Table 2.

Design of Interventions

Authors (Year)	Study Objectives	Explicit theoretical framework cited	Description of Intervention	Target of Intervention	Intergenerational component
Anand et al. (2007)	To determine if a household-based lifestyle intervention is effective at reducing energy intake and increasing physical activity among Aboriginal families after 6 months, compared to control group families receiving basic energy balance educational materials	Protection Motivation Theory, Social Learning Theory, Normative Influences, Theories of Persuasion	Home counseling and goal setting, filtered water provided, physical activity program for children, and educational events provided over six months	Canadian Aboriginal children, ages 5+, and a parent	Families involved in counseling & goal setting
Beech et al. (2003)	To assess the feasibility, acceptability, and outcomes of 2 versions of a culturally relevant, family-based intervention to prevent excess weight gain in pre-adolescent African-American girls	Social Cognitive Theory	Twelve separate weekly group sessions with girls and with parents involving physical activity and nutrition education	African American daughters, ages 8–10	Parents and children have separate weekly educational sessions
Caballero et al. (2003)	To evaluate effectiveness of a school-based body fat reduction program Among American Indian children (intervention schools were compared to control schools).	Social Learning Theory	Classroom curriculum, food service, physical activity, and family involvement offered in school settings over 3 years	Predominantly American Indian children, grades 3–5	Families have materials based on classroom curriculum to be used at home, and families participate in workshops and events
Cookson et al. (2000)	To evaluate effectiveness of HeartSmart Family Fun Pack in promoting family-based lifestyle changes	Transtheoretical Model	3 month program using “Family Fun Pack” with games, posters, brochures, growth chart	Children, ages 6–10, and a parent	Families participate in Fun Pack activities
Cullen & Thompson (2008)	To assess log-on rates and change in mediating variables achieved from a web-based nutrition intervention for African American families.	Social Cognitive Theory	8 weekly web-based lessons on nutrition	African American daughters, ages 8–10, and a parent	Parents are expected to be involved in activities via the web
De Bourdeaudhuij & Brug (2000)	To assess the impact of tailored nutrition education letters addressed to each family member compared with control condition of standardized, non-personalized nutrition education letters	Operant and Social Learning Theories, Theory of Planned Behavior	Provision of individually tailored or standardized nutrition education letters to family members	2+ children, ages 12–18, and both parents	Family members receive intervention separately but simultaneously
De Bourdeaudjuij et al. (2002)	To assess the impact of a tailored nutrition intervention on fat intake and psychosocial determinates of fat intake, including differential impact of family-based and individual-based interventions.	Operant and Social Learning Theories, Theory of Planned Behavior	Tailored nutrition education letters focused on fat intake sent either to parents only or to adolescents only	Children, ages 15–18, and one parent	Adolescents and parents receive the intervention
Eisenmann et al. (2008)	To modify children’s physical activity, nutrition, and screen time through a randomized community, school, and family-based intervention.	Bronfenbrenner’s Social Ecological Model	Community component included public education via community leaders and other strategies to increase public awareness; school components included teacher’s packet and other curriculum items; family component included monthly materials packets, including meal planners, recipes, etc. All components offered over 9 months.	Children, grades 3–5	Children are exposed to intervention at school and family received packet at home (meal planners, informational materials)
Epstein et al. (2000)	To test the relative efficacy of three treatment arms on weight loss among obese children: standard family based treatment (FBT); FBT plus problem solving taught to parents and child; FBT plus problem solving taught to child	None explicit	6-month family-based behavioral weight-control program with either parent and child problem-solving, child problem-solving, or no additional problem-solving component.	Overweight children, ages 8–12, and a parent	Parents and children participated in individual sessions together and in group sessions separately.
