Parent‐only interventions for childhood overweight or obesity in children aged 5 to 11 years

Emma Loveman; Lena Al‐Khudairy; Rebecca E Johnson; Wendy Robertson; Jill L Colquitt; Emma L Mead; Louisa J Ells; Maria‐Inti Metzendorf; Karen Rees

doi:10.1002/14651858.CD012008

Intervenciones sólo en padres para el sobrepeso y la obesidad en niños de 5 a 11 años de edad

Appendices

Appendix 1. Search strategies

Cochrane Library

Part I: Obesity

1. [mh ^Obesity]

2. [mh ^"Obesity, Morbid"]

3. [mh ^"Obesity, Abdominal"]

4. [mh ^"Pediatric Obesity"]

5. [mh ^Overweight]

6. [mh ^"Weight Loss"]

7. (adipos* or obes*):ti,ab

8. (overweight* or ("over" next weight*)):ti,ab

9. ("weight" near/1 (reduc* or los* or control* or manage*)):ti,ab

10. {or #1‐#9}

Part II: Intervention

11. [mh "Behavior Therapy"]

12. [mh "Counseling"]

13. [mh ^"Family Therapy"]

14. [mh ^"Social Support"]

15. [mh ^"Program Evaluation"]

16. [mh "Exercise"]

17. [mh "Exercise Therapy"]

18. [mh "Physical Education and Training"]

19. [mh "Exercise Movement Techniques"]

20. [mh ^"Motor Activity"]

21. [mh Diet]

22. [mh "Diet Therapy"]

23. [mh ^"Patient Education as Topic"]

24. [mh ^"Health Education"]

25. [mh "Health Behavior"]

26. [mh "Health Promotion"]

27. [mh ^"School Health Services"]

28. [mh ^"School Nursing"]

29. [mh ^"Life style"]

30. (("obesity" near/4 "intervention") or "program" or "programme" or "camp" or "camps"):ti,ab

31. ("lifestyle" or "life style"):ti,ab

32. exercis*:ti,ab

33. (physic* next (activ* or fit*)):ti,ab

34. (walk* or jog* or swim* or ("weight" next lift*) or danc* or "aerobics"):ti,ab

35. ((physic* or strength* or resist* or "circuit" or "weight" or aerob* or "cross" or "endurance" or structur*) near/4 train*):ti,ab

36. ("behavioral" or "behavioural" or (("behavior" or "behaviour") next "modification") or psychoth* or "psychosocial"):ti,ab

37. (("group" or "family" or cognit* or behav*) next therap*):ti,ab

38. (counselling or counselling):ti,ab

39. educat*:ti,ab

40. (("parent" or "parents" or "family") next ("based" or "focused" or "directed" or "centered" or "only" or "led")):ti,ab

41. (diet* or "healthy nutrition" or (nutrition* next ("knowledge" or educat* or therap* or program* or intervention*))):ti,ab

42. {or #11‐#41}

Part III: Part I + Part II and additional MeSH/subheading combination

43. #10 and #42

44. [mh ^Obesity] or [mh ^"Obesity, Morbid"] or [mh ^Overweight]

45. [mh /DH,PC,RH,TH,PX][diet therapy or prevention & control or rehabilitation or therapy or psychology]

46. #44 and #45

47. #43 or #46

Part IV: Population [adapted from Leclercq 2013]

48. [mh ^Adolescent]

49. [mh Child]

50. [mh ^Infant]

51. [mh ^Pediatrics]

52. "minors":ti,ab

53. ("boy" or "boys" or "boyhood"):ti,ab

54. girl*:ti,ab

55. ("kid" or "kids"):ti,ab

56. infant*:ti,ab

57. ("baby" or "babies"):ti,ab

58. ("toddler" or "toddlers"):ti,ab

59. ("child" or "childs" or children* or childhood* or childcare* or schoolchild*):ti,ab

60. adolescen*:ti,ab

61. juvenil*:ti,ab

62. youth*:ti,ab

63. (teen* or preteen*):ti,ab

64. (underage* or ("under" next age*)):ti,ab

65. pubescen*:ti,ab

66. (paediatric* or paediatric*):ti,ab

67. {or #48‐#66}

Part V: Part III AND IV and additional MeSH/subheading combination

68. #47 and #67

69. [mh ^"Pediatric Obesity"]

70. [mh /DH,PC,RH,TH,PX]

71. #69 and #70

72. #68 or #71

MEDLINE (Ovid SP)

Part I: Obesity

1. Obesity/

2. Obesity, Morbid/

3. Obesity, Abdominal/

4. Pediatric Obesity/

5. Overweight/

6. Weight Loss/

7. (adipos* or obes*).tw.

8. (overweight* or over weight*).tw.

9. (weight adj1 (reduc* or los* or control* or manage*)).tw.

10. or/1‐9

Part II: Intervention

11. exp Behavior Therapy/

12. exp Counseling/

13. Family Therapy/

14. Social Support/

15. Program Evaluation/

16. exp Exercise/

17. exp Exercise Therapy/

18. exp "Physical Education and Training"/

19. exp Exercise Movement Techniques/

20. Motor Activity/

21. exp Diet/

22. exp Diet Therapy/

23. Patient Education as Topic/

24. Health Education/

25. exp Health Behavior/

26. exp Health Promotion/

27. School Health Services/

28. School Nursing/

29. Life style/

30. ((obesity adj3 intervention) or program or programme or camp?).tw.

31. (lifestyle or life style).tw.

32. exercis*.tw.

33. (physic* adj (activ* or fit*)).tw.

34. (walk* or jog* or swim* or weight lift* or danc* or aerobics).tw.

35. ((physic* or strength* or resist* or circuit or weight or aerob* or cross or endurance or structur*) adj3 train*).tw.

36. (behavio?ral or behavio?r modification or psychoth* or psychosocial).tw.

37. ((group or family or cognit* or behav*) adj therap*).tw.

38. counsel?ing.tw.

39. educat*.tw.

40. ((parent? or family) adj (based or focused or directed or centered or only or led)).tw.

41. (diet* or healthy nutrition or (nutrition* adj (knowledge or educat* or therap* or program* or intervention*))).tw.

42. or/11‐41

Part III: Part I + Part II and additional MeSH/subheading combination

43. 10 and 42

44. Obesity/ or Obesity, Morbid/ or Overweight/ or Weight Loss/

45. diet therapy.fs. or prevention & control.fs. or rehabilitation.fs. or therapy.fs. or psychology.fs.

46. 44 and 45

47. 43 or 46

Part IV: Population [adapted from Leclercq 2013]

48. Adolescent/

49. exp Child/

50. Infant/

51. Pediatrics/

52. minors.tw.

53. (boy or boys or boyhood).tw.

54. girl*.tw.

55. infant*.tw.

56. (baby or babies).tw.

57. toddler?.tw.

58. (kid or kids).tw.

59. (child or childs or children* or childhood* or childcare* or schoolchild*).tw.

60. adolescen*.tw.

61. juvenil*.tw.

62. youth*.tw.

63. (teen* or preteen*).tw.

64. (underage* or under age*).tw.

65. pubescen*.tw.

66. p?ediatric*.tw.

67. or/48‐66

Part V: Part III AND IV and additional MeSH/subheading combination

68. 47 and 67

69. Pediatric Obesity/

70. diet therapy.fs. or prevention & control.fs. or rehabilitation.fs. or therapy.fs. or psychology.fs.

71. 69 and 70

72. 68 or 71

Part VI: Study filter [Cochrane Handbook 2008 RCT filter ‐ sensitivity and precision maximizing version]

73. randomised controlled trial.pt.

74. controlled clinical trial.pt.

75. randomi?ed.ab.

76. placebo.ab.

77. clinical trials as topic/

78. randomly.ab.

79. trial.ti.

80. or/73‐79

81. exp animals/ not humans/

82. 80 not 81

Part VII: Part V + Part VI

83. 72 and 82

EMBASE (Ovid SP)

Part I: Obesity

1. obesity/

2. morbid obesity/

3. abdominal obesity/

4. childhood obesity/

5. weight reduction/

6. weight control/

7. (adipos* or obes*).tw.

8. (overweight* or over weight*).tw.

9. (weight adj1 (reduc* or los* or control* or manage*)).tw.

10. or/1‐9

Part II: Intervention

11. behavior therapy/

12. cognitive therapy/

13. exp counselling/

14. family therapy/

15. social support/

16. exp program evaluation/

17. exp exercise/

18. exp physical education/

19. exp physical activity/

20. exp motor activity/

21. training/

22. exp diet/

23. exp diet therapy/

24. nutritional health/

25. child nutrition/

26. feeding behavior/

27. patient education/

28. health promotion/

29. health literacy/

30. nutrition education/

31. health education/

32. school health education/

33. school health service/

34. lifestyle/

35. lifestyle modification/

36. ((obesity adj3 intervention) or program or programme or camp?).tw.

37. (lifestyle or life style).tw.

38. exercis*.tw.

39. (physic* adj (activ* or fit*)).tw.

40. (walk* or jog* or swim* or weight lift* or danc* or aerobics).tw.

41. ((physic* or strength* or resist* or circuit or weight or aerob* or cross or endurance or structur*) adj3 train*).tw.

42. (behavio?ral or behavio?r modification or psychoth* or psychosocial).tw.

43. ((group or family or cognit* or behav*) adj therap*).tw.

44. counsel?ing.tw.

45. educat*.tw.

46. ((parent? or family) adj (based or focused or directed or centered or only or led)).tw.

47. (diet* or healthy nutrition or (nutrition* adj (knowledge or educat* or therap* or program* or intervention*))).tw.

48. or/11‐47

Part III: Part I + Part II and additional MeSH/subheading combination

49. 10 and 48

50. obesity/ or morbid obesity/

51. pc.fs or rh.fs or th.fs. [prevention.fs. or rehabilitation.fs. or therapy.fs.]

52. 50 and 51

53. 49 or 52

Part IV: Population [adapted from Leclercq 2013]

54. juvenile/

55. adolescent/

56. child/

57. infant/

58. baby/

59. toddler/

60. preschool child/

61. school child/

62. pediatrics/

63. minors.tw.

64. (boy or boys or boyhood).tw.

65. girl*.tw.

66. infant*.tw.

67. (baby or babies).tw.

68. toddler?.tw.

69. (kid or kids).tw.

70. (child or childs or children* or childhood* or childcare* or schoolchild*).tw.

71. adolescen*.tw.

72. juvenil*.tw.

73. youth*.tw.

74. (teen* or preteen*).tw.

75. (underage* or under age*).tw.

76. pubescen*.tw.

77. p?ediatric*.tw.

78. or/54‐77

Part V: Part III AND IV and additional MeSH/subheading combination

79. 53 and 78

80. childhood obesity/

81. pc.fs or rh.fs or th.fs. [prevention.fs. or rehabilitation.fs. or therapy.fs.]

82. 80 and 81

83. 79 or 82

Part VI: Study filter [ Wong 2006afilter ‐ SDSSGS version]

84. random*.tw. or clinical trial*.mp. or exp treatment outcome/

Part VII: Part V + Part VI

85. 83 and 84

PsycINFO (Ovid SP)

Part I: Obesity

1. exp Overweight

2. (adipos* or obes*).tw.

3. (overweight* or over weight*).tw.

