Integrative review of school-based childhood obesity prevention programs.

Childhood and adolescent overweight and obesity in the United States are rapidly becoming a major pediatric health concern. Schools are a critical part of the social environment that shape children's eating and physical activity patterns. While school-based programs may affect a student's perception of physical activity and the influence of dietary practices on overall health, the current variability in the theoretical underpinnings and methodological approaches used to implement these programs makes them difficult to evaluate for quality and evidence of effectiveness of the outcomes achieved across programs. The purpose of this study is to conduct an integrative research review using Cooper's framework to provide an overview of the degree of variability in the methodological approaches and theoretical frameworks of school-based obesity prevention programs that utilize one or more of the following interventions: dietary, physical activity, healthy lifestyle education, and/or parental involvement. This review will examine the variations in the duration of the interventions; whether the interventions were guided by the use of a theoretical framework; the strength of evidence supporting the studies; and whether the interventions demonstrated a reduction in body mass index or weight loss. A total of 16 articles were found based on the inclusion criteria for this study. Eight of the 16 studies (50%) applied theoretical frameworks. Significant variability was found in the duration of intervention between the studies analyzed. The range of duration was 5 weeks to 8 years, with an average of 16.8 months. Fourteen of 16 studies (88%) implemented dietary habit interventions. Fourteen of 16 studies (88%) implemented physical education programs. All 16 studies applied healthy lifestyle education. Nine of 16 studies integrated family involvement into the obesity intervention. Nine of 16 studies (56%) evaluated the effect of their intervention on body mass index.