Epstein et al. (2004)	To compare the effects of two methods of reducing target sedentary behaviors (reinforcement or stimulus control) on patterns of activity and weight loss in overweight children.	Behavioral economic theory	6 month intensive intervention that included 16 weekly meetings followed by two bi-weekly meetings and two monthly meetings. Group meetings focusing on Traffic Light Diet; weight control and self-monitoring; and behavior change techniques. One group was also taught stimulus control.	Obese children, 8–12 years old and a parent	Parents and children participate in separate group meetings.
Epstein et al. (2008)	To compare the effect of a family-based intervention targeting increased eating of fruits and vegetables and low-fat dairy foods to one targeting reduced intake of high energy-dense foods on children’s weight.	None explicit	Weekly sessions for 2 months; biweekly sessions for 2 months; one session at 6 months, 1 year and 2 years. Traffic light diet with a focus on increasing fruits and vegetables and low-fat dairy foods or with a focus on decreasing high energy dense foods. Information about physical activity. Goal setting and self-monitoring. Stimulus control.	Overweight or obese children, 8–12 years old and a parent	Parents and children participated in individual sessions together and in group sessions separately.
Fitzgibbon et al. (2002)	To describe a family-oriented obesity prevention program targeted at minority preschool-aged children.	Social Learning Theory, Self-Determination Theory, Transtheoretical Model	3 child classes per week for 14 weeks, focusing on the Traffic Light Diet healthy eating activities and physical activity; for parents, weekly newsletters, homework assignments, and twice-weekly low impact aerobics classes	African American and Latino Head Start children and their parents	Parents and children receive intervention
Golan et al. (1998)	To compare the effectiveness of a family-based childhood obesity treatment intervention in which parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of change.	None explicit	Hour-long support and educational sessions were conducted by a clinical dietitian-14 sessions for the parents in the experimental intervention and 30 for the children in the conventional intervention. Individual sessions were held for members of both groups, when necessary.	Obese children, ages 6–11	Parents and children received group sessions separately
Golan et al. (2006)	To evaluate the efficacy of a family-based intervention that involves parents alone versus parents plus obese children together.	None explicit	32 families were randomized into parent only group or parent plus children group; both groups received sixteen one hour educational programs that emphasized healthy eating, encouraged regular physical activity, and, for the parents, emphasized parental control techniques. Parents and children attended the mixed group together. Families in both groups also received approximately six individual family sessions.	Overweight Israeli children, ages 6–11	Parent and children receive intervention separately
Gombosi et al. (2007)	To evaluate the impact of a school, family, community, and industry-based intervention on the rates of overweight and obesity among rural children over 5 years.	None explicit	“Fit for Life” involved 5 components implemented over 5 years: school based education, a wellness club, point source (nutritional info for each item on restaurant menus in community restaurants), occupational health, and community activities (e.g., family fun days)	Children, kindergarten - grade 8	Children involve parents in the home activities of the intervention. Family participates in family fun days
Grassi et al. (1999)	To determine whether a walking club program increased physical activity levels and changed perceived barriers to physical activity among a convenience sample of adults	None explicit	4 educational meetings offered over a 3 month period, as well as no-cost walking clubs	Adults, age 18–55	All generations allowed to participate in activities
Harrington et al. (2005)	To evaluate the predictors of completing a dietary intervention program involving school curriculum, family fun nights, and family meal and game sharing.	Social Cognitive Theory	7 sessions with menu suggestions, educational workshops, family fun nights, peer leaders, etc. Schools randomized to assessment only, curriculum only, or curriculum plus family do-at-home activities	Children, elementary school, and a parent	Family is involved in kick off night, and in at-home intervention activities
Harvey-Berino & Rourke (2003)	To evaluate the relative effectiveness of maternal participation in an obesity prevention parenting support program compared to a control of parenting support only on reducing obesity prevalence rates among Native-American children.	None explicit	16-week obesity prevention classes plus parenting support intervention, or parenting support alone.	Native-American children, 9 months to 3 years, and overweight mothers	Mothers participate in instructional intervention
Hopper et al. (2005)	To examine the efficacy of a school-based physical activity and nutrition program involving a parental component, with 6 school randomly assignment to program versus control groups.	Social Learning Theory	Enhanced 20 week school curriculum and a home program in which parents and children completed activities for points and rewards	Children, grade 3, and a parent	Children and parents work together on home activities.
