Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, UK.
Health Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand.
Obes Rev. 2021 Feb;22(2):e13152. doi: 10.1111/obr.13152.
The global prevalence of children with overweight and obesity continues to rise. Obesity in childhood has dire long-term consequences on health, social and economic outcomes. Promising interventions using behavioural insights to address obesity in childhood have emerged. This systematic review examines the effectiveness and health equity implications of interventions using behavioural insights to improve children's diet-related outcomes. The search strategy included searches on six electronic databases, reference lists of previous systematic reviews and backward searching of all included studies. One-hundred and eight papers describing 137 interventions were included. Interventions using behavioural insights were effective at modifying children's diet-related outcomes in 74% of all included interventions. The most promising approaches involved using incentives, changing defaults and modifying the physical environment. Information provision alone was the least effective approach. Health equity implications were rarely analysed or discussed. There was limited evidence of the sustainability of interventions-both in relation to their overall effectiveness and cost-effectiveness. The limited evidence on health equity, long-term effectiveness and the cost-effectiveness of these interventions limit what can be inferred for policymakers. This review synthesises the use of behavioural insights to improve children's diet-related outcomes, which can be used to inform future interventions.
全球超重和肥胖儿童的比例持续上升。儿童肥胖会对健康、社会和经济结果产生严重的长期影响。已经出现了一些有前途的使用行为洞察来解决儿童肥胖问题的干预措施。本系统评价研究了使用行为洞察来改善儿童饮食相关结果的干预措施的有效性和健康公平影响。搜索策略包括在六个电子数据库上进行搜索、对以前的系统评价的参考文献进行搜索以及对所有纳入研究进行回溯搜索。描述 137 项干预措施的 108 篇论文被纳入。在所有纳入的干预措施中，74%的干预措施使用行为洞察来有效改变儿童的饮食相关结果。最有前途的方法包括使用激励措施、改变默认设置和改变物理环境。仅提供信息是最无效的方法。健康公平影响很少被分析或讨论。这些干预措施的可持续性证据有限——无论是在其整体效果还是成本效益方面。这些干预措施在健康公平、长期效果和成本效益方面的有限证据限制了决策者的推断。本综述综合了使用行为洞察来改善儿童饮食相关结果的情况，可为未来的干预措施提供信息。
