Lifestyle weight management services for children and adolescents

This case study follows the 5-step process for accessing and using evidence in response to a request from commissioners regarding Lifestyle Weight Management Services (LWMS) for children and adolescents.

Identify

Using PICO, the scope of the evidence search was defined as:

Population: Overweight/ obese children and adolescents

Intervention: Tier 2 weight management, also known as lifestyle weight management

Comparison: Local health systems

Outcomes: Weight management

Access

A Clinical Effectiveness Programme Officer was asked to conduct the search and report findings.
The following search questions were addressed:

“What is the evidence for having a Tier 2 weight management service for children and adolescents?”
The search strategy involved searching the following databases and websites:

• Cochrane Library
• MEDLINE
• PubMed
• CINAHL
• NICE Evidence

The following search strategy was used:

(“tier 2 weight management” OR “lifestyle weight management”) AND (programme OR service OR intervention) AND (child* OR adolescen*)

Appraise

A range of study types were reviewed including systematic reviews (SRs), randomised controlled trials (RCTs) and mixed-methods studies. Appraisal was conducted according to the strengths and limitations of each piece of evidence, including issues concerning sampling, differences in the description and use of LWMS, and measuring outcomes.

Apply

Findings were reported in an evidence review and are being used to support local work in taking a whole system approach to healthy weight.  Key points of this review included:

• The evidence base regarding LWMS for children and adolescents has been limited by several factors
• There is evidence to indicate that family focused LWMS are associated with a range of improvements
• There is evidence to suggest that there are three critical components of successful LWMS
• There is evidence to suggest that school based LWMS are not effective

Share & manage

The findings of the review were consolidated into two documents, a full evidence review and a briefing version with the headline findings. This was done to enable greater accessibility of the evidence to stakeholders and commissioners who may be limited on time. To promote sharing of learning, this review was uploaded to Health Innovation West of England’s Evidence Repository on the Futures NHS platform.