When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.
Analytic Framework [PDF - 293 kB]
The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).
Anderson AS, Porteous LE, Foster E, Higgins C, Stead M, Hetherington M, et al. The impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables. Public Health Nutr 2005;8(6):650-6.
Coleman KJ, Shordon M, Caparosa SL, Pomichowski ME, Dzewaltowski DA. The healthy options for nutrition environments in schools (Healthy ONES) group randomized trial: using implementation models to change nutrition policy and environments in low income schools. International Journal of Behavioral Nutrition and Physical Activity 2012;9(80).
Cullen KW, Watson K, Zakeri I. Improvements in Middle School Student Dietary Intake After Implementation of the Texas Public School Nutrition Policy. American Journal of Public Health 2008;98(1):111-7.
Frerichs L. Architecture and design for healthy eating in schools. Dissertation Abstracts International: Section B: The Sciences and Engineering 2015;75(12-B[E]).
Fung C, McIsaac JLD, Kuhle S, Kirk SFL, Veugelers PJ. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children. Preventive Medicine 2013;57(6):934-940.
Mâsse LC, de Niet-Fitzgerald JE, Watts AW, Naylor PJ, Saewyc EM. Associations between the school food environment, student consumption and body mass index of Canadian adolescents. Int J Behav Nutr Phys Act 2014;11(1):29.
Mendoza JA, Watson K, Cullen KW. Change in dietary energy density after implementation of the Texas Public School Nutrition Policy. J Am Diet Assoc 2010;110(3):434-40.
Mullally ML, Taylor JP, Kuhle S, Bryanton J, Hernandez KJ, MacLellan DL, et al. A province-wide school nutrition policy and food consumption in elementary school children in prince Edward Island. Canadian Journal of Public Health 2010;101(1):40-3.
Rappaport EB, Daskalakis C, Sendecki JA. Using routinely collected growth data to assess a school-based obesity prevention strategy. International Journal of Obesity 2013;37:79-85.
Sanchez-Vaznaugh EV, Sanchez BN, Baek J, Crawford PB. ‘Competitive’ food and beverage policies: are they influencing childhood overweight trends? Health Affairs 2010;29(3):436-46.
Spence S, Delve J, Stamp E, Matthews JN, White M, Adamson AJ. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England. PLoS One 2013;8(10):e78298.
Anderson A, Porteous L, Foster E, et al. The impact of a school-based nutrition education intervention on dietary intake and cognitive and attitudinal variables relating to fruits and vegetables. Public Health Nutrition 2005;8(06):650-6.
Mobley CC, Stadler DD, Staten MA, et al. Effect of nutrition changes on foods selected by students in a middle school-based diabetes prevention intervention program: the HEALTHY Experience. Journal of School Health 2012;82(2):82-90.
Probart C, McDonnell E, Hartman T, Weirich JE, Bailey-Davis L. Factors associated with the offering and sale of competitive foods and school lunch participation. Journal of the American Dietetic Association 2006;106(2):242-7.
The search strategy described below was used for the following reviews of interventions to support healthier foods and beverages in schools:
The CPSTF findings are based on evidence from a systematic review published in 2013 (Wang et al, 2013) combined with more recent evidence. Wang et al. searched five bibliographic databases: MEDLINE®, EMBASE®, PsychInfo®, CINAHL®, and the Cochrane Library for relevant studies from their inception through April 22, 2013. The Community Guide systematic review team conducted an updated search for evidence through January 4, 2017. In the updated search for evidence, PubMed® was used instead of MEDLINE®, and a search was conducted using Clinicaltrials.com.
Search terms and search strategies were adjusted to each database, based on controlled and uncontrolled vocabularies and search software. Once the literature search was completed, Community Guide staff reviewed the citations using inclusion and exclusion criteria to narrow down the publications to be included.
Database: Embase (OVID)
Date Searched: 1/04/2017
- (school or schools or afterschool or kindergarten or educational-setting*).ti,ot,sh,ab,tw.
- school/ or high school/ or kindergarten/ or middle school/ or primary school/
- exp obesity/
- exp body composition/
- waist hip ratio/ or waist to height ratio/
- (bmi or healthy weight or body weight or adiposity or body mass index or skinfold thickness or body fat or waist circumference or waist hip ratio or waist to height ratio or body composition or overweight or obese or obesity or over weight).ti,ot,sh,ab,tw.
- body weight/
- (normal weight or normal weights or hip circumference).ti,ot,sh,ab,tw.
- body fat/
- body mass index/
- skinfold thickness/
- waist circumference/
- 1 or 2
- 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12
- 13 and 14
- 2014*.em. or 2015*.em. or 2016*.em. [Individual update weeks were no longer available to be searched for 2014.]
- 15 and 16
- limit 17 to english language
The published literature was searched for economic information about the two interventions that were found to be effective.
The search for economic evidence included studies identified in the search for effectiveness evidence described earlier (search period through March 8, 2016) and a search within specialized databases at CRD-York and in EconLit (search period through January 5, 2016). Search terms and strategies were adjusted for each database, based on controlled and uncontrolled vocabularies and software. In addition, reference lists in included studies were screened and subject matter experts were consulted for additional studies that may have been missed.
Database: CRD-York (NHS-EED)
Date Searched: 01/05/2016
- (obesity or overweight or "over weight" or adiposity or obese or "body fat" OR "waist hip" or "waist to hip" or "skinfold thickness" or "skinfold measurement" or "skin fold thickness" or "skin fold measurement" or "hip circumference" or "waist circumference")
- ("normal weight" or "bmi" or "body mass index" OR "waist to height" or "body composition" or "body fat")
- #1 OR #2
- (school or schools or "educational setting" or kindergarten or schoolchild* or preschool*)
- #3 AND #4
Limit to NHS EED studies
Date Searched: 01/05/2016
Modes - Boolean/Phrase
S10 (S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8) AND (S9)
S9 TX "educational setting" OR TX school OR TX schools OR TX kindergarten* OR TX "educational settings" OR TX "academic setting" OR TX "academic settings"
S8 TX "adiposity"
S7 TX "skinfold thickness"
S6 TX overweight or TX "over weight"
S5 TX "healthy weight" or TX "waist hip" OR TX "waist to height" OR TX "waist circumference”
S4 TX "body mass" OR TX bmi OR TX "body composition" or TX "normal weight"
S3 TX obesity or TX obese
S2 TX "skinfold thickness" OR TX "hip measurement" OR TX "waist measurement"
S1 TX “body fat” OR TX "hip circumference" OR TX "waist to hip"
Centers for Disease Control and Prevention. Recommendations to prevent and control iron deficiency in the United States. MMWR 1998;47: 1-29.
Centers for Disease Control and Prevention. School health guidelines to promote healthy eating and physical activity. MMWR 2011;60(5):1-76.
Centers for Disease Control and Prevention. School Nutrition Environment. Atlanta (GA): 2016 [cited 2017 Jan 4]. Available from: https://www.cdc.gov/healthyschools/nutrition/schoolnutrition.htm .
Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 (Report to the Secretary of Agriculture and the Secretary of Health and Human Services). Washington (DC): 2010 [cited 2017 Jan 4]. Available from: http://www.nutriwatch.org/05Guidelines/dga_advisory_2010.pdf.
Wang Y, Wu Y, Wilson RF, Bleich S, Cheskin L, et al. Childhood Obesity Prevention Programs: Comparative Effectiveness Review and Meta-Analysis. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2013. Report No.: 13-EHC081-EF.