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Appendix A Table 2Study eligibility criteria

  1. Populations. The following apply to all Key Questions:
    1. Age 2–18. If study substantially overlaps our age range (e.g., 14–65), include article if results for younger participants reported separately. For study of “young adult” or “college-aged”, exclude unless average age is <19 or “college freshmen” is specified.
    2. Either (a) entire sample is overweight or obese (85th percentile for age and sex-specific BMI, or who meet previously accepted criteria for overweight based on ideal body weight) or (b) ≥50% of the sample are overweight or obese AND ≥80% of the sample have one of the following risk factors for overweight or obesity-related medical problems: Children of overweight parents; Hispanic, Black, or American Indian/Alaska Native; children with the following medical conditions: diabetes, metabolic syndrome, hypertension, lipid abnormalities, or other cardiovascular-related disorders.
    3. Primary care population or comparable.
    4. Exclude trials in which the sample is limited to youth: (1) with eating disorders, (2) pregnant/post-partum, (3) overweight/obesity secondary to genetic or medical condition, including Polycystic ovarian syndrome, hypothyroid, Cushings, GH deficiency, insulinoma, hypothalamic disorders (e.g. Froehlich’s syndrome), Laurence-Moon-Biedl syndrome, Prader-Willi syndrome, weight gain secondary to medications (e.g., antipsychotics), or (4) other idiosyncratic weight-loss issues.
  2. Study Design.
    1. All studies for KQ1 and KQ2 (including sub-KQ) must have an outcomes assessment at 6 months or later post-baseline. No minimum follow-up is required for serious (i.e., requiring urgent medical care) adverse events, KQ3.
    2. Behavioral interventions: limit to RCT or CCT with minimal intervention or placebo control, with a minimum of 10 subjects per treatment arm
    3. Pharmacological interventions: RCT with placebo pill control, with a minimum of 10 subjects per treatment arm
  3. Setting.
    1. For Behavioral interventions: all KQ except serious (i.e., requiring urgent medical care) adverse effects (KQ3): limit to countries listed as “high” human development on Human Development Index (over .90): Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Hong Kong, Iceland, Ireland, Israel, Italy, Japan, Korea, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Singapore, Slovenia, Spain, Sweden, Switzerland, United Kingdom, United States.
    2. Excluded trials in settings not feasible for implementation in primary care or health care systems to which primary care providers could refer, such as schools and inpatient settings.
  4. Intervention.
    1. Include behavioral (published ≥1985), pharmacological, complimentary/alternative, or health care system interventions, singly or combined, designed to promote weight control/loss or weight maintenance, or an important components of weight loss (e.g., physical activity).
    2. Intevention must be either conducted in primary care, feasible for conduct in primary care, or comparable to programs widely available for referral from primary care. We also accepted programs that would be feasible for implementation in a health care system and therefore could be available for referral from primary care, if available.
    3. Exclude trials in which intervention focuses primary prevention, changes in the build environment, mazindol.
  5. Outcomes.
    1. KQ1 and KQ2 (and sub-KQs): Must provide acceptable adiposity outcome (2-C, 3-C or 4-C models, except 2-C models not using Lohman’s age and sex-specific equation or using the measurement of total bady fat K+) or weight outcome (e.g., baseline and post-intervention weight, weight change, net weight change over control group, or a related measures (such as BMI, BMI SDS, etc.)
    2. KQ3: All potential harms reported in KQ1 & KQ2 trials will be included. For trials that are not included for KQ1 or KQ2, outcomes are limited to serious adverse events, such as death, need for medical or psychiatric treatment, or growth retardation

From: Appendix A, Detailed Methods

Cover of Effectiveness of Primary Care Interventions for Weight Management in Children and Adolescents
Effectiveness of Primary Care Interventions for Weight Management in Children and Adolescents: An Updated, Targeted Systematic Review for the USPSTF [Internet].
Evidence Syntheses, No. 76.
Whitlock EP, O'Conner EA, Williams SB, et al.

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