Home Visitation as an Intervention Opportunity to Prevent Childhood Obesity Within the First 2000 Days: A Scoping Review.

Abstract

Background: Home visitation programs are uniquely positioned to reach young children during the first 2000 days of life (ages 0 to 5 years), a critical time period to prevent childhood obesity.

Objective: This scoping review aimed to identify early childhood obesity prevention interventions implemented within home visitation during the first 2000 days of life, summarize outcomes assessed, and examine if and how nonmaternal caregivers and technology were included.

Methods: Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, three databases (PubMed, Web of Science, CINAHL) were searched from January 1980 to June 2023 for obesity prevention interventions that utilized home visitation as a treatment modality, targeted children ≤5 years old, reported on child weight outcomes, were experimental or quasi-experimental designs with a control or comparison arm, and had full-text available in English. The quality and risk of bias of included studies were rated using the Academy of Nutrition and Dietetics' Quality Criteria Checklist for Primary Research.

Results: Of the 871 identified articles, 21 met inclusion criteria, and all reported at least one obesogenic behavioral outcome in the intervention group compared to the control group. Intervention duration ranged from 4 months to 3 years, and frequency of home visits varied from weekly, biweekly, monthly, or a designated number of home visits within a defined time frame. Three interventions partnered with an established home visiting program, but home visits in all interventions were conducted by either professional or paraprofessional individuals. Nine of the 21 studies targeted other caregivers in addition to the mother and 12 of 21 incorporated a form of technology.

Conclusions: Several different early childhood obesity prevention interventions have been implemented within home visitation during the first 2000 days of life. Future research is needed to investigate the effectiveness of these interventions on weight- and behavioral-related outcomes, as well as explore the impacts of the interventionist type, program duration, inclusion of nonmaternal caregivers, and use of technology on childhood obesity-related outcomes.