The impact of school-based prevention of overweight on psychosocial well-being of children.

This review aimed to gain insight in the extent to which psychosocial effects of obesity prevention programmes have been studied, to give an overview of the methods used to measure the particular psychosocial aspects and - if possible - to quantify the effects found. Intervention studies (n = 267) covering the period 1990-October 2005 were derived from seven reviews about childhood obesity interventions. An additional search identified 2754 studies covering the period January 2005-February 2008. In total, 2901 papers (excluding 120 duplicates) were screened for inclusion. Sixty-nine papers covering 53 interventions were included and screened on measuring psychosocial variables. All original authors were contacted. Seven of the selected interventions measured psychosocial variables, five of which evaluated a net intervention effect as compared with a control condition. Only two interventions reported a statistically significant net intervention effect (a decrease in use of purging or diet pills and a decrease in peer ratings of aggression and observed verbal aggression). We conclude that a minority of childhood obesity interventions investigate the effects of their programmes on psychosocial well-being of children and adolescents. It is recommended that in the future, these programmes will be evaluated in a uniform way on a broad range of psychosocial aspects.

Implementation research for 'evidence-based' guideline development by dietitians: a pilot study to test an instrument.

AIM: To improve the quality of dietetic care, dietitians in the University Medical Center Utrecht (UMCU) are encouraged to develop and implement 'evidence-based' guidelines. The aim of this pilot study was to develop and test a questionnaire for implementation research to monitor the process of developing and implementing these guidelines. METHODS: A questionnaire was developed and distributed to 15 dietitians, who have started developing an 'evidence-based' guideline. The questionnaire measures determinants of dietitians' behaviour and the presence of conditions facilitating the development of a guideline. Cronbach's alpha with a cut-off point of 0.7 was used to analyse the internal consistence between the items related to behavioural determinants. A panel of professionals such as a member of staff from the UMCU, a communication expert and project-managers ensured the completeness of the questionnaire. RESULTS: The internal consistency was high (alpha > 0.7) between the items related to the determinants of behaviour. The questionnaire gives a structured overview of factors affecting positively or negatively the process of guideline development. Although dietitians have a positive behaviour towards guideline development, they perceived barriers related to the presence of conditions to develop a guideline. CONCLUSION: We concluded that the applied questionnaire is appropriate for implementation research and has given a structured overview of factors that influence the development of dietetic guidelines by dietitians in the UMCU.