4. or/1‐3

Part II: Intervention

5. Weight Control/

6. Weight Loss/

7. Aerobic Exercise/

8. Diets/

9. exp Exercise/

10. Movement Therapy/

11. Dance Therapy/

12. exp Physical Activity/

13. Physical Fitness/

14. Health Behavior/

15. Health Promotion/

16. Health Knowledge/

17. Health Literacy/

18. Health Education/

19. Client Education/

20. Lifestyle/

21. Physical Education/

22. exp Program Evaluation/

23. Educational Programs/

24. Educational Therapy/

25. exp Program Development/

26. School Based Intervention/

27. School Counseling/

28. Counseling/

29. Group Counseling/

30. Family Therapy/

31. Support Groups/

32. Social Support/

33. School Counselors/

34. exp Behavior Modification/

35. Cognitive Behavior Therapy/

36. Cognitive Therapy/

37. ((obesity adj3 intervention) or program or programme or camp?).tw.

38. (lifestyle or life style).tw.

39. exercis*.tw.

40. (physic* adj (activ* or fit*)).tw.

41. (walk* or jog* or swim* or weight lift* or danc* or aerobics).tw.

42. ((physic* or strength* or resist* or circuit or weight or aerob* or cross or endurance or structur*) adj3 train*).tw.

43. (behavio?ral or behavio?r modification or psychoth* or psychosocial).tw.

44. ((group or family or cognit* or behav*) adj therap*).tw.

45. counsel?ing.tw.

46. educat*.tw.

47. ((parent? or family) adj (based or focused or directed or centered or only or led)).tw.

48. (diet* or healthy nutrition or (nutrition* adj (knowledge or educat* or therap* or program* or intervention*))).tw.

49. or/5‐48

Part III: Part I + Part II

50. 4 and 49

Part IV: Population [adapted from Leclercq 2013]

51. minors.tw.

52. (boy or boys or boyhood).tw.

53. girl*.tw.

54. infant*.tw.

55. (baby or babies).tw.

56. toddler?.tw.

57. (kid or kids).tw.

58. (child or childs or children* or childhood* or childcare* or schoolchild*).tw.

59. adolescen*.tw.

60. juvenil*.tw.

61. youth*.tw.

62. (teen* or preteen*).tw.

63. (underage* or under age*).tw.

64. pubescen*.tw.

65. p?ediatric*.tw.

66. or/51‐65

Part V: Part III AND IV and additional MeSH/subheading combination

67. 50 and 66

Part VI: Study filter [ Eady 2008filter ‐ BS version]

68. control*.tw. OR random*.tw. OR exp Treatment/

Part VII: Part V + Part VI

69. 67 and 68

CINAHL (EBSCOhost)

Part I: Obesity

S1. MH "Obesity+"

S2. TX (adipos* or obes*)

S3. TX (overweight* or "over weight*")

S4. S1 OR S2 OR S3

Part II: Intervention

S5. MH "Weight Loss"

S6. MH "Behavior Modification+"

S7. MH "Counseling"

S8. MH "Family Therapy"

S9. MH "Support, Psychosocial"

S10.MH "Support Groups"

S11.MH "Program Evaluation"

S12.MH "Program Implementation"

S13.MH "Exercise+"

S14.MH "Sports+"

S15.MH "Therapeutic Exercise+"

S16.MH "Physical Fitness"

S17.MH "Physical Education and Training+"

S18.MH "Health Education+"

S19.MH "Diet+"

S20.MH "Diet Therapy+"

S21.MH "Health Behavior"

S22.MH "Eating Behavior"

S23.MH "Health Promotion"

S24.MH "School Health Services+"

S25.MH "Life style changes"

S26.MH "Life style"

S27.TX (weight N1 (reduc* or los* or control* or manage*))

S28.TX ((obesity N3 intervention) OR program OR programme OR camp#)

S29.TX (lifestyle or "life style")

S30.TX exercis*

S31.TX (physic* N1 (activ* or fit*))

S32.TX (walk* or jog* or swim* or weight lift* or danc* or aerobics)

S33.TX ((physic* or strength* or resist* or circuit or weight or aerob* or cross or endurance or structur*) N3 train*)

S34.TX (behavio#ral or behavio#r modification or psychoth* or psychosocial)

S35.TX ((group or family or cognit* or behav*) N1 therap*)

S36.TX counsel#ing

S37.TX educat*

S38.TX ((parent# or family) N1 (based or focused or directed or centered or only or led))

S39.TX (diet* or "healthy nutrition" or (nutrition* N1 (knowledge or educat* or therap* or program* or intervention*)))

S40.S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR S25 OR S26 OR S27 OR S28 OR S29 OR S30 OR S31 OR S32 OR S33 OR S34 OR S35 OR S36 OR S37 OR S38 OR S39

Part III: Part I + Part II and additional MeSH/subheading combination

S41.S4 AND S40

S42.(MH "Obesity+/DH/ED/PC/PF/RH/TH") [diet therapy or education or prevention & control or psychosocial factors or rehabilitation or therapy]

S43.S41 OR S42

Part IV: Population [based on Leclercq 2013]

S44.MH "Adolescence"

S45.MH "Child+"

S46.MH "Infant"

S47.MH "Pediatrics"

S48.TX minors

S49.TX (boy OR boys OR boyhood)

S50.TX girl*

S51.TX infant*

S52.TX (baby OR babies)

S53.TX toddler#

S54.TX (kid OR kids)

S55.TX (child OR childs OR children* OR childhood* OR childcare* OR schoolchild*)

S56.TX adolescen*

S57.TX juvenil*

S58.TX youth*

S59.TX (teen* or preteen*)

S60.TX (underage* or under age*)

S61.TX pubescen*

S62.TX (paediatric* OR paediatric*)

S63.S44 OR S45 OR S46 OR S47 OR S48 OR S49 OR S50 OR S51 OR S52 OR S53 OR S54 OR S55 OR S56 OR S57 OR S58 OR S59 OR S60 OR S62

Part V: Part III AND IV and additional MeSH/subheading combination

S64.S43 AND S63

S65.(MH "Pediatric Obesity/DH/ED/PC/PF/RH/TH") [diet therapy or education or prevention & control or psychosocial factors or rehabilitation or therapy]

S66.S64 OR S65

Part VI: Study filter [ Wong 2006bfilter ‐ SDSSGS version]

S67.MH "treatment outcomes+" OR MH "experimental studies+" or random*

Part VII: Part V + Part VI

S68.S66 AND S67

LILACS (IAHx)

((((MH:"Obesity" OR MH:"Obesity, Morbid" OR MH:"Obesity, Abdominal" OR MH:"Pediatric Obesity" OR MH:"Overweight" OR adipos$ OR obes$ OR overweight$ OR "over weight" OR sobrepes$ OR "exceso de peso" OR "excesso de peso") AND (MH:"Weight Loss" OR MH:"Exercise" OR MH:"Exercise Therapy" OR MH:"Physical Education and Training" OR MH:"Exercise Movement Techniques" OR MH:"Weight Reduction Programs" OR MH:"Motor Activity" OR MH:"Behavior Therapy" OR MH:"Counseling" OR MH:"Family Therapy" OR MH:"Social Support" OR MH:"Program Evaluation" OR MH:"Diet" OR MH:"Diet Therapy" OR MH:"Patient Education as Topic" OR MH:"Health Education" OR MH:"Health Behavior" OR MH:"Health Promotion" OR MH:"Weight Reduction Programs" OR MH:"School Health Services" OR MH:"Life style" OR exerci$ OR ejerci$ OR ((physic$ OR fisic$) AND (activ$ OR ativid$ OR fit$ OR educac$ OR entrenam$ OR treinam$)) OR ((physic$ OR fisic$ OR strength$ OR forca OR fuerza OR resist$ OR circuit$ OR weight OR aerob$ OR endurance OR structur$ OR estructur$) AND train$ OR treina$ OR entrena$) OR program$ OR "estilo de vida" OR padres OR pais OR familia OR familias OR familiar OR terapia OR orienta$ OR educa$ OR diet$ OR nutric$ OR "weight reduction" OR "weight loss" OR "weight control" OR "control de peso")) OR (MH:"Obesity/diet therapy" OR MH:"Obesity, Morbid/diet therapy" OR MH:"Overweight/diet therapy" OR MH:"Obesity/prevention & control" OR MH:"Obesity, Morbid/prevention & control " OR MH:"Overweight/prevention & control" OR MH:"Obesity/rehabilitation" OR MH:"Obesity, Morbid/rehabilitation" OR MH:"Overweight/rehabilitation" OR MH:"Obesity/therapy" OR MH:"Obesity, Morbid/therapy" OR MH:"Overweight/therapy" OR MH:"Obesity/psychology" OR MH:"Obesity, Morbid/psychology" OR MH:"Overweight/psychology")) AND (MH:"Adolescent" OR MH:"Child" OR MH:"Pediatrics" OR MH:"Infant" OR minors OR boy OR boys OR girl$ OR kid OR kids OR child OR childs OR children$ OR childhood$ OR childcare$ OR schoolchild$ OR escolar$ OR adolescen$ OR preadolescen$ OR juvenil$ OR juventud$ OR youth$ OR teen$ OR preteen$ OR underage$ OR pubescen$ OR paediatri$ OR pediatri$ OR joven$ OR jovem$ OR niños OR niñas OR crianca$ OR menin$ OR "menor de edad" OR "menores de edad" OR "menor de idade" OR "menores de idade")) OR MH:"Pediatric Obesity/diet therapy" OR MH:"Pediatric Obesity/prevention & control" OR MH:"Pediatric Obesity/rehabilitation" OR MH:"Pediatric Obesity/therapy" OR MH:"Pediatric Obesity/psychology"

[activated filter "Controlled Clinical Trial"]

ICTRP Search Portal (Advanced search)

[activated "Search for clinical trials in children"]:

in Title: obes* OR overweight*

OR

in Condition: obes* OR overweight*

Recruitment Status: ALL

ClinicalTrials.gov (Advanced search)

Conditions: obese OR overweight OR obesity

Study type: Interventional Studies

Age Group: Child (birth‐17)

