Inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions: systematic review protocol

IntroductionIt has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We will synthesise evidence on how different measures of inequality moderate the uptake, adherence and effectiveness of behavioural weight management interventions in adults.Methods and analysisWe will update a previous systematic literature review from the United States Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults aged 18 years and over that were, or could feasibly be, conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO will be searched. Only randomised controlled trials (RCTs) and cluster-RCTs will be included. Two investigators will independently screen articles for eligibility and conduct risk of bias assessment. We will curate publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) will be used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change and PROGRESS-Plus-related data will be extracted. Data will be synthesised narratively. We will present a Harvest plot for each PROGRESS-Plus criterion and whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta-analysis.Ethics and disseminationEthical approval is not required as no primary data are being collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences, and contribute to the lead author’s PhD thesis. Authors of trials included in the completed systematic review may be invited to collaborate on a future individual participant data meta-analysis.PROSPERO registration numberCRD42020173242.

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A systematic review of inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions

10.7244/cmj.2021.03.001.1 ◽

2021 ◽

Author(s):

Jack Birch ◽

Rebecca Jones ◽

Julia Mueller ◽

Matthew McDonald ◽

Rebecca Richards ◽

...

Keyword(s):

Systematic Review ◽

Weight Management ◽

Health Inequalities ◽

Randomised Controlled Trials ◽

Data Extraction ◽

Meta Analysis ◽

Original Research ◽

Controlled Trials ◽

Management Interventions ◽

Randomised Controlled

Background: It has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including intervention uptake, adherence and effectiveness. We conducted a systematic review to synthesise evidence on how different measures of inequality moderate the uptake of, adherence to and effectiveness of behavioural weight management interventions in adults. Methods: We updated a previous systematic literature review from the US Preventive Services Taskforce to identify trials of behavioural weight management interventions in adults that could be conducted in or recruited from primary care. Medline, Cochrane database (CENTRAL) and PsycINFO were searched. Only randomised controlled trials and cluster-randomised controlled trials were included. Two investigators independently screened articles for eligibility and conducted risk of bias assessment. We curated publication families for eligible trials. The PROGRESS-Plus acronym (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) was used to consider a comprehensive range of health inequalities. Data on trial uptake, intervention adherence, weight change, and PROGRESS-Plus related-data were extracted. Results: Data extraction in currently underway. A total of 108 studies are included in the review. Data will be synthesised narratively and through the use of Harvest Plots. A Harvest plot for each PROGRESS-Plus criterion will be presented, showing whether each trial found a negative, positive or no health inequality gradient. We will also identify potential sources of unpublished original research data on these factors which can be synthesised through a future individual participant data meta- analysis. Conclusions and implications: The review findings will contribute towards the consideration of intervention-generated inequalities by researchers, policy makers and healthcare and public health practitioners. Authors of trials included in the completed systematic review may be invited to collaborate on a future IPD meta-analysis. PROSPERO registration number: CRD42020173242

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Impact of adult weight management interventions on mental health: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2019-031857 ◽

2020 ◽

Vol 10 (1) ◽

pp. e031857

Author(s):

Rebecca A Jones ◽

Emma R Lawlor ◽

Simon J Griffin ◽

Esther M F van Sluijs ◽

Amy L Ahern

Keyword(s):

Mental Health ◽

Systematic Review ◽

Weight Loss ◽

Weight Management ◽

English Language ◽

Meta Analysis ◽

Overweight And Obesity ◽

Primary Data ◽

Management Interventions ◽

The Impact

IntroductionThe effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ≥25 kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ≥18 years, with overweight/obesity, defined as BMI ≥25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and ‘levels of evidence’ assessment will be completed.Ethics and disseminationEthical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author’s PhD thesis.PROSPERO registration numberCRD42019131659.

