Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors

Review question

Does it make a difference if parents or other adult caregivers are involved in interventions to encourage children to eat healthier or be more physically active?

Background

Diet and physical activity behaviors are important determinants of health. Parents and other adult caregivers have an essential role in shaping children's health habits by controlling availability of and access to healthy foods and opportunities to be active; supporting, encouraging, and role‐modeling healthy behaviors; and adopting supportive feeding styles and practices. For these reasons, it often is argued that parent and caregiver involvement in children's diet and physical activity interventions is important; however, it remains unclear if involvement of parents and caregivers actually provides benefit.

Objectives

We assessed the effects of involving parents or other adult caregivers in children's healthy eating and physical activity interventions compared to the effects of the same child interventions without a parent or caregiver component. We were particularly interested in understanding effects on children's dietary intake, children's physical activity levels, and adverse effects of interventions.

Study characteristics

We found 23 studies, published between 1982 and 2019, that implemented diet interventions, physical activity interventions, or combined diet and physical activity interventions with children or adolescents, and evaluated the effects of adding an intervention component involving parents or other adult caregivers. Approximately 12,192 children aged 2 to 18 years were examined. More than half of studies took place in North America, and all but two were conducted in high‐income countries. Most studies were school‐based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment. The breadth of information provided about intervention content varied between studies. The most commonly used intervention techniques were those aimed at shaping participants' knowledge, such as providing instruction about how to perform a behavior (e.g. dance, cooking lessons). About three‐quarters of studies reported their funding source; no studies reported industry funding.

Key results

The findings of this review suggest that adding a parent or caregiver component to dietary behavior change interventions or physical activity interventions may make little or no difference to children's dietary intake or physical activity levels. For interventions that target both diet and physical activity behaviors, involving a parent or caregiver probably slightly reduces children's sugar‐sweetened beverage intake by the end of the intervention. We do not know whether any of these types of interventions result in adverse effects because these data are not available.

Quality of evidence

Overall, the evidence from studies is of low or very low quality, which means that we are uncertain about study results.

Currentness of evidence

The evidence is current to January 2019.