Appendix 2. Description of interventions

	Intervention(s)	Comparator(s)
Resnicow 2015	Parent‐only PCP motivational interviewing: 4 sessions over 2 years with the primary care provider and standard advice on healthy eating and exercise	Usual care: standard advice on healthy eating and exercise
Resnicow 2015	Parent‐only PCP + dietician motivational interviewing: 4 sessions over 2 years with the primary care provider and 6 sessions with a dietician. Standard advice on healthy eating and exercise
Mazzeo 2014	Parent NOURISH: parents' self efficacy to make positive changes in eating and exercise behaviours	Parent control: single session on diet and exercise and mailed out information
van Grieken 2013	Parent‐only: healthy lifestyle counselling at well‐child visit and up to 3 additional sessions at 3, 6 and 12 months, included motivational interviewing; focus on targeting key lifestyle‐related behaviours	Usual care control: general information about healthy lifestyle
Small 2013	Parent‐only: focus on healthy habits in young children, nutritional information, information regarding increasing physical activity	Parent control: provision of educational age‐appropriate, evidence‐based health and safety information and group sessions
Esfarjani 2013	Parent‐only: educational sessions on nutrition, physical activity and behavioural control	Parent control: 2 parent training sessions
Moens 2012	Parent‐only: 5‐month intervention, 6 group meetings of 2 hours, focused on education of dietary requirements and training for parenting behavioural skills	Waiting list control: for 6 months
Raynor 2012a	Parent‐only: included behavioural strategies focused on increasing child growth monitoring and providing feedback to families	(I2) C1: parent intervention diet 'decrease': parent intervention as in parent‐only intervention and children and parents intervention focusing on decreasing sugar‐sweetened beverage and sweet and salty snack food intake
Raynor 2012a		(I3) C2: parent intervention diet 'increase': parent intervention as in parent‐only intervention and children and parents intervention focusing on increasing fruit, vegetable and low‐fat dairy intake
Raynor 2012b	Parent‐only: included behavioural strategies focused on increasing child growth monitoring and providing feedback to families	(I2) C1: parent intervention diet and activity 'traditional': parent intervention as in parent‐only intervention and children and parents intervention focusing on decreasing sugar‐sweetened beverage intake and increasing physical activity
Raynor 2012b		(I3) C2: parent intervention diet and activity 'substitute': parent intervention as in parent‐only intervention and children and parents intervention focusing on increasing low‐fat milk intake and decreasing TV watching
Magarey 2011	Parent healthy lifestyle group: delivered in 4 sessions, standardised and evaluated generic parenting programme widely used in Australia and provides comprehensive facilitator training; followed by 8 healthy lifestyle sessions (as described for healthy lifestyle group)	Healthy lifestyle group: delivered in 8 sessions, included recommendations on specific core food servings; practical skills for healthy eating, reduced sedentary behaviours and increased activity; and monitoring of lifestyle behaviours and roles and responsibilities around eating, managing appetite, self esteem and teasing
Jansen 2011	Parental CBT: included a focus on behavioural and nutritional components	Waiting list control: 6 month no treatment group
Collins 2011	Parent‐only diet: includes behavioural techniques for food choices	C1: parent‐child (physical activity): includes physical activity goals and key skills C2: parent‐child (physical activity and diet): incorporates both the physical activity and diet‐only components of the other interventions
Boutelle 2011	Parent‐only behavioural change: included self monitoring of targeted behaviours, positive reinforcement, stimulus control, pre‐planning and modelling	Parent‐child behavioural: included self monitoring of targeted behaviours, positive reinforcement, stimulus control, pre‐planning and modelling for parents and material taught in the child groups was similar but presented in an age‐appropriate manner
West 2010	Parent‐only behavioural change, 'Group Lifestyle Triple P': included positive‐parenting strategies, physical activity strategies and nutrition strategies	Waiting list control: included a physical activity and nutritional advice components
Resnick 2009	Educational material plus personal encounters: included choices of topics such as biological, social and environmental influences on childhood overweight; nutrition advice, physical activity guidelines	Educational material: included components on increased physical activity and nutritional components
Estabrooks 2009	Parent group and IVR counselling: 2 group sessions addressing behavioural health skills and knowledge of weight, nutrition and physical activity. Based on social‐ecological theory. Utilised the workbook in the control group and followed by 10 IVR sessions including prompts for physical activity, nutrition, behavioural components	Group sessions: 2 group sessions as per group + IVR intervention; utilised the workbook
Estabrooks 2009		Control: workbook group: 61‐page workbook to promote physical activity, healthy habits, nutrition
Munsch 2008	Mother‐only CBT: included nutrition and eating behaviour, physical activity, social competences, body concept, relapse prevention; children attended a relaxation training session	Mother‐child CBT: included the same components as the mother‐only intervention; children received sessions on nutrition and eating behaviour, basic nutritional education, reinforcement and tokens, lessons in physical activity, social competencies, developing a positive body concept, relapse prevention
Janicke 2008	Parent‐only: includes behavioural, nutritional and physical activity components	C1: parent‐child: includes behavioural, nutritional and physical activity components
Janicke 2008		C2: waiting list control: no active treatment
Golley 2007	Parenting‐skills training with intensive lifestyle education: behavioural change intervention including nutritional components; also 7 intensive lifestyle support group sessions	C1: parenting‐skills training: behavioural change intervention including nutritional components
Golley 2007		C2: waiting list control: general healthy‐lifestyle pamphlet
Golan 2006	Parent‐only: included behavioural, nutritional and physical activity components	Parent‐child: similar to the parent‐only but including activities for the children
Aragona 1975	I1: parent‐only response‐cost plus reinforcement: nutritional information, exercise instructions, weight and calorie information, behavioural techniques including reinforcement techniques	Waiting list control
Aragona 1975	I2: parent‐only ‐ response‐cost: as above without the reinforcement techniques	Waiting list control
I: intervention; C: comparator; CBT: cognitive behavioural therapy; IVR: interactive voice response; NOURISH: Nourishing Our Understanding of Role modelling to Improve Support and Health; PCP: primary care providers; PHL: parent healthy lifestyle; TV: television

Appendix 3. Baseline characteristics (I)

	Intervention(s) and comparator(s)	Duration of intervention (duration of follow‐up)	Description of participants	Study period (year to year)	Country	Setting	Ethnic groups (%)	Socioeconomic status (%)
Resnicow 2015	I1: parent‐only PCP motivational interviewing	2 years (follow‐up: 2 years)	Parents of children aged 2‐8 years with BMI ≥ 85th and ≤ 97th percentile	‐	USA	Primary care	White: 53.6 Black: 11.0 Hispanic: 30.14 Asian: 1.14 Other: 3.83	Income < USD 40,000: 38.6%; ≥ USD 40,000: 61.4% Education < college: 70.1%; ≥ college: 29.9%
	I2: parent‐only PCP + dietician motivational interviewing						White: 59.1 Black: 6.09 Hispanic: 20.9 Asian: 8.7 Other: 5.2	Income < USD 40,000: 29.8%; ≥ USD 40,000; 70.2% Education < college: 52.6%; ≥ college: 47.4%
	C: usual care						White: 67.9 Black: 2.6 Hispanic: 13.3 Asian: 6.6 Other: 9.7	Income < USD 40,000: 27.2%; ≥ USD 40,000: 72.8% Education < college: 61.8%; ≥ college: 38.2%
Mazzeo 2014	I: parent NOURISH	12 weeks (24 weeks)	Parents of overweight children aged 6‐11 years	2008‐2009	USA	Community	‐	‐
	C: parent control
van Grieken 2013	I: parent‐only	up to 12 months (at 24 months)	Parents of overweight or obese children aged 5 years	September 2007‐October 2008	The Netherlands	Community (youth health care centres)	Dutch: 75.8	Mother's education level low/mid: 34.8; mid‐high/high: 65.2
	C: usual care						Dutch: 80.6	Mother's education level low/mid: 31.5; mid‐high/high: 68.5
Small 2013	I: parent‐only	16‐24 weeks (40‐48 weeks)	Parents of overweight or obese children aged 4‐8 years	‐	USA	Primary care office	White: 63 Black: 9 Hispanic: 24 Other: 4	Mothers' education: High school degree or less: 24.3 At least some college: 75.7 Mothers' marital status: Married: 75.7 Single/divorced/widowed: 24.3 Family structure: 2 parent: 97 1 parent: 3
	C: control						White: 66 Hispanic: 25 Other: 7	Mothers' education: High school degree or less: 29.7 At least some college: 70.3 Mothers' marital status: Married: 74.1 Single/divorced/widowed: 25.9 Family structure: 2 parent: 81.5 1 parent: 18.5
Esfarjani 2013	I: parent‐only	6 months (follow‐up unclear)	Parents of obese children aged 7 years	‐	Iran	‐	‐	Father's education Under high school diploma: 4.3 High school diploma: 41.4 Higher than high school diploma: 54.3
	C: control							Father's education Under high school diploma: 7 High school diploma: 38.4 Higher than high school diploma: 54.7
Moens 2012	I: parent‐only	6 months (6 months)	Parents of overweight or obese children aged 6‐12 years	2001‐2006	Belgium	University research setting	100% European (Caucasian)	Index of social position, low 26%, middle 52%, high 22%
	C: waiting list control						100% European (Caucasian)	Index of social position, low 0%, middle 75%, high 25%
Raynor 2012a	I: parent‐only	24 weeks (12 months)	Parents of overweight or obese children	November 2005‐September 2007	USA	University and primary care	White: 90.9 Hispanic: 21.2	‐
	C1: parent ‐ diet decrease						White: 80 Hispanic: 20
	C2: parent ‐ diet increase						White: 87 Hispanic: 15.2
Raynor 2012b	I: parent‐only	24 weeks (12 months)	Parents of overweight or obese children	November 2005‐September 2007	USA	University and primary care	White: 93.1 Hispanic: 13.8	‐
	C1: parent ‐ diet and activity traditional						White: 84.6 Hispanic: 11.5
	C2: parent ‐ diet and activity substitute						White: 92.3 Hispanic: 7.7
Magarey 2011	I: parent healthy lifestyle	24 weeks (104 weeks)	Parents of children classified as overweight aged 5‐9 years	May 2004‐estimated May 2006	Australia	Outpatient clinic	‐	Reported for area of residence (Sydney or Adelaide) only, not by study arm
	C: healthy lifestyle
Jansen 2011	I: parent CBT	12 weeks (24 weeks)	Parents of overweight children aged 7‐13 years	‐	Netherlands	Community health centre, university site	‐	‐
	C: waiting list control
Collins 2011	I: parent‐only diet	24 weeks (104 weeks)	Parents of overweight children aged 5‐9 years	January 2005‐2008	Australia	Outpatient clinic	‐	‐
	C1: parent‐child (physical activity)
	C2: parent‐child (physical activity + diet)
Boutelle 2011	I: parent‐only	20 weeks (44 weeks)	Parents and their overweight or obese (> 85th BMI percentile) children aged 8‐12 years	‐	USA	University	‐	Total household income: < USD 20,000: 2.6% USD 20,001‐40,000: 7.9% USD 40,001‐60,000: 18.4% > $60,000: 63.2% Don't know: 7.9% Education‐highest parent: Less than high school 0.0% High school 7.9% Vocational school 7.9% Some college 23.7% College graduate 42.1% Advanced degree 18.4%
	C: parent‐child							Total household income: < USD 20,000: 5.0% USD 20,001‐40,000: 10.0% USD 40,001‐60,000: 15.0% > USD 60,000: 65.0% Don't know: 5.0% Education‐highest parent: Less than high school 2.5% High school 12.5% Vocational school 5.0% Some college 25.0% College graduate 35.0% Advanced degree 20.0
West 2010	I: parent‐only	12 weeks (1 year)	Children described as overweight by parents, aged 4‐11 years, and their parents	September 2003‐October 2004	Australia	University, hospitals and schools	White: 88.5 Mediterranean: 3.8 Asian: 3.8 Indigenous: 3.8	Mother's education: secondary only: 25.0; tertiary: 75.0 Father's education: secondary only: 20.9; tertiary: 79.1 Mother employed: no: 38.5; yes: 61.5 Father employed: no: 7.0; yes: 93.0 Annual family income: < AUD 20,000: 3.8; AUD 20,000‐40,000: 25.0; AUD 40,000‐100,000: 51.9; > AUD 100,000: 19.2 Mean (SD): mother's paid work (hour/week): 10.50; father's paid work (hour/week): 6.83
	C: control						White: 85.7 Mediterranean: 8.2 Asian: 4.1 Indigenous: 2.0	Mother's education: secondary only: 34.7; tertiary: 65.3 Father's education: secondary only: 25.6; tertiary: 74.4 Mother employed: no: 32.7; yes: 67.3 Father employed: no: 5.1; yes: 94.9 Annual family income: < AUD 20,000: 0; AUD 20,000‐40,000: 22.4; AUD 40,000‐100,000: 51.0; > AUD 100,000: 26.5 Mean (SD): mother's paid work (hour/week): 12.33; father's paid work (hour/week): 11.91
Resnick 2009	I: educational material + personal encounters	18 weeks (unclear follow‐up, 41 week mail out)	Parents of overweight children aged 5‐11 years	October 2006‐ April 2007	USA	Community	‐	‐
	C: educational material
Estabrooks 2009	I: parent group + IVR	12‐24 weeks (52 weeks)	Parents of children aged 8‐12 years with a BMI > 85th percentile for their age	May 2004‐December 2007	USA	Outpatient clinic	White: 60 Hispanic: 30	‐
	I2: parent group						White: 69 Hispanic: 19
	C: parent workbook						White: 59 Hispanic: 29
Munsch 2008	I: mother only	10 weeks (34 weeks)	Mothers of children aged 8‐12 years with a BMI > 85th percentile adjusted for age and gender	‐	Switzerland	Efficacy of US Pediatric obesity primary care guidelines: 2 randomised trials Outpatient clinic and university	‐	‐
	C: mother‐child
Janicke 2008	I: parent‐only	16 weeks (40 weeks)	Parents of overweight children aged 8‐13 years	‐	USA	Community	Child: White: 80.8 African‐American: 3.8 Hispanic: 3.8 Bi‐racial: 11.5	Annual family income: ≤ USD 19,999: 19.2% USD 20,000‐59,999: 46.1% ≥ USD 60,000: 34.6%
	C1 parent‐child						Child: White: 66.7 African‐American: 12.5 Hispanic: 16.7 Bi‐racial: 4.2	Annual family income: ≤ USD 19,999: 16.6% USD 20,000‐59,999: 45.8% ≥ USD 60,000: 29.2%
	C2: waiting list control						Child: White 80.9 African‐American 14.3 Hispanic 4.8 Bi‐racial 0	Annual family income: ≤ USD 19,999: 19.1% USD 20,000‐59,999: 61.9% ≥ USD 60,000: 19.1%
Golley 2007	I: parent + lifestyle education	24 weeks (48 weeks)	Parents of overweight children aged 6‐9 years	July 2002‐August 2003	Australia	Outpatient clinic	‐	‐
	C1 parent
	C2: waiting list control
Golan 2006	I: parent‐only	26 weeks (18 months)	Parents of overweight children aged 6‐11 years	‐	Israel	Unclear	‐	‐
	C: parent‐child
Aragona 1975	I1: parent‐only + reinforcement	12 weeks (51 weeks)	Parents of overweight girls aged 5‐10 years	‐	USA	‐	‐	‐
	I2: parent‐only
	C: control
"‐" denotes not reported C: comparator; CBT: cognitive behavioural therapy; I: intervention; IVR: interactive voice response; NOURISH: Nourishing Our Understanding of Role modelling to Improve Support and Health; PCP: primary care providers; SD: standard deviation

