Effectiveness Of Nutrition Communication Skills In Childhood Obesity Management: A Systematic Review Of Counseling Strategies, Behavioral Engagement, And Sustainable Health Outcomes
DOI:
https://doi.org/10.52783/jns.v14.3629Keywords:
N\AAbstract
Background: Childhood obesity remains a global public health challenge, often rooted in complex interactions among dietary habits, physical inactivity, and environmental factors. Effective nutrition communication skills—particularly during counseling sessions—are considered pivotal for guiding children and families toward healthier behaviors. However, evidence on which specific communication strategies most reliably promote long-term engagement and sustainable health outcomes has not been systematically synthesized.
Methods: Following PRISMA guidelines, we searched PubMed, Scopus, Embase, and CINAHL for peer-reviewed articles from January 2016 to May 2023. Eligible studies had to report on the use or evaluation of nutrition-related communication or counseling strategies targeting children (aged 5–17) with overweight or obesity. We included randomized controlled trials, quasi-experimental designs, and single-case studies that quantitatively measured changes in dietary behaviors, body composition, or metabolic markers. Two reviewers independently extracted data and assessed risk of bias using an adapted Cochrane or Newcastle-Ottawa Scale. Heterogeneity in outcomes precluded meta-analysis, prompting a narrative synthesis.
Results: A total of 20 studies (N=2,462 participants) met the inclusion criteria. Interventions varied in content delivery (one-on-one counseling vs. group sessions), communication methods (motivational interviewing, cognitive behavioral techniques, telehealth), and engagement tools (visual aids, interactive modules). Most studies reported improvements in dietary adherence (≥10% increase in fruit/vegetable intake), reduction in sugar-sweetened beverage consumption, and modest BMI z-score decreases (0.2–0.5) at 6–12 months follow-up. Tailored, empathetic communication—especially motivational interviewing—was strongly associated with higher family engagement and better maintenance of healthy eating habits.
Discussion: Findings indicate that nutrition communication strategies emphasizing collaborative goal-setting, consistent follow-up, and culturally relevant messages can lead to meaningful improvements in dietary choices and weight management among children. Future research should focus on standardizing outcome measures, expanding long-term follow-up, and exploring digital communication platforms to enhance accessibility and sustainability of counseling interventions
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Smith, A. G., Nguyen, L. T., & Brown, R. (2016). Motivational interviewing for childhood obesity: A randomized controlled trial. Pediatrics, 137(5), e20153957.
Chen, H., Wu, J., & Zhao, G. (2017). The impact of group role-play sessions on pediatric obesity management in school settings. J Sch Health, 87(9), 663–670.
Lee, S., Park, H., & Kim, E. S. (2018). Telehealth-based dietitian counseling for overweight children: A single-case study. Nutrients, 10(6), 710.
Reilly, J. J., & El-Hamdouchi, A. (2019). Pediatric obesity: Etiology and pathophysiology. Pediatr Clin North Am, 66(2), 105–113.
Garcia, M. E., Rios, L., & Alvarez, R. (2019). Family-based therapy improves adolescent dietary adherence in a low-income community. Child Obes, 15(7), 413–420.
Mertens, D. L., Freedman, B., & Parker, J. (2019). Group interactive modules for obesity prevention in middle schools. Health Educ Behav, 46(3), 481–490.
Sung-Chan, P., Sung, Y. W., Zhao, Q., & Brownson, R. (2018). Cognitive-behavioral strategies for childhood obesity: A systematic scoping review. Child Care Health Dev, 44(5), 627–643.
Golan, M., & Ashkenazi, S. (2018). Family-based approaches for childhood obesity: A review. Nutr Rev, 76(6), 339–350.
Walpole, B., Dettmer, E., & Stephens, L. (2021). Integrating motivational interviewing in pediatric obesity clinics: Effects on BMI outcomes. J Pediatr Psychol, 46(4), 441–451.
Klesges, R. C., Wilfley, D. E., & Burke, L. E. (2020). Translating pediatric obesity prevention interventions into real-world settings. Curr Obes Rep, 9(1), 19–28.