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Racial/Ethnic Disparities of Depressive Symptoms in the United States A Systematic Review and Meta-Analysis of Individual Participant Data

10.31234/osf.io/prsz6 ◽

2022 ◽

Author(s):

José M. Causadias ◽

Kevin Michael Korous ◽

Karina M Cahill ◽

Eiko I Fried ◽

Longfeng Li

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Meta Analysis ◽

Ethnic Disparities ◽

The United States ◽

Individual Participant Data ◽

Individual Participant ◽

Nationally Representative ◽

Minority Participants ◽

Racial Ethnic

Although a growing body of research has documented racial/ethnic disparities in depressive symptoms in the United States, the precise magnitude of these differences is not known. We conducted a systematic review and meta-analysis of individual participant data to (1) estimate the average difference of depressive symptoms between Whites and racial/ethnic minorities, as well as differences between (i.e., Asian American, African American, Latinxs, Multiracial, Native American, other race) and within (i.e., Latinx: Central American, Cuban American, Mexican American, Puerto Rican, other Latinx) minority groups, and (2) determine if moderators account for these differences. We screened 2,425 nationally-representative studies from the Inter-university Consortium for Political and Social Research (ICPSR), and identified 127 datasets of studies conducted from 1971 to 2018. We included 73 datasets from 26 nationally-representative studies (N = 2,116,853). The average absolute difference was d = 0.09, 95% CI [0.07, 0.12] between White and minority participants; was d = 0.07, 95% CI [0.06, 0.09] between minority participants; and d = 0.10, 95% CI [0.06, 0.15] within minority Latinx participants. Increases in socioeconomic status exacerbated these disparities. Psychometric analyses showed that measure reliability was related to larger differences. We discuss the implications of these findings.

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The Contribution of “Individual Participant Data” Meta-Analyses of Psychotherapies for Depression to the Development of Personalized Treatments: A Systematic Review

Journal of Personalized Medicine ◽

10.3390/jpm12010093 ◽

2022 ◽

Vol 12 (1) ◽

pp. 93

Author(s):

Pim Cuijpers ◽

Marketa Ciharova ◽

Soledad Quero ◽

Clara Miguel ◽

Ellen Driessen ◽

...

Keyword(s):

Systematic Review ◽

Statistical Power ◽

Randomized Trials ◽

Meta Analysis ◽

Primary Data ◽

Individual Participant Data ◽

Psychological Treatments ◽

Gender Education ◽

Individual Participant ◽

Meta Analyses

While randomized trials typically lack sufficient statistical power to identify predictors and moderators of outcome, “individual participant data” (IPD) meta-analyses, which combine primary data of multiple randomized trials, can increase the statistical power to identify predictors and moderators of outcome. We conducted a systematic review of IPD meta-analyses on psychological treatments of depression to provide an overview of predictors and moderators identified. We included 10 (eight pairwise and two network) IPD meta-analyses. Six meta-analyses showed that higher baseline depression severity was associated with better outcomes, and two found that older age was associated with better outcomes. Because power was high in most IPD meta-analyses, non-significant findings are also of interest because they indicate that these variables are probably not relevant as predictors and moderators. We did not find in any IPD meta-analysis that gender, education level, or relationship status were significant predictors or moderators. This review shows that IPD meta-analyses on psychological treatments can identify predictors and moderators of treatment effects and thereby contribute considerably to the development of personalized treatments of depression.

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Protocol for a Systematic Review and Meta-Analysis of Individual Participant Data on the Magnitude of Racial Disparities of Depressive Symptoms in the United States

10.31234/osf.io/26d85 ◽

2018 ◽

Author(s):

José M. Causadias ◽

Kevin Michael Korous ◽

Karina M Cahill ◽

Eiko I Fried ◽

Longfeng Li

Keyword(s):

United States ◽

Systematic Review ◽

Depressive Symptoms ◽

Racial Disparities ◽

Sex Education ◽

Mexican Americans ◽

Meta Analysis ◽

The United States ◽

Individual Participant Data ◽

Individual Participant

A growing body of research has documented racial disparities in depressive symptoms in the United States, although the precise magnitude on these differences is less well understood. This issue has important implications for informing public health policy, and developing and administering prevention and intervention strategies. In this protocol, we propose a systematic review and meta-analysis of individual participant data from nationally representative studies from the United States drawn from Inter-university Consortium for Political and Social Research (ICPSR). Our three aims are to: 1) Estimate the overall average difference of depressive symptoms between Whites and minorities, as well as between- (e.g., African-Americans, Latinos) and within- (e.g., Latinos: Mexican-Americans, Cuban-Americans) minority groups; 2) Determine if age, sex, education, income, occupation, socioeconomic status, and other variables account for these differences; 3) Test the cultural differences and similarities hypotheses. We argue that these health disparities are the result of social inequalities.

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