THEORY USE AND BEHAVIOUR CHANGE TECHNIQUES IN HEALTHCARE PROFESSIONAL-DELIVERED INFANT FEEDING INTERVENTIONS TO PREVENT CHILDHOOD OBESITY: A SYSTEMATIC REVIEW

摘要

Background: Infant feeding is implicated in the aetiology of childhood obesity. Examining components of early feeding interventions is essential to develop effective obesity prevention interventions. Objectives: 1) To identify behaviour change techniques (BCTs) and theory use in healthcare professional-delivered early feeding interventions, in children < 2 years, to prevent childhood obesity; 2) To examine associations between theory, BCTs and intervention effectiveness for child feeding, dietary intake, and weight. Methods: Seven electronic databases were searched in May 2017. Ten trials (16 papers) were identified. BCTs were identified using were the Behaviour Change Technique Taxonomy v1. Theory use was identified using the Theory Coding Scheme. A modified vote counting approach was used to assess intervention effectiveness. Results: Half of all trials explicitly stated basing infant feeding interventions on theory. Thirteen BCTs were identified in reviewed interventions. Links between theory use and BCTs were poor. A significant association was noted between improved child weight outcomes and greater integration of theory in interventions (r=.69, p=.026). Significant associations were not observed between intervention effectiveness and any other factors. Conclusion: This review highlights insufficient integration of theory in development of healthcare professional-delivered interventions. Findings also provide little support for the use of individual BCTs to enhance intervention effectiveness. Further comprehensive examinations of associations between BCTs, theory and specific outcomes are a critical next step in developing and evaluating healthcare professional-delivered early child feeding interventions.