Preventing childhood obesity: a realist review in the UK context

WestChild Health
Published Date: 24 Jun 2019

Childhood obesity has been increasing rapidly in the UK for the last 30 years. National data shows that 20 per cent of 4-5 year olds and one third of 10-11 year olds have either overweight or obesity (NHS Digital, 2017).

Children spend a quarter of their waking lives in schools. We know that schools can’t improve children’s health on their own, but the school setting presents a real opportunity for intervention.

We are involved in the update of the Cochrane Review on preventing childhood obesity. This review includes a range of programmes aimed at preventing childhood obesity in children aged 4-18 years, including school-based programmes.

The Cochrane Review tells us that some of these preventive programmes are beneficial in maintaining a healthy weight in children. But it doesn’t tell us which elements of a programme might work, for which groups of children and under what circumstances. Since the interventions included in these studies are often only funded for the duration of the research, this raises questions about what happens to these preventive programmes when the research funding ends.

So we are left wondering, what does an obesity prevention programme that can realistically be implemented and sustained in UK primary schools look like?

In this project, we are carrying out a ‘realist review’ – a novel approach to looking at evidence. The realist review will identify the key components of an obesity prevention programme which can be successfully implemented in the UK.

We initially wanted to know what primary educators thought might be implementable in schools, so we asked them in an online survey that’s still open. The findings from this survey will help to ensure that our recommendations from the realist review are more likely to be put into practice, as well as creating our criteria for including studies.

We will extract data from all the studies that meet these criteria, and try to identify what made the programme succeed. An intervention’s effectiveness is affected by the context in which it takes place, so our review will explore these factors too. This might include the different types of school, the level of available resources, and the characteristics of the children such as age or level of deprivation.

This review will provide key information for UK decision-makers planning obesity prevention programmes in primary schools. We hope our review will also impact national policies.