A systematic review to identify behavioural models underpinning school-based interventions in pre-primary and primary settings for the prevention of obesity in children aged 4-6 years.

The aim of this comprehensive systematic review was to identify the most important behavioural models underpinning school-based interventions aimed at preventing or counteracting obesity in 4-6 year olds. Searching was conducted in April 2010, with relevant literature included in the review from 1995 up to and including the search date on MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library. Epidemiological studies relevant to the research question with controlled assignment of participants were included in the review, if they had follow up periods of six months or longer. Outcomes included markers of weight gain; markers of body composition; physical activity behaviour changes and dietary behaviour changes. A total of twelve individual studies were included in review. The most commonly used model was Social Cognitive Theory (SCT)/Social Learning Theory (SLT) either as a single model or in combination with other behavioural models. Studies that used SCT/SLT in the development of the intervention had significant favourable changes in one, or more, outcome measures. Those interventions that combine (a) high levels of parental involvement and interactive school-based learning and (b) that target physical activity plus dietary change, require further consideration in the development of useful interventions for children aged 4-6 years old.