Janicke et al. (2008)	To compare the effects of a behavioral family based intervention to a behavioral parent-only intervention on children’s weight delivered through Cooperative Extension Services offices.	None explicit	8 weekly and then 8 biweekly sessions focusing on Stoplight diet, combined with diet and physical activity goal setting and self-monitoring.	Overweight or obese rural children, ages 8–14, and a parent	Parents and children received intervention separately
Kalavainan et al. (2007)	To compare the efficacy of a group treatment program emphasizing healthy lifestyle versus a routine counseling group for obesity among 70 obese children.	None explicit	Nutrition education, physical activity, and behavioral therapy delivered either via routine child counseling (2 sessions plus informational booklets) or family-based group sessions (15 sessions).	Obese children, ages 7–9	Parents and children receive intervention
Klohe-Lehman et al. (2007)	To evaluate the effects of a weight loss intervention delivered to mothers on diet and physical activity of the mothers and their 1–3 year old children	Social Cognitive Theory	Weekly 2-hour sessions for mothers, involving exercise, nutrition education, and cognitive-behavioral strategies, over 8 weeks	Children, ages 1–3 years, of overweight and obese mothers	Mother only receives intervention
Levine et al. (2001)	To evaluate the feasibility, acceptability, and effects of a family based intervention for children with severe obesity.	None explicit	10–12 session behavioral group intervention adopted from Epstein’s Stoplight Diet. Group sessions and self-monitoring.	Obese children, ages 8–12, and a parent	Parents and children receive intervention
Lytle et al. (2006)	To evaluate the effectiveness of a school-based dietary intervention by comparing intervention and control schools.	None explicit	Multi-component school-based intervention included classroom based curricula, family newsletters, and changes in the school food environment, various components conducted over two years	Students, middle school	Family is involved in intervention, including newsletters/informati on, coupons, etc.
Müller et al. (2001)	To discuss the background, approach and initial findings of the 8 year Kiel Obesity Prevention Study.	None explicit	8 hours of nutrition education delivered annually for 3 years to students, parents given same information at school meeting. In addition, family counseling and support program using 3–5 home visits, plus a structured sports program, offered to families with overweight or obese children and to families with normal-weight children but obese parents.	Children, ages 5–7	Parents receive educational intervention. Families offered counseling and support program. Children receive separate intervention.
Nemet et al. (2008)	To evaluate the effectiveness of a family-based diet and physical activity intervention for obese children from obese families, comparing children in the intervention with controls.	None explicit	3 months of family-oriented behavioral groups focused on diet (weekly sessions), physical activity (twice-weekly sessions), and movement therapy (weekly for children only)	Obese children, ages 8–11, and an obese parent	Parents and children receive group sessions separately
Northrup et al. (2008)	To discuss the development of a school based program to improve lifestyle (specifically diet and physical activity)	Maslow’s Hierarchy of Needs, Social Cognitive Theory	School-based activities including physical activity and nutrition interventions and health screenings offered over 5 years	Children, grade 5, and a parent	Family members participate in intervention
Ransdell et al. (2003)	To compare the effects of a home-based versus university-based physical activity program delivered to mother-daughter dyads.	Social Cognitive Theory	2 introductory sessions addressing physical activity topics, followed by either university-based (group physical activity sessions 3 times per week) or home-based (provided with information, exercise logs, and recommended physical activity calendar to complete at home on their own) programs for 12 weeks	Healthy but sedentary – daughters, ages 14–17, and mothers, ages 31–60	Mothers and daughters participate in intervention together; For the home-based intervention, they participate either together or separately
Ransdell et al. (2004)	To compare the effects of a home-based physical activity program for mother-daughter-grandmother triads versus a control group condition.	None explicit	6-month home-based physical activity program; following 2 introductory sessions addressing physical activity topics, participants asked to complete 3 bouts of physical activity sessions each week. Materials were provided to recommend activities increasing in duration and intensity over the course of the intervention	Healthy but sedentary – daughters, ages 8–13, mothers, ages 30–50, and grandmothers, ages 50–70	Three generations of female family members participate in intervention together
