Effectiveness Review
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.
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).
Effectiveness Review
Laws R, Counterweight Project Team. A new evidence-based model weight management in primary care: the Counterweight Programme. J Hum Nutr Diet 2004;17:191-208.
McCallum Z, Wake M, Gerner B, et al. Outcome data from LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes 2007;31:630-6.
Ockene IS, Hebert JR, Ockene JK, et al.. Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population. Arch Intern Med 1999, 159:725-31.
Vinicor F, Cohen SJ, Mazzuca A, et al. DIABEDS: A randomized trial of the effects of physician and/or patient education on diabetes patient outcomes. J Chron Dis 1987, 40(4):345-56.
The following outlines the search strategy used for evidence reviews of provider-oriented interventions to prevent and control obesity: provider education, provider feedback, provider reminders, provider education with a client intervention, multicomponent provider interventions, and multicomponent provider interventions with client interventions.
Using Medical Subject Headings and text words, in July 2007 we searched the following databases: Medline, Embase, LILACS, PsycInfo, CINAHL, Dissertation Abstracts, and Cochrane. We used search terms related to provider/medical care combined with terms related to weight and overweight. The specific search terms used are shown on the Community Guide website. Experts in obesity and/or provider-based interventions were consulted for citations, and reference lists of retrieved articles and literature reviews were also reviewed.
Searches were limited to literature published in English-language journals between 1966 and June 30, 2007. To be considered for inclusion, studies had to (1) report on one or more outcomes identified in our analytic framework, specifically either a provider behavior and/or patient weight-related data from ≥6 months from the start of the intervention; and (2) meet the definition of a provider-level intervention. We excluded studies specifically targeting pregnant or post-partum populations.
Effectiveness Review
Search Terms
General search
Limited to humans, English language, and not review
Databases: Medline, Embase, CINAHL, PsycINFO, WOS, SPORTDiscus, ERIC
Terms: BMI (or body mass index)/ obesity (or obese)/ over weight (or overweight)/ body weight + delivery of health care/ quality of health care/ professional practice+ exercise/ physical activity/ nutrition disorders/ nutrition assessment/ nutrition/ nutrition therapy
Cost benefit/ cost-benefit analysis/ cost effectiveness/ effectiveness OR evaluation/ evaluation studies/ outcome assessment/ outcome and process assessment
Provider education specific search
Databases: Medline, PsycInfo, Nexis-Lexis, Embase, CINAHL, Sportdiscus, WOS, Cochrane (DARE, CENTRAL), Dissertation abstracts international, Health promotion and education, LILACS, POPLine, and HealthStar.
Terms: BMI (or body mass index)/ obesity (or obese)/ percent body fat/ weight/ overweight + provider/physician + education/tools/training
Behavioral specific search
Databases: Medline, PsycInfo, Embase, CINAHL, Sportdiscus, Cochrane (DARE, CENTRAL), Dissertation abstracts international, Health promotion and education, LILACS, POPLine, and HealthStar.
Terms:
BMI (or body mass index)/ obesity (or obese)/ body fat/ weight/ overweight
+ exercise/ physical activity/ fitness/ nutrition assessment/ nutrition/ nutrition therapy
+ behavioral/ behavior modification/ self management/ counseling/ education/ support/
+ medical (or health) care/ hospital/ clinic/ general (or family) practice/ provider/ physician/ nurse/ patient/
Technology specific search
Databases: Medline, PsycInfo, Embase, CINAHL, Sportdiscus, Cochrane (DARE, CENTRAL), Dissertation abstracts international, Health promotion and education, LILACS, POPLine, and HealthStar.
Terms:
BMI (or body mass index)/ obesity (or obese)/ body fat/ weight/ overweight
+ medical (or health) care/ hospital/ clinic/ general (or family) practice/ provider/ physician/ nurse/ patient/
+ Internet/ web/ website / message (or discussion) board/ chat/ telephone (or telephony)/ cellphone/ compact disc / digital versatile (or video) disc (or dvd)/ electronic/ interactive voice response (or IVR)/ computer/ touch screen/ interactive/ personal digital assistant (or PDA)/ palm pilot/ pocket pc/ software/ email (or e-mail)
Additional Search Methods
In addition to the library-assisted search, review articles were flagged for review to search their reference lists (an "ancestry search").