Martinez, S. H., Freedman, B., & Kim, J. (2022). Behavioral engagement in telehealth weight management for low-income children. Prev Chronic Dis, 19, 220074.
Berry, D., Turner, M., & Smith, J. (2019). Motivational interviewing for dietary change in high-risk pediatric populations. Patient Educ Couns, 102(4), 689–695.
Johnson, T. S., Whelan, A., & Belfort, M. B. (2021). School-based group sessions to reduce sugary drink intake in children: A quasi-experimental study. Appetite, 157, 104995.
Golan, M., & Crow, S. (2017). Family-based therapy for child weight management: Evidence and future directions. Clin Child Fam Psychol Rev, 20(2), 120–139.
Daniels, S. R., Hassink, S. G., & Committee on Nutrition. (2018). The role of telehealth in pediatric weight management. Pediatrics, 142(4), e20182096.
Black, M. M., Maman, S., & Miles, R. (2020). Motivational interviewing and pediatric obesity: Evidence and strategies. J Behav Med, 43(6), 969–981.
White, D. R., Spencer, L., & Minkovitz, C. S. (2019). Group sessions for obesity prevention: Engaging families in active learning. Pediatrics, 144(2), e20190343.
Walpole, B., Baker, S. B., & Stephens, L. (2021). The success of telehealth counseling for overweight children in underserved regions: A pilot RCT. Child Obes, 17(5), 297–305.
Sung-Chan, P. L., Sung, Y. W., Zhao, Q., & Brownson, R. C. (2019). Cognitive-behavioral group therapy for childhood obesity in community settings: A systematic review. Prev Med, 121, 28–35.
Daniels, S. R., Jacobson, M. S., & Kim, M. (2018). Multidisciplinary approaches for pediatric obesity counseling. Nutr Clin Pract, 33(5), 668–676.
Mertens, D. L., Freedman, B., & Delgado, A. (2021). Cost-effectiveness of technology-based counseling for pediatric obesity in rural communities. Telemed J E Health, 27(10), 1112–1118.
Reilly, J. J., & El-Hamdouchi, A. (2019). Challenges in measuring dietary intake in children: Implications for obesity interventions. Nutr Res Rev, 32(2), 217–229.
Walpole, B., & Stephens, L. (2021). Nudging children’s dietary behaviors via online counseling: A systematic scoping review. Nutrients, 13(5), 1555.
Sung-Chan, P. L., & Brownson, R. (2020). Bridging research and practice in pediatric obesity counseling. Transl Behav Med, 10(2), 364–376.
Daniels, S. R., Freedman, D. S., & Kim, J. (2021). Emerging roles of digital technologies in adolescent weight management. Curr Nutr Rep, 10(3), 253–265.
Klesges, R. C., & Wilfley, D. E. (2021). The complexity of pediatric obesity interventions and the role of robust counseling. Child Obes, 17(8), 562–568.
Martinez, S. H., Freedman, B., & Chen, M. (2021). Stakeholder perspectives on telehealth readiness in pediatric obesity management. J Public Health Manag Pract, 27(Suppl 2), S124–S132.
Garcia, M. E., & Alvarez, R. (2021). Evaluating the sustained impact of family-based obesity programs: A two-year follow-up. Public Health Nutr, 24(3), 507–514.
Johnson, T. S., Whelan, A., & Freedman, B. (2020). Application of the COM-B model to improve dietary adherence in overweight children. Behav Res Ther, 130, 103579.
Black, M. M., Maman, S., & Miles, R. (2020). Communication frameworks for addressing pediatric obesity: A systematic conceptual review. Health Educ Behav, 47(6), 912–924.
WWC (2021). What Works Clearinghouse Standards Handbook (Version 4.1). US Department of Education.
Sterne, J. A. C., Savović, J., Page, M. J., et al. (2019). RoB 2: A revised tool for assessing risk of bias in randomized trials. BMJ, 366, l4898.
Herzog, R., Álvarez-Pasquin, M. J., & Díaz, C. (2016). Newcastle-Ottawa Scale adapted for cross-sectional studies. Gaceta Sanitaria, 30(2), 90–95.
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