Systematic review of paediatric weight management interventions delivered in the home setting.

To increase their accessibility, paediatric weight management interventions are increasingly designed to be delivered in the home setting by trained staff. This systematic review summarizes the available evidence for interventions featuring home visitation and identifies key gaps in the literature. PubMed, CINAHL, Cochrane and PsycINFO were searched for intervention studies that reported change in objectively measured adiposity outcomes in youth ages 2-18 years. Studies published between 1 January 1995 and 12 February 2016 were analysed. Of 15 eligible studies, nine reported that interventions with home visitation were either superior to a control/comparison condition or achieved significant within-subjects reductions in adiposity. Interventions in which professional staff (e.g. dietitians and exercise trainers) conducted home visits tended to be more efficacious than those delivered by paraprofessional or community-based staff, as were interventions with more frequent contact. Most studies were judged to have low or unclear risk of bias across various domains. As most studies compared interventions with home visits with less intensive and qualitatively different approaches, it remains unclear whether home visitation per se enhances weight loss efficacy. Overall, paediatric weight management interventions that feature home visitation are promising, but the incremental benefit of the home visitation treatment modality remains to be rigorously evaluated.