Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol
Authors: Johnson Brittany J , Hunter Kylie E , Golley Rebecca K , Chadwick Paul , Barba Angie , Aberoumand Mason , Libesman Sol , Askie Lisa , Taylor Rachael W , Robledo Kristy P , Mihrshahi Seema , O’Connor Denise A , Hayes Alison J , Wolfenden Luke , Wood Charles T , Baur Louise A , Rissel Chris , Staub Lukas P , Taki Sarah , Smith Wendy , Sue-See Michelle , Marschner Ian C , Espinoza David , Thomson Jessica L , Larsen Junilla K , Verbestel Vera , Stough Cathleen Odar , Salvy Sarah-Jeanne , O’Reilly Sharleen L , Karssen Levie T , Rasmussen Finn E , Messito Mary Jo , Gross Rachel S , Bryant Maria , Paul Ian M , Wen Li Ming , Hesketh Kylie D , González Acero Carolina , Campbell Karen , øverby Nina Cecilie , Linares Ana M , Wasser Heather M , Joshipura Kaumudi J , Palacios Cristina , Maffeis Claudio , Thompson Amanda L , Ghaderi Ata , Lakshman Rajalakshmi , Banna Jinan C , Oken Emily , Rivera Maribel Campos , Perez-Exposito Ana B , Taylor Barry J , Savage Jennifer S , Røed Margrethe , Goran Michael , de la Haye Kayla , Anzman-Frasca Stephanie , Seidler Anna Lene 
Published: December 2020

Introduction

Little is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and behaviour change techniques (BCTs), 2) explore similarities and differences in BCTs used to target behaviours, and 3) explore effectiveness of intervention components in preventing childhood obesity.

Methods and analysis

Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the TOPCHILD Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components.

Ethics and dissemination

The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study’s findings will be disseminated through peer-reviewed publications, conference presentations, and targeted communication with key stakeholders.

Discussion

Our study will provide an in depth understanding of behavioural components and delivery features used in obesity prevention interventions starting antenatally or in the first 12 months after birth. Understanding common intervention approaches in a systematic way will provide much needed insight to advance the design of early obesity prevention interventions and provide the opportunity to undertake future quantitative predictive modelling.

Registration

PROSPERO registration no. CRD42020177408

STRENGTHS AND LIMITATIONS OF THIS STUDY

This study provides an understanding of behaviours targeted, behaviour change techniques and delivery features used in early childhood obesity prevention trials identified in a systematic review as being eligible for inclusion in the Transforming Obesity Prevention in CHILDren (TOPCHILD) Collaboration.

Extends previous methods by coding behaviour change techniques in published and unpublished intervention materials and performing cross validation with trialists through the TOPCHILD Collaboration.

Using standardised coding taxonomies will allow for comparisons across studies, and we will pilot test new ontologies from the Human Behaviour Change Project.

Explores the complex area of targeting parent and caregivers’ behaviours to impact child outcomes across four key obesity prevention behavioural domains (relating to infant feeding practices, food provision and parent feeding practices, movement practices, sleep health practices).

This study will provide preliminary results regarding the examination of intervention components’ effectiveness based on exploratory analysis. Yet, the internationally unique database this project creates will further our understanding of effective intervention components in future research.

To date we already have 38 out of 65 eligible trials agreeing to share data, since not all trials may provide unpublished material we may perform sensitivity analyses comparing trials that have shared data to trials that have not shared materials.