Appendix 4. Baseline characteristics (II)

	Intervention(s) and comparator(s)	Sex [female %]^a	Age [mean (SD)]	BMI measures [mean kg/m² (SD)]	Body weight [mean kg (SD)]	Parental weight [mean BMI (SD) or as stated]	Comedications/cointerventions/ comorbidities
Resnicow 2015	I1: parent‐only PCP motivational interviewing	57	5.1 (1.9)	Percentile: 92.2 (3.3)	‐	BMI: 30.1 (7.4)	‐
	I2: parent‐only PCP + dietician motivational interviewing	60	5.3 (1.8)	Percentile: 92.1 (3.4)	‐	BMI: 28.5 (6.4)
	C: usual care	53	4.9 (1.7)	Percentile: 91.5 (3.3)	‐	BMI: 28.4 (6.8)
Mazzeo 2014	I: parent NOURISH	68	‐	BMI percentile: 98.47 (2.24)	‐	BMI: 34.2 (9.3)	‐
Mazzeo 2014	C: parent control	64	‐	BMI percentile: 97.86 (2.67)	‐	BMI: 34.2 (9.3)	‐
Van Grieken 2013	I: parent‐only	61	5.72 (0.42)	BMI: 18.16 (0.63) BMI SDS: 1.93 (0.38)	‐	Normal: 55.5% Overweight/obese: 44.5%	‐
Van Grieken 2013	C: usual care	63	5.8 (0.45)	BMI: 18.10 (0.61) BMI SDS: 1.88 (0.35)	‐	Normal: 56.6% Overweight/obese: 43.4%	‐
Small 2013	I: parent	52	5.73 (1.38)	BMI: 21.93 (3.51) BMI percentile: 96.7 (4.04)	32.71 (10.14)	BMI: 31.56 (8.80)	‐
Small 2013	C: control	70	5.41 (1.5)	BMI: 20.36 (2.71) BMI percentile: 95.4 (4.62)	28.25 (8.08)	BMI: 31.89 (8.79)	‐
Esfarjani 2013	I: parent‐only	‐	7	22.7 (2.2)	36.4 (4.8)	‐	‐
Esfarjani 2013	C: control	‐	7	22.5 (1.9)	36.6 (4.7)	‐	‐
Moens 2012	I: parent‐only	65	9.10 (1.35)	BMI %: 147.5 (17.93)	‐	Mother: 26.92 (5.43) Father: 27.14 (4.16)	‐
Moens 2012	C: waiting list control	58	9.26 (1.45)	BMI %: 140.45 (10.15)	‐	Mother: 24.75 (3.02) Father: 28.16 (3.15)	‐
Raynor 2012a	I: parent‐only	61	6.8 (1.8)	BMI: 34.6 ± 9.7	‐	‐	‐
	C1: parent ‐ diet decrease	63	7.2 (1.6)	BMI: 33.4 ± 8.3	‐	‐
	C2: parent ‐ diet increase	61	7.6 (1.6)	BMI: 32.2 ± 7.2	‐	‐
Raynor 2012b	I: parent‐only	59	6.7 (1.6)	BMI: 33.2 ± 9.1	‐	‐	‐
	C1: parent ‐ diet + activity traditional	65	7.2 (1.5)	BMI: 30.5 ± 7.2	‐	‐
	C2: parent ‐ diet + activity substitute	58	7.4 (1.3)	BMI: 33.6 ± 8.5	‐	‐
Margarey 2011	I: parent healthy lifestyle	56	All: 8.2 (1.2)	BMI (all): 24.1 (3.22) BMI z score: 2.77 (0.58)	All: 44.4 (9.82)	‐	‐
Margarey 2011	C: healthy lifestyle	All: 56	All: 8.2 (1.2)	BMI (all): 24.1 (3.22) BMI z score 2.68 (0.65)	All: 44.4 (9.82)	‐	‐
Jansen 2011	I: parent CBT	‐	‐	BMI percentile: 96.8 (2.93)	‐	BMI: 28.30 (4.53)	‐
Jansen 2011	C: waiting list control	‐	‐	BMI percentile: 95.9 (3.38)	‐	BMI: 29.35 (6.33)	‐
Collins 2011	I: parent‐only diet	62	8.2 (1.2)	BMI: 24.6 (3.0) BMI z score: 2.8 (0.6)	46.3 (8.6)	‐	‐
	C1: parent‐child (physical activity)	60	8.3 (1.0)	BMI: 25.2 (4.1) BMI z score: 2.8 (0.7)	48 (10.8)	‐	‐
	C2: parent‐child (physical activity + diet)	55	8.1 (1.2)	BMI: 24.4 (3.7) BMI z score: 2.8 (0.7)	45.5 (12.2)	‐	‐
Boutelle 2011	I: parent‐only	50	10.81 (1.31)	Child BMI percentile: 98.37 (1.85) Child BMI z score: 2.29 (0.38) Child BMI: 30.48 (6.08)	‐	Parent BMI: 32.47 (8.25) n = 39	‐
Boutelle 2011	C: parent‐child	70	10.08 (1.15)	Child BMI percentile: 98.34 (1.37) Child BMI z score: 2.25 (0.34) Child BMI: 28.26 (4.64)	‐	Parent BMI: 31.47 (7.46) n = 40	‐
West 2010	I: parent‐only	69	8.58 (1.69)	BMI z score: 2.15 (0.43)	‐	Parent BMI range (n, %) Healthy weight: 20 (38.5) Overweight: 11 (21.2) Obese: 21 (40.4)	‐
West 2010	C: control	65	8.5 (1.65)	BMI z score: 2.11 (0.46)	‐	Parent BMI range (n, %) Healthy weight: 18 (36.7) Overweight: 12 (24.5) Obese: 19 (38.8)	‐
Resnick 2009	I: educational material + personal encounters	‐	‐	BMI percentile: 94.1 (4.3)	‐	BMI: 25.6	‐
Resnick 2009	C: educational material	‐	‐	BMI percentile: 94.1 (4.4)	‐	BMI: 26.2	‐
Estabrooks 2009	I: parent group + IVR	41	10.7	BMI: 27.1 BMI z score: 2.04	‐	‐	‐
	I2: parent group	42	10.6	BMI: 27.4 BMI z score: 2.07	‐	‐
	C: parent workbook	61	11	BMI: 27.1 BMI z score: 2.00	‐	‐
Munsch 2008	I: mother‐only	63	10.6 (1.5)	BMI: 28.0 (5.4), n = 21 BMI SDS: 2.61	‐	BMI: 26.9 (3.9)	‐
Munsch 2008	C: mother‐child	59	10.3 (1.4)	BMI: 26.5 (3.3) BMI SDS: 2.40	‐	BMI: 29.6 (7.5)	‐
Janicke 2008	I: parent‐only	46	11.5 (1.3)	BMI z score: 2.16 (0.35)	‐	BMI: 35.47 (8.2)	‐
	C1 parent‐child	63	11.03 (1.6)	BMI z score: 2.13 (0.43)	‐	BMI: 32.86 (6.8)
	C2: waiting list control	76	11.02 (1.81)	BMI z score: 2.02 (0.41)	‐	BMI: 35.66 (9.3)
Golley 2007	I: parent + lifestyle education	63	‐	BMI z score: 2.74 (0.58)	‐	‐	‐
	C1 parent	65	‐	BMI z score: 2.76 (0.58)	‐	‐
	C2: waiting list control	64	‐	BMI z score: 2.75 (0.39)	‐	‐
Golan 2006	I: parent‐only	59	8.75 (1.9)	24.2 (3.0)	47.1 (12.4)	Weight: kg Mothers: 72.7 (11.1) Fathers: 100.9 (24.7)	‐
Golan 2006	C: parent‐child	50	8.7 (2.0)	24.3 (3.6)	45.5 (15.9)	Weight: kg Mothers: 79.1 (15.5) Fathers: 102.3 (19.1)	‐
Aragona 1975	I1: parent‐only + reinforcement	100	9.4	BMI^b: 21.72 (2.03)	47.89 (7.76)	‐	‐
	I2: parent‐only	100	10	BMI^b: 22.76 (1.58)	47.42 (5.70)	‐
	C: control	100	8.3	BMI^b: 23.06 (3.04)	45.04 (14.51)	‐
'‐' denotes not reported ^aSex of the overweight child ^bCalculated by review authors BMI: body mass index; BMI SDS: standard deviation of BMI: C: comparator; CBT: cognitive behavioural therapy; I: intervention; IVR: interactive voice response; n: number of participants; NOURISH: Nourishing Our Understanding of Role modelling to Improve Support and Health; PCP: primary care providers; SD: standard deviation; TV: television

Appendix 5. Matrix of study endpoints (publications and trial documents)

Appendix 6. Examination of outcome reporting bias according to ORBIT classification

