Obesity prevention interventions in rural children: A systematic review and meta-evaluation

The prevalence of obesity in the United States has increased rapidly over the past few decades and has become a major public health concern. Childhood obesity is a risk factor for the development of several chronic physical and mental health conditions. Studies suggest that children in the rural areas are at a higher risk for obesity. Thus, there is a need to have effective interventions to prevent childhood obesity. The objective of this systematic review and meta-evaluation is to identify existing interventions for prevention of obesity and evaluate quality and applicability of these interventions in different populations. We conducted a systematic search for studies published in electronic databases from 1980 to 2014. Intervention studies with a focus on prevention of obesity in children ages 2-20 years, residing in rural or Appalachian region of the United States were included. The selection process identified 21 eligible studies for inclusion. A majority of the studies used quasi-experimental design (N = 9) and mostly targeted children from the ages of 8-11 years. Outcome measures included attitude and knowledge of healthy lifestyle, change in diet and physical activity, and body mass index. A large variation in meta-evaluation score was obtained (15-29). Overall, studies reported positive changes in healthy behaviors, suggesting the importance and effectiveness of these interventions in the prevention of obesity. These findings provide insight for designing effective future interventions for obesity prevention.