Association for Public Policy Analysis & Management

Parents and other caregivers have important influences on children's health behaviors, but whether their involvement in children's nutrition and physical activity interventions contributes to intervention effectiveness is unknown. This systematic review sought to assess effects of caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors.

Methods

In January 2019, we comprehensively searched 14 databases and three trials registers for randomized controlled trials (RCTs) and quasi‐RCTs evaluating the effects of interventions to improve children's dietary intake or physical activity behavior, or both. Interventions with at least one component involving caregivers were compared to the same interventions without any caregiver component(s). Cochrane review methods were followed.

Results and Conclusions

We included 23 studies, published between 1982 and 2019, which examined approximately 12,192 children. All but two studies were conducted in high‐income countries. We found only a few positive effects of caregiver involvement. Most notably, for interventions that target both diet and physical activity, involving a caregiver may lead to slight reductions in children's sugar‐sweetened beverage intake (standardized mean difference −0.28, 95% CI −0.44 to −0.12, 3 studies, n=651 moderate-quality evidence). However, current evidence is insufficient to support the inclusion of caregiver involvement in children’s diet and physical activity interventions. For most outcomes, the quality of the evidence is adversely impacted by the small number of studies with available data, limited effective sample sizes, risk of bias, and imprecision. Additional studies measuring clinically important outcomes, employing appropriate design and power, and following established reporting guidelines are needed.