	Outcome	High risk of bias (category A)^a	High risk of bias (category D)^b	High risk of bias (category E)^c	High risk of bias (category G)^d
Resnicow 2015	N/A
Mazzeo 2014	N/A
van Grieken 2013	N/A
Small 2013	N/A
Esfarjani 2013	N/A
Moens 2012	N/A
Raynor 2012a	N/A
Raynor 2012b	N/A
Magarey 2011	N/A
Jansen 2011	N/A
Collins 2011	N/A
Boutelle 2011	N/A
West 2010	N/A
Resnick 2009	N/A
Estabrooks 2009	N/A
Munsch 2008	N/A
Janicke 2008	N/A
Golley 2007	N/A
Golan 2006	N/A
Aragona 1975	N/A
^aClear that outcome was measured and analysed; trial report stated that outcome was analysed but only reports that result was not significant (Classification 'A', table 2, Kirkham 2010) ^bClear that outcome was measured and analysed; trial report stated that outcome was analysed but no results reported ( Classification 'D', table 2, Kirkham 2010) ^cClear that outcome was measured; clear that outcome was measured but not necessarily analysed; judgement says likely to have been analysed but not reported because of non‐significant results (Classification 'E', table 2, Kirkham 2010) ^dUnclear whether the outcome was measured; not mentioned but clinical judgement says likely to have been measured and analysed but not reported on the basis of non‐significant results (Classification 'G', table 2, Kirkham 2010) N/A: not applicable

Appendix 7. Definition of endpoint measurement

	Behaviour change	Changes in BMI and body weight	Height	Health‐related quality of life or self esteem	All‐cause mortality/morbidity	Socioeconomic effects	Parent‐child relationship or assessment of parenting	Participants' views of the intervention	Severe/serious adverse events
Resnicow 2015	Parental questionnaire for behavioural outcomes, not validated	Primary care physicians and assistants trained in assessment of height and weight and provided with print and online resources to convert heights and weights to BMI and BMI percentile. All practices were provided with a digital scale. Parent BMI was calculated from self reported heights and weights	All practices were provided with a 36‐inch calibration rod and, if needed, a new stadiometer	‐	‐	‐	‐	‐	‐
Mazzeo 2014	Parents completed the questionnaire ‐ dietary intake was assessed by using the Block Food Screener. This instrument has been validated against the Block 100‐item FFQ. CFQ: parental approaches to and attitudes about feeding their children were measured with the CFQ. This measure includes 7 subscales: perceived responsibility, perceived parent weight, perceived child weight, concern about child weight, pressure to eat, monitoring, and restriction	Height was measured to the nearest quarter of an inch. using a stadiometer. Weight was measured to the nearest quarter of a pound; data were used to calculate BMI in kg/m², which were plotted on the CDC growth charts to obtain BMI percentile for age and gender	‐	See Appendix 11	‐	‐	Parental concern subscale of the CFQ 3 questions, 5‐point scale (1‐5) , higher scores equate to more concern	Participants will complete an exit questionnaire that assesses: what they liked and disliked about the intervention; thoughts about the duration, frequency, and number of sessions; perceived benefits and barriers to implementing the intervention goals; comfort with group leaders and members; overall satisfaction; and suggestions for improvement	‐
van Grieken 2013	Parent report of child health behaviour (unvalidated, not extracted)	Weight was assessed via questionnaire that was completed by the parent. Also the YHC professionals measured at baseline. At follow‐up either the YHC professionals or a research assistant measured using the same standardized methods and equipment. Weight measured to the nearest 0.1 kilogram. BMI calculated by weight/height and children were classified into normal, overweight or obesity according to international age and gender specific cut‐off points (reference provided). Child BMI Standard Deviation Scores (SDS) were calculated using the reference population of children from the 1997 Dutch national Growth study	Height was assessed via questionnaire which was completed by the parent. Also the YHC professional measured at baseline. At follow‐up either the YHC professionals or a research assistant measured using the same standardised methods and equipment. Height measured to the nearest 0.1 cm. Waist circumference measured over naked skin at the level midway between the lower rib margin and the iliac crest at the end of gentle expiration when the child was standing	‐	‐	‐	Parenting practices were assessed by unvalidated measures (not data extracted)	Questionnaire assessing acceptability and feasibility of the protocol were sent after the first or second additional session. Parents were asked to indicate if the information provided was appreciated	‐
Small 2013	‐	Weight was assessed in pounds (scale displayed to the nearest one hundredth decimal place) using a portable Tannita scale. BMI percentile was derived from the BMI z score using the normal distribution function in Microsoft Excel 2003	Height assessed to the nearest eighth inch using a Seca portable stadiometer	‐	‐	‐	‐	‐	‐
Esfarjani 2013	The validated food frequency questionnaire was used to assess typical food intake over the previous year (not data extracted) Unvalidated measures of TV watching, computer use (not data extracted)	Weight was measured by trained experts to the nearest 0.1 kg using a calibrated and certified portable digital scale with lightly dressed, without shoes and empty pockets. BMI was calculated (kg/m² ) Waist circumference was measured at the smallest area between the edge of the lower chest and iliac crest bone	Height was measured by trained experts and determined in a standing position, barefoot using a portable height gauge with accuracy of 0.1 cm	‐	‐	‐	‐	‐	‐
Moens 2012	Dutch Eating Behaviour Questionnaire (DEBQ, child and parent versions) ‐ validated measure with 33 items scored on a 5‐point Likert scale. Child version phrasing adapted slightly. Health principles questionnaire ‐ developed for the study, not validated (not data extracted)	Weight in light clothing by a school physician on a balance‐beam scale. Post intervention and follow‐up measured by parental report. Adjusted BMI (actual BMI/percentile 50 of BMI for age and gender x 100) calculated and overweight or obese identified in relation to European norms for 0‐21 year olds. Also BMI percentiles and z scores calculated by US CDC	Height without shoes measured by a wall‐mounted stadiometer. Post intervention and follow‐up measured by parental report	‐	‐	‐	Ghent Parental Behaviour Scale (GPBS), validated tool, 9 scales	‐	‐
Raynor 2012a	Parents were asked to complete diaries for their children 3 days each week (1 weekend day, 2 weekdays). Leisure‐time activity assessed via The Previous Day Physical Activity Recall (PD‐PAR). Parents were asked to complete the PD‐PAR for their children	By trained research staff blinded to treatment assignment. Weight was assessed by a balance beam scale, and height was assessed using a stadiometer, using standard procedures (16) with participants wearing light clothing and no shoes. BMI was calculated with the following formula: BMI = weight in kg/height in m². For children, standardised BMI (BMI‐z) scores were calculated based upon the value of the 50th BMI percentile and the standard deviation of the age‐ and sex‐ appropriate sample from the CDC growth charts	‐	‐	‐	‐	‐	‐	‐
Raynor 2012b	‐	By trained research staff blinded to treatment assignment. Weight was assessed by a balance beam scale, and height was assessed using a stadiometer, using standard procedures (16) with participants wearing light clothing and no shoes. BMI was calculated with the following formula: BMI = weight in kg/height in m². For children, standardised BMI (BMI‐z) scores were calculated based upon the value of the 50th BMI percentile and the standard deviation of the age‐ and sex‐ appropriate sample from the CDC growth charts	‐	‐	‐	‐	‐	‐	‐
Magarey 2011	‐	BMI measured using standard anthropometric methods, and BMI z scores were calculated using 1990 UK reference data child weight status as determined using IOTF definition	‐	‐	‐	‐	Alabama Parenting Questionnaire (Satisfaction, Efficacy, Involvement, Positive parenting, Poor monitoring, Inconsistent discipline, Corporal punishment) 35 questions, higher scores indicate improvement	‐	‐
Jansen 2011	A self report questionnaire. Child Eating Disorder Examination Questionnaire, which is based on the Eating Disorder Examination Questionnaire. Eating behaviour by interview, Scores for regularity range from 0 to 7, a higher score indicating a more regular eating pattern. Physical activity: filled out by overweight child (in presence of a parent and the interviewer). This questionnaire consists of 3 components: work activity, sports activity and leisure activity. An index score for the 3 components is calculated, ranging from 1 to 5, with higher index scores reflecting higher levels of activity. The Baecke Questionnaire was adapted for use with children by replacing 'work activity' with 'school activity' (including similar questions)	Weight (kg) measured and BMI percentile (Children's BMI‐for‐Age Calculator) was calculated for each child of the participating parents, thus including the target children and their siblings	‐	Self esteem: overweight child filled out the questionnaire (in presence of a parent and the interviewer). Perceived competence was measured with the translated version of the Self‐Perception Profile for Children. Negative thoughts: completed by the overweight child (in presence of a parent and the interviewer). This questionnaire maps the frequency of negative weight‐related thoughts in overweight children. The questionnaire comprises 20 items (for example 'I am worthless because I am overweight'). Scores range from 1 ('I never have this thought') to 5 ('I always have this thought')	‐	‐	‐	‐	‐
Collins 2011	Habitual physical activity was measured using the Actigraph 7164 uniaxial accelerometer, an objective measure of activity. Participants wore the accelerometer during all waking hours over 8 consecutive days. Parents and children recorded periods of non‐wear. The screen behaviours sub‐scale of the Children's Leisure Activities Study Survey completed by parents to assess children's time spent in TV/DVD viewing, playing electronic games, and using the computer	Weight ass measured with the children barefoot and wearing light clothing, using Tanita HD646 scales (Tanita Corporation of America Inc, Illinois, USA) to 0.1 kg	Height was measured to 0.1 cm using the stretch stature method and PE87 portable stadiometers (Mentone Educational Centre, Victoria, Australia)	‐	‐	‐	‐	‐	‐
Boutelle 2011	Usual dietary intake of the child was assessed with the Block Kids Questionnaire. Children completed the Physical Activity Questionnaire for Older Children (PAQ‐C)	Weight measured in kg on a Tanita Digital Scale. BMI was standardised for age and gender (BMI z score) and expressed as a percentile (BMI percentile) using the US CCDC Growth Curves	Height was measured using a portable Schorr height board	‐	‐	‐	‐	‐	‐
West 2010	The Lifestyle Behaviour Checklist lists 25 child problem behaviours related to eating (e.g. eating too quickly), physical activity (e.g. playing too many computer games) and overweight (e.g. complaining about being teased) in children aged 4‐11 years and yields scores on 2 scales ‐ the Problem scale and Confidence scale. For the Problem scale, parents are asked to rate the extent to which they experience each of these behaviours as a problem with their child (higher scores indicate greater problems). For the Confidence scale, parents are asked to rate how confident they feel managing each of these behaviours, even if not currently occurring (higher scores indicate greater confidence). The recommended clinical cut‐offs are a Problem scale score > 50 (range 25‐175) and a confidence scale score < 204 (range 25‐250). The Parenting Scale: for each of the 30 items, parents are asked to rate how they would respond to a given discipline situation by choosing between an effective or ineffective course of action. The ineffective parenting practices assessed by the Problem scale include permissive or inconsistent discipline (e.g. coaxing or begging their child to stop a problem behaviour), coercive discipline (e.g. spanking their child), and emotional discipline and irritability (e.g. getting angry or upset when their child misbehaves)	Height and weight were measured with a custom‐made portable stadiometer and electronic scales using standard procedures. BMI z scores were calculated using parameters published by the CDC	‐	‐	‐	‐	‐	Client Satisfaction Questionnaire	‐
Resnick 2009	Parents were asked whether they received information about their children's nutrition or physical activity from any of the presented sources. Parents were asked to state their confidence, Response categories were 'not at all confident', 'a little confident', 'somewhat confident', 'confident', or 'very confident'. These responses were collapsed into dichotomous categories of confident and very confident vs. not at all confident, a little confident, and somewhat confident. Parents were asked to report the mean number of hours per day that both they and their children watched TV or videos during the 30 days prior to completing the baseline and post‐intervention surveys. Parents were also asked about the number of servings of fruits and vegetables that both they and their children consumed during the 30 days prior to completing the baseline and post‐intervention surveys. Both TV and nutritional responses were collapsed into dichotomous categories of those who consumed ≥ 5 servings of fruit and vegetables per day vs. those who consumed < 5 servings	BMI collected standardised by school taken by school nurse. BMI was calculated and re‐scaled to represent the percentage of BMI measures for that age group	‐	‐	‐	‐	‐	Parent satisfaction: parents were asked whether they read the study materials, whether they found at least 1 material to be helpful, and whether they would recommend the programme to other families. Parents in the educational material plus personal encounters (intervention 2) group were also asked whether they found their community health workers to be helpful	‐
Estabrooks 2009	‐	Weight was assessed using a regularly calibrated medical scale	‐	‐	‐	‐	‐	‐	‐
Munsch 2008	Description of validated measures consistent with psychology/psychometrics. The Child Behavior Checklist for children and adolescents aged 4‐18 years recorded the assessments of parents in terms of social skills and problems of emotional well‐being and behaviour of their children the total value of internalising and externalising subscales, as well as the syndrome scale "Social problems" were recorded, representing a relevant concept in obese children	BMI measures taken and consistent with others, e.g. weight on a secca e scale. Percent overweight = [(effective BMI/BMI 50th percentile) ‐ 1] was calculated based on age and gender	Stadiometer to measure height	All children completed questionnaires to assess depressive symptoms (Children's Depression Inventory; DIKJ), anxiety (STAIK; SASC‐R and its German version), SAD, and FNE	‐	‐	‐	‐	‐
Janicke 2008	Parents were asked to help their children complete the measure. The Youth/Adolescent Food Frequency Questionnaire was used to assess the child's dietary intake during the preceding month	Height without shoes measured to the nearest 0.1 cm using a Harpendon stadiometer. Weight to nearest 0.1 kg with 1 layer of clothing on and without shoes using a calibrated balance bean scale. Measured 3 times and averaged	Measured without shoes to nearest 0.1 cm using a Harpendon stadiometer (Holtain Ltd, Crosswell, UK). Measured 3 times and averaged	Children completed, Self‐Perception Profile for Children, which is a self report assessment of the child's perception of his or her global self worth and competence in 6 specific domains: scholastic competence, social acceptance, athletic competence, physical appearance, behavioural conduct, and global self worth	‐	‐	‐	‐	‐
Golley 2007	‐	Weight was measured to the nearest 0.1 kg with "SECA" electronic scales. BMI z: BMI was calculated and converted to a BMI z score by using UK reference data provided as a computer program (Child Growth Foundation, London, UK)	‐	‐	‐	‐	‐	Validated, anonymous 16‐item questionnaire adapted from the one usually used as part of the Triple P programme	‐
Golan 2006	‐	BMI: weight and height were measured to the nearest 0.1 kg and 1 cm, respectively, using a standard medical balance‐beam scale with a rigid vertical height rod	‐	‐	‐	‐	‐	‐	‐
Aragona 1975	‐	Used bathroom scales. 3 baseline measurements obtained over a 2‐week period for both experimental groups. Control group were measured at home on the same day. To ensure reliability the experimenters independently read all height and weight measurements in the presence of the parents. If there were any inter‐rater discrepancies on weight, the child was weighed again. Weights recorded when there was inter‐rater agreement on 2 consecutive measurements	Not reported how measured	‐	‐	‐	‐	‐	‐
"‐" denotes not reported. 1 inch (in) = 2.5 cm; 1 pound (lb) = 450 g BMI: body mass index; CDC: Centers for Disease Control and Prevention; CFQ: Child Feeding Questionnaire; cm: centimetre; DIKJ: Depressionsinventar für Kinder und Jugendliche; FFQ: Food Frequency Questionnaire; FNE: Fear of Negative Evaluation; IOTF: International Obesity Task Force; kg: kilogram; lb: pound; PAQ‐C: Physical Activity Questionnaire for Older Children; PD‐PAR SDS: Previous Day Physical Activity Recall; SAD: Social Avoidance and Distress; SASC‐R: Social Anxiety Scale for Children‐Revise; STAIK: State und Trait Angst‐Inventar für Kinder; TV: television; YHC: Youth Health Centre