Robinson et al. (2008)	To describe the study design and baseline results of an trial comparing a family-based physical activity and screen time reduction intervention with a control group receiving community-based health education.	Social Cognitive Theory	GEMS Jewels after-school dance classes incorporating cultural themes important in the local African-American community; START (Sisters Taking Action to Reduce Television) intervention in which a young adult African-American female role model conducted home visits aimed at family screen-time reduction. Interventions occur over 2 years.	Low socioeconomic status, African American daughters, ages 8–10	Family members involved in in-home activities, although dance classes were for children only
Rodearmel et al. (2006)	To evaluate the effects of an intervention focusing on small lifestyle changes (increasing walking and consuming two servings of ready-to-eat cereal) on the weight of overweight children and their family	None explicit	Family members asked to increase walking by at least 2000 steps per day above baseline and to consume 2 servings of cereal per day (breakfast and snack)	Overweight or at risk for overweight children, ages 8–12, and a parent	All families participate in intervention together
Sääkslahti et al. (2004)	To evaluate the effects on children’s physical activity over 3 years of a parent-education intervention versus a no-intervention comparison group.	Social Learning Theory	2 annual hour-long educational meetings with parents focused on children’s physical activity; participants provided with ideas and resources for increasing children’s physical activity levels	Preschool-aged Finnish children	Only parents involved in intervention, though outcomes are measured in children
Stern et al. (2006)	To present formative research leading to the development of a weight management intervention among African American girls and to present baseline results from the intervention.	None explicit	Individualized program focusing on nutrition, exercise, and behavior modification, using self monitoring.	2 part study 1: Overweight daughters, mean age 14, and their mothers 2: Obese daughters, ages 11–17, and a primary caretaker	Daughters and mothers participate together
Teufel-Shone et al. (2005)	To present a case study describing the development, delivery and outcomes of a family based diabetes education intervention, La Diabetes y La Unión Familiar.	Social Learning Theory	“La Diabetes y La Union Familiar” provided 10 contacts over 12 weeks, focused on teaching team-building and communication skills; provision of information on food choices and physical activity; and celebratory events. Used games, educational flip charts, stories, food sampling and preparation, and low level-physical activities.	Diabetic patient and supporting family members (some of whom were children)	Family participates in intervention
Warren et al. (2003)	To compare the effectiveness of a control, dietary, physical activity, and combined dietary-physical activity school and family-based interventions for prevention of obesity in children 5–7 years old.	Social Learning Theory	Interactive nutrition and/or physical activity curriculum was delivered over 20 weeks through lunchtime clubs.	Children, ages 5–7	Worked with parents to overcome barriers to the desired health behavior.
Wilfley et al. (2007)	To examine the relative efficacy of two weight management interventions (behavioral skills maintenance and social faciliation maintenance) compared to a conrol condition following a standard family-based childhood obesity treatment program.	None explicit	16 weekly sessions. 20 minute family treatment and 40 minute separate child and parent groups. Dietary modification (traffic light diet), physical activity, and behavior change skills (self monitoring and goal setting). 3 conditions: behavioral skills maintenance, social facilitation maintenance and usual care.	Overweight children (20%–100%), 7–12 years old and at least one parent	Parents and children participated in individual sessions together and in group sessions separately.
Williams et al. (2004)	To present a description of a randomized controlled trial testing the efficacy of a family based intervention to increase physical activity among individual at high risk for diabetes	Theory of Planned Behavior	Face-to-face, telephone, and/or mail contacts focusing on education, goal setting, strategies to increase physical activity, and self-monitoring with pedometers	Inactive, non-diabetic adult-children of diabetics, ages 30–50	Family participation is encouraged in intervention