	76.8
1000–2000	12	0.015	− 0.03	0.06	0.506	0.142	31.1
≥ 2000	11	0.028	− 0.047	0.103	0.46	< 0.001	99.9
Frequency of intervention
Daily	11	− 0.029	− 0.105	0.046	0.444	0	99.9
Weekly	18	− 0.013	− 0.068	0.042	0.643	0.002	55.7
Monthly	2	0.067	− 0.075	0.209	0.357	0.687	0
NR^b	14	− 0.035	− 0.12	0.049	0.412	0	82.7
Duration of intervention (years)
≤ 1	24	− 0.046	− 0.105	0.012	0.119	< 0.001	68.7
1–2	10	− 0.037	− 0.147	0.072	0.506	< 0.001	86.3
> 2	11	0.033	− 0.042	0.109	0.386	< 0.001	99.9
> 2	1	− 0.14	− 0.277	− 0.003	0.045
Follow up from baseline (years)
≤ 1	15	− 0.03	− 0.089	0.029	0.313	0.021	47.4
1–2	14	− 0.016	− 0.108	0.076	0.739	< 0.001	81.1
> 2	16	− 0.02	− 0.083	0.043	0.539	< 0.001	99.9
Sex
Boys and girls	32	− 0.034	− 0.079	0.012	0.147	< 0.001	99.8
Girls	7	0.011	− 0.084	0.105	0.826	0.272	20.7
Boys	6	0.079	− 0.098	0.257	0.382	0.031	59.4
Quality rating
Strong	12	0.032	− 0.046	0.109	0.104	< 0.001	75.6
Moderate	16	− 0.054	− 0.118	0.011	0.423	< 0.001	73.9
Weak	17	− 0.024	− 0.092	0.044	0.482	< 0.001	99.9

The nine studies was included as two individual studies [2,3,4, 14, 21, 23, 33,34,35], three studies as three individual studies [20, 28, 31], and one study as four individual studies [30]; the significant P-values are presented as italic numbers
WMD weighted mean difference, PA physical activity
^aEducation, is various training that can be different based on policies, but education as curricula is a unit of instruction in schools that is done as course regularly during the school year
^bNot reported

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