Appendix 8. Adverse events

	Intervention(s) and comparator(s)	Participants included in analysis [N]	Deaths [N (%)]	Participants with adverse events [N (%)]	Participants with severe/serious adverse events [N (%)]	Participants discontinuing study due to adverse events [N / %]	Participants hospitalised [N (%)]	Participants with outpatient treatment [N (%)]	Participants with specific adverse events [description] [N /%]
Resnicow 2015	I1: parent‐only PCP motivational interviewing	16 practices 212 participants	‐	‐	‐	‐	‐	‐	‐
	I2: parent‐only PCP + dietician motivational interviewing	15 practices 235 participants	‐	‐	‐	‐	‐	‐	‐
	C: usual care	11 practices 198 participants	‐	‐	‐	‐	‐	‐	‐
Mazzeo 2014	I: parent NOURISH	48	‐	‐	‐	‐	‐	‐	‐
Mazzeo 2014	C: parent control	45	‐	‐	‐	‐	‐	‐	‐
van Grieken 2013	I: parent‐only	349	‐	‐	‐	‐	‐	‐	‐
van Grieken 2013	C: usual care	288	‐	‐	‐	‐	‐	‐	‐
Small 2013	I: parent‐only	34	‐	‐	‐	‐	‐	‐	‐
Small 2013	C: control	33	‐	‐	‐	‐	‐	‐	‐
Esfarjani 2013	I: parent‐only	70	‐	‐	‐	‐	‐	‐	‐
Esfarjani 2013	C: control	86	‐	‐	‐	‐	‐	‐	‐
Moens 2012	I: parent‐only	27	‐	‐	‐	‐	‐	‐	‐
Moens 2012	C: control	19	‐	‐	‐	‐	‐	‐	‐
Raynor 2012a	I: parent‐only	33	‐	‐	‐	‐	‐	‐	‐
	C1: parent ‐ diet decrease	33	‐	‐	‐	‐	‐	‐	‐
	C2: parent ‐ diet increase	35	‐	‐	‐	‐	‐	‐	‐
Raynor 2012b	I: parent‐only	29	‐	‐	‐	‐	‐	‐	‐
	C1: parent ‐ diet and activity traditional	26	‐	‐	‐	‐	‐	‐	‐
	C2: parent ‐ diet and activity substitute	26	‐	‐	‐	‐	‐	‐	‐
Magarey 2011	I: parent healthy lifestyle	85	‐	‐	‐	‐	‐	‐	‐
Magarey 2011	C: healthy lifestyle	84	‐	‐	‐	‐	‐	‐	‐
Jansen 2011	I: parent CBT	59	‐	‐	‐	‐	‐	‐	‐
Jansen 2011	C: waiting list control	39	‐	‐	‐	‐	‐	‐	‐
Collins 2011	I: parent‐only diet	63	‐	‐	‐	‐	‐	‐	‐
	C1: parent‐child (physical activity)	73	‐	‐	‐	‐	‐	‐	‐
	C2: parent‐child (physical activity + diet)	70	‐	‐	‐	‐	‐	‐	‐
Boutelle 2011	I: parent‐only	40	‐	‐	‐	‐	‐	‐	‐
Boutelle 2011	C: parent‐child	40	‐	‐	‐	‐	‐	‐	‐
West 2010	I: parent‐only	52	‐	‐	‐	‐	‐	‐	‐
West 2010	C: control	49	‐	‐	‐	‐	‐	‐	‐
Resnick 2009	I: educational material + personal encounters	22	‐	‐	‐	‐	‐	‐	‐
Resnick 2009	C: educational material	24	‐	‐	‐	‐	‐	‐	‐
Estabrooks 2009	I: parent group + IVR	85	‐	‐	‐	‐	‐	‐	‐
	I2: parent group	85	‐	‐	‐	‐	‐	‐	‐
	C: parent workbook	50	‐	‐	‐	‐	‐	‐	‐
Munsch 2008	I: mother only	25	‐	‐	‐	‐	‐	‐	‐
Munsch 2008	C: mother‐child	31	‐	‐	‐	‐	‐	‐	‐
Janicke 2008	I: parent‐only	34	‐	‐	‐	‐	‐	‐	‐
	C1: parent‐child	33	‐	‐	‐	‐	‐	‐	‐
	C2: waiting list control	26	‐	‐	‐	‐	‐	‐	‐
Golley 2007	I: parent + lifestyle education	38	‐	‐	‐	‐	‐	‐	‐
	C1: parent	37	‐	‐	‐	‐	‐	‐	‐
	C2: waiting list control	36	‐	‐	‐	‐	‐	‐	‐
Golan 2006	I: parent‐only	14	‐	‐	‐	‐	‐	‐	‐
Golan 2006	C: parent‐child	18	‐	‐	‐	‐	‐	‐	‐
Aragona 1975	I1: parent‐only + reinforcement	5	‐	‐	‐	‐	‐	‐	‐
	I2: parent‐only	5	‐	‐	‐	‐	‐	‐	‐
	C: control	5	‐	‐	‐	‐	‐	‐	‐
"‐" denotes not reported C: comparator; CBT: cognitive behavioural therapy; I: intervention; IVR: interactive voice response; NOURISH: Nourishing Our Understanding of Role Modelling to Improve Support and Health; PCP: primary care providers

Appendix 9. Checklist to aid consistency and reproducibility of GRADE assessments

		Body mass index (BMI) variables
Study limitations (risk of bias)^a	1. Was random sequence generation used (i.e. no potential for selection bias)?	Yes
	2. Was allocation concealment used (i.e. no potential for selection bias)?	Unclear
	3. Was there blinding of participants and personnel (i.e. no potential for performance bias)?	Unclear
	4. Was there blinding of outcome assessment (i.e. no potential for detection bias)?	Unclear
	5. Was an objective outcome used?	Yes
	6. Were > 80% of participants enrolled in trials included in the analysis (i.e. no potential reporting bias)?	No (↓)
	7. Were data reported consistently for the outcome of interest (i.e. no potential selective reporting)?	No (↓)
	8. No other biases reported (i.e. no potential of other bias)?	Yes
	9. Did the trials end up as scheduled (i.e. not stopped early)?	Yes
Inconsistency^b	1. Point estimates did not vary widely?	Yes
	2. To what extent did confidence intervals overlap (substantial: all confidence intervals overlap at least 1 of the included studies point estimate; some: confidence intervals overlap but not all overlap at least 1 point estimate; no: at least 1 outlier: where the confidence interval of some of the studies do not overlap with those of most included studies)?	Substantial
	3. Was the direction of effect consistent?	No
	4. What was the magnitude of statistical heterogeneity (as measured by I²) ‐ low (I² < 40%), moderate (I² 40‐60%), high I²> 60%)?	Low
	5. Was the test for heterogeneity statistically significant (P < 0.1)?	Not statistically significant
Indirectness^c	1. Were the populations in included studies applicable to the decision context?	Highly applicable
	2. Were the interventions in the included studies applicable to the decision context?	Highly applicable
	3. Was the included outcome not a surrogate outcome?	No (however, only relevant outcome)
	4. Was the outcome timeframe sufficient?	Sufficient
	5. Were the conclusions based on direct comparisons?	Yes
Imprecision^d	1. Was the confidence interval for the pooled estimate consistent with benefit?	No (↓)
	2. What is the magnitude of the median sample size (high: > 300 participants, intermediate: 100‐300 participants, low: < 100 participants)?^e	Low to intermediate (↓)
	3. What was the magnitude of the number of included studies (large: > 10 studies, moderate: 5‐10 studies, small: < 5 studies)?^e	Small (↓)
	4. Was the outcome a common event (e.g. occurs more than 1/100)?	N/A
Publication biased	1. Was a comprehensive search conducted?	Yes
	2. Was grey literature searched?	Yes
	3. Were no restrictions applied to study selection on the basis of language?	Yes
	4. There was no industry influence on studies included in the review?	Yes
	5. There was no evidence of funnel plot asymmetry?	Unclear
	6. There was no discrepancy in findings between published and unpublished trials?	Unclear
^aQuestions on risk of bias are answered in relation to the majority of the aggregated evidence in the meta‐analysis rather than to individual trials. ^bQuestions on inconsistency are primarily based on visual assessment of forest plots and the statistical quantification of heterogeneity based on I². ^cWhen judging the width of the confidence interval it is recommended to use a clinical decision threshold to assess whether the imprecision is clinically meaningful. ^dQuestions address comprehensiveness of the search strategy, industry influence, funnel plot asymmetry and discrepancies between published and unpublished trials. ^eDepends on the context of the systematic review area. (↓): key item for possible downgrading the quality of the evidence (GRADE) as shown in the footnotes of the 'Summary of finding' table(s); GRADE: Grading of Recommendations Assessment, Development and Evaluation; N/A: not applicable.

