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- Charlotte A Pratt, Catherine M Loria, Sonia S Arteaga, Holly L Nicastro, Maria Lopez-Class, Janet M de Jesus, Pothur Srinivas, Christine Maric-Bilkan, Lisa Schwartz Longacre, BoyingtonJosephine E AJEANIH, Bethesda, Maryland., Abera Wouhib, and Nara Gavini.
- NIH, Bethesda, Maryland. Electronic address: prattc@nhlbi.nih.gov.
- Am J Prev Med. 2017 Jul 1; 53 (1): 113-122.
ContextA review of interventions addressing obesity disparities could reveal gaps in the literature and provide guidance on future research, particularly for populations with a high prevalence of obesity and obesity-related cardiometabolic risk.Evidence AcquisitionA systematic review of clinical trials in obesity disparities research that were published in 2011-2016 in PubMed/MEDLINE resulted in 328 peer-reviewed articles. Articles were excluded if they had no BMI, weight, or body composition measure as primary outcome or were foreign (n=201); were epidemiologic or secondary data analyses of clinical trials (n=12); design or protocol papers (n=54); systematic reviews (n=3); or retracted or duplicates (n=9). Forty-nine published trials were summarized and supplemented with a review of ongoing obesity disparities grants being funded by the National, Heart, Lung and Blood Institute.Evidence SynthesisOf the 49 peer-reviewed trials, 27 targeted adults and 22 children only or parent-child dyads (5 of 22). Interventions were individually focused; mostly in single settings (e.g., school or community); of short duration (mostly ≤12 months); and primarily used behavioral modification (e.g., self-monitoring) strategies. Many of the trials had small sample sizes and moderate to high attrition rates. A meta-analysis of 13 adult trials obtained a pooled intervention effect of BMI -1.31 (95% CI=-2.11, -0.52, p=0.0012). Institutional review identified 140 ongoing obesity-related health disparities grants, but only 19% (n=27) were clinical trials.ConclusionsThe reviews call for cardiovascular-related obesity disparities research that is long term and includes population research, and multilevel, policy, and environmental, or "whole of community," interventions.Published by Elsevier Inc.
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