Ovid MEDLINE(R)
- (educat$ or train$).hw,tw. or ed.fs.
- exp health personnel/ or family practice/ or primary health care/ or physician$.mp. or nurs$.mp. or pharmac$.mp. or health care provider$.mp.
- 1 and 2
- exp Overweight/
- exp obesity/
- body mass index/ or skinfold thickness/ or waist-hip ratio/
- bmi.tw. or obes$.mp.
- weight$.hw,tw. or body fat.tw. or overweight.mp.
- or/4-8
- 3 and 9
- limit 10 to english language
- limit 11 to humans
EMBASE
- 'education'/exp OR educat* OR training OR train* OR 'reminder system'/de OR 'feedback system'/exp OR remind* OR feedback OR 'feed back' AND [english]/lim AND [humans]/lim AND [embase]/lim AND [1966-2007]/py
- 'health care personnel'/exp OR 'medical care'/exp OR 'primary health care'/exp OR 'general practice'/exp OR physician* OR nurs* OR pharmacist* OR 'health care provider' AND [english]/lim AND [humans]/lim AND [embase]/lim AND [1966-2007]/py
- 'body mass index' OR 'bmi' OR 'overweight' OR 'weight' OR 'body fat' OR obes* OR 'obesity'/exp OR 'body mass'/de OR 'waist hip ratio'/de OR 'skinfold thickness'/de AND [english]/lim AND [humans]/lim AND [embase]/lim AND [1966-2007]/py
- 1 AND 2 AND 3
CINAHL
- (educat$ or train$).hw,tw. or ed.fs.
- exp health personnel/ or family practice/ or primary health care/ or physician$.mp. or nurs$.mp. or pharmac$.mp. or health care provider$.mp.
- 1 and 2
- exp Overweight/
- exp obesity/
- body mass index/ or skinfold thickness/ or waist-hip ratio/
- bmi.tw. or obes$.mp.
- weight$.hw,tw. or body fat.tw. or overweight.mp.
- or/4-8
- 3 and 9
- limit 10 to english language
- limit 11 to humans [Limit not valid in: CINAHL; records were retained]
- limit 12 to yr="1966 - 2007"
- 13 not 200707$.ew.
DIALOG
Dissertation Abs Online
- 166 ((EDUCAT? OR TRAIN? OR FEEDBACK OR REMIND?) AND (PHYSICIAN? OR NURS? OR PHARMAC?) AND (OVERWEIGHT OR OBES? OR BMI)) AND PY=1966:2007
- 166 Sort S1/1-500/PY,D
- 166 S2
- 164 RD S3/1-5000 (unique items)
COCHRANE
"educat* or train* or remind* or feedback or "feed back" in Title, Abstract or Keywords and "health personnel" or "family practice" or "primary health care" or physician* or nurs* or pharmac* or "health care provider*" in Title, Abstract or Keywords and overweight or obes* or bmi or "body mass index" or "skinfold thickness" or "waist-hip ratio" or weight or "body fat" in Title, Abstract or Keywords
PsycINFO
- (educat$ or train$).hw,tw. (407505)
- exp health personnel/ or family medicine/ or primary health care/ or physician$.mp. or nurs$.mp. or pharmac$.mp. or health care provider$.mp. (138179)
- 1 and 2 (33083)
- obesity/ (6534)
- body mass index/ or skinfold thickness.tw. or waist-hip ratio.tw. (439)
- bmi.tw. or obes$.mp. (11038)
- weight$.hw,tw. or body fat.tw. or overweight.mp. (41558)
- or/4-7 (46143)
- 3 and 8 (456)
- limit 9 to (human and english language) (409)
- limit 10 to yr="1966 - 2007" (404)
- 11 not 200707$.up. (403)
- from 12 keep 1-403 (403)
LILACS
educat$ or train$ or feedback or "feed back" or reminder$ [Palavras] and doctor$ or nurs$ or pharmac$ or "health care provider$" [Palavras] and overweight or obes$ or bmi or "body mass index" or skinfold or weight or "body fat" [Palavras]