Appendix 10. Survey of study investigators providing information on included trials

	Study author contacted (DD/MM/YYYY)	Study author replied (DD/MM/YYYY)	Study author asked for additional information (short summary)	Study author provided data (short summary)
Resnicow 2015	15/11/2015	‐	‐	‐
Mazzeo 2014	10/08/2015	10/08/2015	Allocation concealment approach and blinding of outcome assessors	‐
van Grieken 2013	10/08/2015	10/08/2015	Allocation concealment approach and selective reporting of outcomes	Yes, 14/09/2015
Small 2013	11/08/2015	‐	N/A	N/A
Esfarjani 2013	11/08/2015	‐	N/A	N/A
Moens 2012	18/08/2015	25/08/2015	Details blinding of participants, personnel and outcome assessors	Yes, 03/09/15
Raynor 2012a	20/11/2014	25/11/2014	Mean and standard deviation of the BMI z scores for each of the 3 arms in the trial	Yes, 25/11/2014
Raynor 2012b	20/11/2014	25/11/2014	Mean and standard deviation of the BMI z scores for each of the3 arms in the trial	Yes, 25/11/2014
Magarey 2011	11/08/2015	11/08/2015	N/A	N/A
Jansen 2011	11/08/2015	11/08/2015	Randomisation procedures, blinding of outcome assessors, selective reporting of outcomes	‐
Collins 2011	11/08/2015	11/08/2015	Allocation concealment approach	‐
Boutelle 2011	11/08/2015	‐	N/A	N/A
West 2010	11/08/2015	12/08/2015	Selective reporting of outcomes	‐
Resnick 2009	11/08/2015	‐	N/A	N/A
Estabrooks 2009	11/08/2015	‐	N/A	N/A
Munsch 2008	16/04/2014	16/04/2014	Additional data for Child Behaviour Checklist and English version of study publication	Yes, 16/04/2014
Janicke 2008	11/08/2015	11/08/2015	Allocation concealment approach, blinding of outcome assessors	Yes, 24/08/15
Golley 2007	11/08/2015	11/08/2015	N/A	N/A
Golan 2006	11/08/2015	‐	N/A	N/A
Aragona 1975	No email address	‐	N/A	N/A
N/A: not applicable

Appendix 11. Health‐related quality of life: instruments

	Name (type of measurement)	Dimensions (subscales) (number of items)	Validated instrument	Answer options	Scores	Direction of scales	Minimal important difference
Mazzeo 2014	Pediatric Health‐Related Quality of Life (PedsQL4.0)	4 (physical (8 items), emotional (5 items), social (5 items), and school (5 items))	Yes	5‐point Likert scale from 0 (never) to 4 (almost always)	Scores are transformed on a scale from 0 to 100	Higher scores indicate better HRQoL	Unknown
HRQoL: health‐related quality of life

Figure 1

Study flow diagram.

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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies (blank cells indicate that the particular outcome was not investigated in some studies).

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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study (blank cells indicate that the study did not report that particular outcome).

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Analysis 1.1

Comparison 1 Parent‐only interventions versus parent‐child interventions, Outcome 1 BMI z score change post intervention.

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Analysis 1.2

Comparison 1 Parent‐only interventions versus parent‐child interventions, Outcome 2 BMI z score change longest follow‐up.

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Analysis 2.1

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 1 BMI z score change post intervention.

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Analysis 2.2

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 2 BMI z score change longest follow‐up.

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Analysis 2.3

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 3 BMI percentile change post intervention.

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Analysis 2.4

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 4 BMI percentile change longest follow‐up.

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Analysis 2.5

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 5 BMI change post intervention.

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Analysis 2.6

Comparison 2 Parent‐only interventions versus waiting list interventions, Outcome 6 BMI change longest follow‐up.

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Analysis 3.1

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 1 BMI z score change post intervention.

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Analysis 3.2

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 2 BMI z score change longest follow‐up.

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Analysis 3.3

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 3 BMI percentile change post intervention.

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Analysis 3.4

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 4 BMI percentile change longest follow‐up.

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Analysis 3.5

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 5 BMI change post intervention.

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Analysis 3.6

Comparison 3 Parent‐only interventions versus minimal contact interventions, Outcome 6 BMI change longest follow‐up.

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Analysis 4.1

Comparison 4 Parent‐only intervention versus parent‐only intervention, Outcome 1 BMI z score change post intervention.

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Analysis 4.2

Comparison 4 Parent‐only intervention versus parent‐only intervention, Outcome 2 BMI z score change longest follow‐up.

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Analysis 4.3

Comparison 4 Parent‐only intervention versus parent‐only intervention, Outcome 3 BMI change post intervention.

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Analysis 4.4

Comparison 4 Parent‐only intervention versus parent‐only intervention, Outcome 4 BMI change longest follow‐up.

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Analysis 4.5

Comparison 4 Parent‐only intervention versus parent‐only intervention, Outcome 5 BMI percentile change post intervention [%].

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Summary of findings for the main comparison. Parent‐only interventions versus parent‐child interventions for childhood overweight or obesity

Parent‐only interventions vs. parent‐child interventions for childhood overweight or obesity
Population: children with overweight or obesity Settings: outpatients; community/university Intervention: parent‐only interventions Comparison: parent‐child interventions
Outcomes	Parent‐child	Parent‐only	Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
*BMI z score change (x SD)** Follow‐up: 40‐104 weeks	The mean BMI z score change ranged across control groups from ‐0.16 to ‐0.24	The mean BMI z score change in the intervention groups was 0.04 lower (0.15 lower to 0.08 higher)	‐	267 (3)	⊕⊕⊝⊝ low^a	Lower scores indicate improved weight loss
Adverse events	See comment	See comment	See comment	See comment	See comment	No trials reported adverse events
Health‐related quality of life	See comment	See comment	See comment	See comment	See comment	No trials reported health‐related quality of life
All‐cause mortality	See comment	See comment	See comment	See comment	See comment	No trials reported all‐cause mortality
Morbidity	See comment	See comment	See comment	See comment	See comment	No trials reported morbidity
Parent‐child relationship or assessment of parenting	See comment	See comment	See comment	See comment	See comment	No trials reported outcomes assessing parent‐child relationships or an assessment of parenting
Socioeconomic effects	See comment	See comment	See comment	See comment	See comment	No trials reported socioeconomic effects
The basis for the assumed risk* (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index; CI: confidence interval; SD: standard deviation. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
"A BMI z score or standard deviation score indicates how many units (of the standard deviation) a child's BMI is above or below the average BMI value for their age group and sex. For instance, a z score of 1.5 indicates that a child' is 1.5 standard deviations above the average value, and a z score of ‐1.5 indicates a child is 1.5 standard deviations below the average value" (Noo NHS 2011). ^aDowngraded by one level because of serious risk of attrition bias and one level for serious imprecision (see Appendix 9).

Summary of findings for the main comparison. Parent‐only interventions versus parent‐child interventions for childhood overweight or obesity

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Summary of findings 2. Parent‐only interventions versus waiting list control for childhood overweight or obesity

Parent‐only interventions vs. waiting list control for childhood overweight or obesity
Population: children with overweight or obesity Settings: outpatients; community Intervention: parent‐only interventions Comparison: waiting list control
Outcomes	Waiting list	Parent‐only	Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
*BMI z score change (x SD)** Follow‐up: 40‐48 weeks	The mean BMI z score change ranged across control groups from ‐0.13 to 0.02	The mean BMI z score change in the intervention groups was 0.1 lower (0.19 lower to 0.01 lower)	‐	136 (2)	⊕⊕⊝⊝ low^a	Lower scores indicate improved weight loss
Adverse events	See comment	See comment	See comment	See comment	See comment	No trials reported adverse events
Health‐related quality of life	See comment	See comment	See comment	See comment	See comment	No trials reported health‐related quality of life
All‐cause mortality	See comment	See comment	See comment	See comment	See comment	No trials reported all‐cause mortality
Morbidity	See comment	See comment	See comment	See comment	See comment	No trials reported morbidity
Parent‐child relationship or assessment of parenting (parenting scale (PS), 30 items, scored from 1 to 7; lower scores indicate more effective parental discipline practices) Follow‐up: 12 weeks	The mean PS score for the control group was 3.4	The mean PS score in the intervention group was 0.6 points lower	‐	101 (1)	⊕⊕⊝⊝ low^a	‐
Socioeconomic effects	See comment	See comment	See comment	See comment	See comment	No trials reported socioeconomic effects
The basis for the assumed risk* (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index; CI: confidence interval; PS: parenting scale; SD: standard deviation. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
"A BMI z score or standard deviation score indicates how many units (of the standard deviation) a child's BMI is above or below the average BMI value for their age group and sex. For instance, a z score of 1.5 indicates that a child' is 1.5 standard deviations above the average value, and a z score of ‐1.5 indicates a child is 1.5 standard deviations below the average value" (Noo NHS 2011). ^aDowngraded by one level because of serious risk of attrition bias and one level for serious imprecision (see Appendix 9).

Summary of findings 2. Parent‐only interventions versus waiting list control for childhood overweight or obesity

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Summary of findings 3. Parent‐only interventions versus minimal contact control for childhood overweight or obesity

Parent‐only interventions vs. minimal contact control for childhood overweight or obesity
Population: children with overweight or obesity Settings: outpatients Intervention: parent‐only interventions Comparison: minimal contact control
Outcomes	Minimal contact	Parent‐only	Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
*BMI z score change (x SD)** Follow‐up: 52 weeks	The mean BMI z score change ranged across control groups from ‐0.06 to ‐0.06	The mean BMI z score change in the intervention group was 0.01 lower (‐0.07 lower to 0.09 higher)	‐	165 (1)	⊕⊕⊝⊝ low^a	Lower scores indicate improved weight loss
Adverse events	See comment	See comment	See comment	See comment	See comment	No trials reported adverse events
Health‐related quality of life (Pediatric Health‐Related Quality of Life, scale from 0 to 100; higher scores indicate better HRQoL) Follow‐up: 24 weeks)	See comment	See comment	See comment	93 (1)	See comment	No data were presented ('"no improvements in health‐related quality of life")
All‐cause mortality	See comment	See comment	See comment	See comment	See comment	No trials reported all‐cause mortality
Morbidity	See comment	See comment	See comment	See comment	See comment	No trials reported morbidity
Parent‐child relationship or assessment of parenting (Child Feeding Questionnaire subscale parental concern (total of 7 subscales), score range 3‐15; higher scores indicate greater parental concern) Follow‐up: 12 weeks	The mean parent concern score was 4.7 in the control group	The mean parent concern score in the intervention group was 0.1 lower.	‐	93 (1)	⊕⊕⊝⊝ low^a	‐
Socioeconomic effects	See comment	See comment	See comment	See comment	See comment	No trials reported socioeconomic effects
The basis for the assumed risk* (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index; CI: confidence interval; HRQoL: health‐related quality of life; SD: standard deviation. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
"A BMI z score or standard deviation score indicates how many units (of the standard deviation) a child's BMI is above or below the average BMI value for their age group and sex. For instance, a z score of 1.5 indicates that a child' is 1.5 standard deviations above the average value, and a z score of ‐1.5 indicates a child is 1.5 standard deviations below the average value" (Noo NHS 2011). ^aDowngraded by one level because of serious risk of attrition bias and one level for serious imprecision (see Appendix 9).

