A systematic review of children's dietary interventions with parents as change agents: Application of the RE-AIM framework

Introduction. Interventions targeting children's dietary behavior often include strategies that target parents as implementation agents of change, though parent involvement on intervention effectiveness is unclear. The present study systematically assessed (1) reporting of reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of child dietary intervention studies with parents as change agents and (2) evaluated within these studies the comparative effectiveness of interventions with and without a parent component. Methods. The search was conducted in PubMed, PsycINIFO, and Cochrane Library. Eligible studies were required to include a condition with a parental component, a comparison/control group, and target a child dietary behavior outcome. Forty-nine articles met criteria. Raters extracted RE-AIM and parent implementation information for each study. Results. Effectiveness (72.5%) was the highest reported RE-AIM element, followed by reach (27.5%), adoption (12.5%), implementation (10%), and maintenance (2.5%). Median reporting of parent implementation was highest for adoption and enactment (20%), followed by receipt (7.5%), and maintenance (2.5%). Six studies tested comparative effectiveness of parental involvement on child dietary outcomes. Conclusion. Current RE-AIM reporting among children's dietary interventions is inchoate. The contribution of parental involvement on intervention effectiveness remains unclear. Increased focus should be placed on reporting of external validity information, to enable better translation of research to practical applications. (C) 2016 Published by Elsevier Inc.