Preventing Childhood and Adolescent Obesity: Interventions Utilizing an Ecological Model

Introduction: Childhood obesity is a leading health indicator and is recognized as a national health concern. Rates of childhood obesity continue to rise as a result of a complex number of factors. Recently, Healthy People 2020 indicated the need for research utilizing multi-level approaches to identifying and addressing determinants of childhood and adolescent obesity. Ecological approaches consider individual and interpersonal characteristics, as well as, broader community and societal determinants as interdependent influences on health behaviors. Purpose: The purpose of this presentation is to highlight findings from a literature review done to assess the effectiveness of interventions which have been designed using an ecological approach towards preventing childhood and adolescent obesity. Methods: A comprehensive literature review was conducted to locate peer-reviewed research articles describing childhood and adolescent obesity prevention programs carried out between 1995 and 2010. Inclusion criteria required studies to focus on school-aged children and/or adolescents participating in a physical activity and/or dietary intervention designed specifically or implicitly using an ecological or multi-level approach to determine intervention activities. Results: After accounting for conditions outlined by inclusion and exclusion criteria, only six (6) studies were retained. While all six obesity prevention interventions used multiple dimensions of the social ecological model in various combinations, success in health outcomes was limited. Importantly, none of the studies reported a decrease in overall percent body fat or body mass index as a result of ecological interventions. The reviewed studies did, however, report several moderate changes in several obesity prevention health behaviors. Conclusion: To address the numerous factors that place a child at risk for being overweight, change must occur on multiple levels. Unfortunately, up until now, health education interventions using an ecological model have achieved only modest success in combating adolescent and childhood obesity. While multi-level interventions aimed at personal, social, environmental, and political factors can be successful in the prevention of adolescent and childhood obesity, current multi-level obesity prevention programs are still in their infancy and require further development and evaluation to distinguish effective versus ineffective elements.