Process evaluations of early childhood obesity prevention interventions delivered via telephone or text messages: A systematic review

Childhood obesity prevention intervention delivered by telephone or text messages is effective and potentially more acceptable to clients, however, this is not well reported.  Understanding participants’ acceptability of an intervention is important for successful uptake upon scaling up. 

Mahalakshmi Ekambareshwar, PhD candidate with EPOCH CRE Stream 4 (research translation), conducted a systematic review of process evaluations in childhood obesity interventions delivered via telephone/text messages, to explore its acceptability to stakeholders.

The review included studies that aimed at changing caregivers’ behaviours to prevent early childhood obesity published from inception to May 2020. Of the 24 studies included in this review, only one-third reported process evaluation to measure perceptions of participants.

The outcomes from the studies suggest that while it is more difficult to change weight outcomes such as BMIz, interventions delivered by telephone can be effective in supporting behaviours important for the prevention of obesity. Participation via telephone/text messages was convenient to caregivers and they were likely to modify behaviour if they received information from a credible source such as from health professionals. Lack of personalisation of text messages and caregivers’ lack of time due to return to work were perceived as barriers.

None of the included studies evaluated the perceptions of other key stakeholders, such as, those who delivered the interventions or health managers or policymakers.  Program reach or fidelity was also not evaluated in the studies.  Evidence gathered through process evaluation of trials contribute crucial knowledge to refinement of interventions and programs prior to their replication and scale up.

This review provides high level evidence that childhood obesity prevention interventions can be delivered using low-cost methods such as telephone or text messages, due to participants’ acceptability and convenience.

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