BACKGROUND Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. METHODS Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. RESULTS From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. CONCLUSIONS Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives.

中文翻译：

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通过基于学校的家庭干预措施来预防儿童肥胖的有效策略：对Feel4Diabetes研究型基于学校的研究的发展的重要评论。

背景技术尽管有许多针对儿童肥胖症预防的干预措施，但只有极少数的措施显示出积极的效果。当前的审查旨在收集和评估现有的以学校为基础的干预研究，以家庭参与为目标，以小学生及其家庭的饮食，身体活动和久坐行为为目标，以便确定最有效的策略。方法从科学的电子数据库和灰色文献中检索2000年至2015年1月之间发表的研究。使用的数据库包括MEDLINE / PubMed，科学网络，CINAHL和Scopus。纳入的研究必须是实验性对照研究，持续时间超过1个学年，有家庭参与，将PA和饮食行为结合起来并在学校中实施。进行了一次补充检索以更新评价，以涵盖2015年2月至2019年1月的期间。结果从所研究的研究（n = 425）中，有27个干预项目（33个出版物）达到了纳入标准。其中，有15个对体重状况和/或超重/肥胖症或临床指标有显着影响，有3个对大多数能量平衡相关行为（EBRB）有显着影响，而9个对一些/很少有EBRB或决定因素有显着影响。有效干预措施中实施的策略是：教师扮演榜样并积极参与干预措施的实施；学校政策支持选择健康的食品和饮料并限制不健康的零食，校园变化，在休假规则中和在体育课中增加身体活动，并通过作业，会议，信息材料鼓励父母参与干预，并鼓励他们改善家庭环境。发现使用对儿童的奖励措施，社会营销技巧以及与当地利益相关者的合作可以提高有效性。人们发现，只针对父母的教育会议和教材而没有促进相关的环境和政策变化的计划效果不佳。有人建议采取文化适应措施，以增加干预措施在特定或脆弱人群中的接受度。结论在所审查的程序中确定了几种有效的策略。