The Views of Young People in the UK About Obesity, Body Size, Shape and Weight
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The views of young people in the UK about obesity, body size, shape and weight A systematic review Report written by Rebecca Rees, Jenny Caird, Kelly Dickson, Carol Vigurs, James Thomas EPPI-Centre Social Science Research Unit Institute of Education University of London EPPI-Centre report • April 2013 REPORT The authors of this report are: Rebecca Rees (RR), Jenny Caird (JC), Kelly Dickson (KD), Carol Vigurs (CV), James Thomas (JT) (EPPI-Centre). Acknowledgements It is important to acknowledge the work of the authors of the studies included in this review and the children who participated in them, without which the review would have had no data. Particular thanks also go to Claire Stansfield (CS) and Josephine Kavanagh (JK) from the EPPI-Centre, who worked on several stages of the review; to members of the Steering Group of the EPPI-Centre’s Health Promotion and Public Health Reviews Facility for their helpful suggestions and material for the review; to the participants in the National Children’s Bureau’s Young People’s Public health Education, Awareness, Research (PEAR) Group for their work reflecting on the review’s findings; to Louca-Mai Brady and Deepa Pagarani from the National Children's Bureau for facilitating a consultation session with the PEAR Group; to the Cochrane Information Retrieval Methods Group, especially Andrew Booth and Mala Mann for searching advice; and to Chloe Austerberry and other members of the Health Promotion and Public Health team for their support and advice. Funding This is an independent report commissioned and funded by the Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department. The views expressed in the publication are those of the authors and not necessarily those of the EPPI-Centre or the Department of Health. Responsibility for the views expressed remains solely with the authors. Conflicts of interest There were no conflicts of interest in the writing of this report. Contributors The protocol was developed by JC, KD, JK, RR, CS, JT. JC, KD, RR, CS and CV conducted searches and screened studies. JC, KD, RR and CV developed the data extraction tool, and described, appraised and synthesised studies. The NCB PEAR group commented on interim findings. The report was written by RR, KD, JC, CV and JT. This report should be cited as: Rees R, Caird J, Dickson K, Vigurs C, Thomas J (2013) The views of young people in the UK about obesity, body size, shape and weight: a systematic review. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. ISBN: 978-1-907345-52-4 © Copyright Authors of the systematic reviews on the EPPI-Centre website (http://eppi.ioe.ac.uk/) hold the copyright for the text of their reviews. The EPPI-Centre owns the copyright for all material on the website it has developed, including the contents of the databases, manuals, and keywording and data-extraction systems. The centre and authors give permission for users of the site to display and print the contents of the site for their own non-commercial use, providing that the materials are not modified, copyright and other proprietary notices contained in the materials are retained, and the source of the material is cited clearly following the citation details provided. Otherwise users are not permitted to duplicate, reproduce, re-publish, distribute or store material from this website without express written permission The views of young people in the UK about obesity, body size, shape and weight Contents Preface ......................................................................................... iii Scope of this report ........................................................................ iii How to read this report ................................................................... iv A note on language ........................................................................ iv Executive summary ........................................................................... 1 Part I: Background and findings of the review ..................................... 7 1. Background ............................................................................... 8 1.1 Why body size is an issue .......................................................... 8 1.2 Understanding young people’s body sizes ....................................... 9 1.3 Young people centred frameworks for health ................................ 12 1.4 Policy background ................................................................. 13 1.5 Existing research .................................................................. 14 2. Aims and research questions ........................................................ 16 2.1 Aims ................................................................................. 16 3. Review methods ....................................................................... 17 4. Findings ................................................................................. 19 4.1 The young people and studies in the synthesis ............................... 20 4.2 What were the views of the young people in these studies? ................ 22 4.3 How credible are the review findings and how should they be reported? 44 5. Discussion ............................................................................... 45 5.1 Discussion of principal findings .................................................. 45 5.2 Strengths and weaknesses of this review ...................................... 48 6. Conclusions and implications for policy, practice and research ............. 50 6.1 Conclusions ......................................................................... 50 6.2 Implications ........................................................................ 51 i Contents Part II: Technical description of the review ...................................... 55 7. Detailed methods ..................................................................... 56 7.1 Stakeholder involvement ......................................................... 56 7.2 Inclusion and exclusion criteria ................................................. 57 7.3 Searching ........................................................................... 58 7.4 Screening for eligibility .......................................................... 59 7.5 Characterising the studies and extracting their findings .................... 59 7.6 Appraising the quality of study findings ....................................... 60 7.7 Synthesising study findings ...................................................... 61 8. Detail of studies encountered in the review ..................................... 62 8.1 Flow of studies through the review ............................................. 62 8.2 The quality of the study findings in the syntheses ........................... 64 References ................................................................................... 70 Appendices ................................................................................... 85 Appendix A: Details of included studies: aims and sample characteristics ....... 85 Appendix B: Details of included studies: methods and study quality .............. 99 Appendix C: Themes from the synthesis: the contribution of each study ....... 135 Appendix D: Search strategy ........................................................... 137 Appendix E: Criteria used for appraisal of study quality ........................... 141 ii The views of young people in the UK about obesity, body size, shape and weight Preface Scope of this report This report describes the methods and findings of a systematic review of research about the perspectives of young people aged 12-18 on obesity and body size, shape and weight. Since it aims to inform a particular country’s national policy, it focuses upon young people living in the UK. This review forms part of a core programme of Department of Health-funded work at the EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. It is designed to dovetail with other EPPI-Centre research projects (all of which are available from the EPPI-Centre website1): a systematic map of reviews of social and environmental interventions to reduce childhood obesity; a map and searchable database of schemes tackling obesity and overweight in children and young people in England; a systematic map of the research on the relationship between obesity and sedentary behaviour in young people; a systematic review that explores the relationships between obesity and educational attainment; and a systematic review of children’s views (aged 4-11) about obesity and body size, shape and weight. Conclusions are discussed in detail, and the policy, practice and research implications of the findings are outlined. There are many useful messages in this work for policy makers, commissioners, practitioners and researchers who have a remit to explore policy issues or to promote or conduct research about young people and obesity. 1 http://eppi.ioe.ac.uk/ iii Preface How to read this report Because this review is a systematic review, using explicit and rigorous methods to synthesise the evidence in this topic area, the report is necessarily detailed. Without compromising on the transparency that is expected of a systematic review, we have structured this report to help those who are more concerned with the findings of the review, than with its methods: For skim readers: o There is a seven page executive summary