Summary of findings 3. Parent‐only interventions versus minimal contact control for childhood overweight or obesity

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Summary of findings 4. Parent‐only interventions versus parent‐only interventions for childhood overweight or obesity

Parent‐only interventions vs. parent‐only interventions for childhood overweight or obesity
Population: children with overweight or obesity Settings: outpatients; university + primary care Intervention: parent‐only interventions Comparison: parent‐only interventions
Outcomes	Parent‐only	Parent‐only	Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
*BMI z score change (x SD)** Follow‐up: 12‐24 months	See comment	See comment	See comment	467 (5)	⊕⊕⊝⊝ low^a	No meta‐analysis because of little consistency between trial interventions and comparators; there were no substantial differences between different parent‐only interventions
Adverse events	See comment	See comment	See comment	See comment	See comment	Two trials reported that there were no serious adverse events (Raynor 2012a; Raynor 2012b)
Health‐related quality of life	See comment	See comment	See comment	See comment	See comment	No trials reported health‐related quality of life
All‐cause mortality	See comment	See comment	See comment	See comment	See comment	No trials reported all‐cause mortality
Morbidity	See comment	See comment	See comment	See comment	See comment	No trials reported morbidity
Parent‐child relationship or assessment of parenting (Alabama Parenting Questionnaire, 35 items; higher scores indicate improvement) Follow‐up: 24 months	See comment	See comment	See comment	106 (1)	See comment	1 study assessed parent‐child relationship or assessment of parenting but there were no data for comparisons between intervention groups provided
Socioeconomic effects	See comment	See comment	See comment	See comment	See comment	No trials reported socioeconomic effects
The basis for the assumed risk* (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index; CI: confidence interval; SD: standard deviation. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
"A BMI z score or standard deviation score indicates how many units (of the standard deviation) a child's BMI is above or below the average BMI value for their age group and sex. For instance, a z score of 1.5 indicates that a child' is 1.5 standard deviations above the average value, and a z score of ‐1.5 indicates a child is 1.5 standard deviations below the average value" (Noo NHS 2011). ^aDowngraded by one level because of serious risk of attrition bias and one level for serious imprecision (see Appendix 9)

Summary of findings 4. Parent‐only interventions versus parent‐only interventions for childhood overweight or obesity

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Table 1. Overview of study populations

	Intervention(s) and comparator(s)	Sample size^a	Screened/eligible [N]	Randomised [N]	ITT [N]	Analysed [N]	Finishing trial [N]	Randomised finishing trial [%]	Follow‐up (extended follow‐up)^a
(20) Resnicow 2015	I1: parent‐only PCP motivational interviewing	The study was powered to detect a 3‐point difference in BMI percentile between any pair of study groups at 2‐year follow‐up, with an assumed SD for BMI percentile between 4 and 6: power of 0.80 and 2‐tailed a of 0.05. Sample size was inflated to account for practice‐level clustering, assuming an intraclass correlation between 0.01 and 0.05. On this basis and a projected 25‐30% attrition at 2‐year follow‐up, 10‐12 practices per arm (30‐36 total) and a mean of 15‐20 children per practice at baseline were required	‐	16 practices 212 participants	145	145	145	68	2 years (2 years)
	I2: parent‐only PCP + dietician motivational interviewing			15 practices 235 participants	154	154	154	66
	C: usual care			11 practices 198 participants	158	158	158	80
	total:			645	457	457	457	71
(19) Mazzeo 2014	I: parent NOURISH	‐	235	48	‐	46	10	21	12 weeks post 12‐week intervention (24 weeks)
	C: parent control	‐	235	45	‐	45	16	36
	total:			93		91	26	28
(18) Van Grieken 2013	I: parent‐only	Sample size was calculated taking into account the intracluster correlation coefficient (ρ = 0.1), the number of clusters (44), the expected prevalence of overweight children in the study population, the SD, expected effect (a difference in mean), and the power of the study (80%). With a participation of 50%, an expected prevalence of overweight children of 9% and a loss‐to‐follow‐up of 30%, at least 11,301 children (and their parents) should be invited by the YHC teams to participate in the study to have a final sample of about 356 overweight children (178 in both the intervention and control group). Assuming a SD of BMI to be 1.0 kg/m², a difference in mean BMI of 0.35 kg/m² between the children in the intervention group and the children in the control group can be established under the assumptions mentioned above	22 clusters 7004 participants	349	‐	21 clusters 277 participants	277	79	2 years post up to 12‐month intervention
	C: usual care		22 clusters 7004 participants	288	‐	21 clusters 230 participants	230	80
	total			637	‐	42 (507)	507	80
(17) Small 2013	I: parent‐only	‐	‐	34	33	33	33	97	24 weeks post 16‐week intervention (41 weeks)
	C: parent control	‐	‐	33	27	27	27	82
	total:			67	60	60	60	90
(16) Esfarjani 2013	I: parent‐only	‐	550/156	70	‐	55	58	83	Intervention 6 months (not reported)
	C: parent control	‐	550/156	86	‐	52	59	69
	total:			156	‐	107	117	75
(15) Moens 2012	I: parent‐only	‐	80/75	31	‐	‐	31	100	Immediately following 6‐month intervention
	C: waiting list control	‐	80/75	19	‐	‐	15	79
	total:			50	‐	‐	46	92
(14) Raynor 2012a	I1: parent‐only	Sample size calculations presumed 2‐sided hypothesis testing at 6‐month assessment, with type 1 error rate = 0.05. To reject with 80% power the null hypothesis of no pre‐ to post‐treatment difference between intervention conditions vs. the alternative that the pre‐ to post‐treatment difference was 0.6 or greater (effect size), 24 participants per group were needed	549	33	33	33	29	88	24 weeks post 24‐week intervention (reported as '12 months')
	I2: parent ‐ diet decrease			33	33	33	29	88
	I3: parent ‐ diet increase			35	35	35	32	91
	total:			101	101	101	90	89
(13) Raynor 2012b	I1: parent‐only	Sample size calculations presumed 2‐sided hypothesis testing at 6‐month assessment, with type 1 error rate = 0.05. To reject with 80% power the null hypothesis of no pre‐ to post‐treatment difference between intervention conditions vs. the alternative that the pre‐ to post‐treatment difference is 0.6 or greater (effect size), 24 participants per group were needed	549	29	29	29	26	90	24 weeks post 24‐week intervention (reported as '12 months')
	I2: parent ‐ diet and activity traditional			26	26	26	24	92
	I3: parent ‐ diet and activity substitute			26	26	26	24	92
	total:			81	81	81	74	91
(12) Margarey 2011	I: parent healthy lifestyle	Sample size calculation was based on a reduction in BMI z score of 0.26 (SD 0.49) over 12 months (power 80%, alpha = 0.05, and drop‐out rate of 30%). This represents a 50% reduction in weight velocity over 12 months and no change in height velocity. We sought 42 children per group per site (168 children)	398	85	85	85	52	61	80 weeks post 24‐week intervention (104 weeks)
	C: healthy lifestyle		398	84	84	84	54	64
	total:			169	169	169	106	63
(11) Jansen 2011	I: parent CBT	‐	161	59	‐	54	54	92	12 weeks post 12‐week intervention (24 weeks)
	C: waiting list control	‐	161	39	‐	34	34	87
	total:			98		88	88	90
(10) Collins 2011	I: parent‐only ‐ diet	Power: 80% chance of detecting significance (2‐sided 5% level), with a 0.26 BMI z score difference from baseline to 12 months as the initial end point, with an anticipated loss to follow‐up of 20%	505/319	63	‐	42	22	35	80 weeks post 24‐week intervention (104 weeks)
	C1: parent‐child (physical activity)			73	‐	63	35	48
	C2: parent‐child (physical activity + diet)			70	‐	60	36	51
	total:			206	‐	165	93	45
(9) Boutelle 2011	I: parent‐only	Sample size was determined by pragmatic factors, including budget and investigator time commitments. No interim analyses were done. The hypotheses tested related to non‐inferiority of the parent treatment to the parent‐child treatment on child and parent weight loss and child daily caloric intake and physical activity. The bound for non‐inferiority hypotheses related to BMI percentile was set to 1. This is the maximum value the parent‐child group could do better than parent‐only, below which non‐inferiority would be concluded. This bound could correspond to an mean‐aged child in this sample having a BMI of 26 in the parent‐child group and 28.5 in the parent‐only group at post‐treatment/follow‐up, assuming equivalence at baseline. For a non‐inferiority bound for child BMI, which was selected post hoc, we considered choosing a BMI that would correspond to the BMI percentile non‐inferiority bound (BMI = 2.5), but instead chose a more rigorous value of BMI = 1	157	40	‐	24	24	60	24 weeks post 20‐week intervention (week 44)
	C: parent‐child		157	40	‐	28	28	70
	total:			80		52	52	65
(8) West 2010	I: parent‐only	‐	205	52	52	52	34	65	40 weeks post 12‐week intervention (52 weeks)
	C: waiting list control	‐	205	49	49	49	46	94
	total:			101	101	101	80	79
(7) Resnick 2009	I: educational material + personal encounters	‐	84/46	22	‐	18	18	82	Unclear (41 weeks between start and last mail out)
	C: educational material	‐	84/46	24	‐	24	24	100
	total:			46		42	42	91
(6) Estabrooks 2009	I1: parent group + IVR	Sample size calculations were completed, varying the detectable effect sizes from small to medium with a power of 0.8. The result was a need for 42 participants per intervention to detect a medium effect and 64 participants to detect a small effect	1487/656	85	‐	63	63	74	28‐40 weeks post 12‐ to 24‐week intervention (52 weeks)
	I2: parent group			85	‐	56	56	66
	C: parent workbook			50	‐	36	36	72
	total:			220		155	155	70
(5) Munsch 2008	I: mother‐only CBT	Trial authors did not reach the necessary sample size of 68 families with obese children within the given time span (the target sample size of 68 was based on a repeated‐measures analysis with alpha = 0.05, 1 ‐ beta = 0.8, and a medium effect size for the linear term of the interaction between treatment and time, assuming a drop‐out rate of 20%	181/60	25	‐	7	7	28	24 weeks post 10‐week intervention (34 weeks)
	C: mother‐child CBT		181/60	31	‐	20	20	65
	total:			56		27	27	48
(4) Janicke 2008	I: parent‐only	Post hoc power analyses were used to determine the detectable change in BMI z score from 0 to 10 months for the family based and parent‐only interventions relative to the waiting list control condition. Effect sizes (standardised BMI index) detectable with 80% power and 2‐sided level 0.05 tests were used. Standard deviations and sample sizes were set equal to their observed values. For comparing the family‐based and waiting list control conditions, trial authors reported 80% power to detect a shift from 0.022 to ‐0.145. For comparing the parent‐only and waiting list control conditions, trial authors reported 80% power to detect a shift from 0.022 to ‐0.135	111	34	‐	26	26	76	14 weeks post 16‐week intervention (40 weeks)
	C1: parent‐child			33	‐	24	24	73
	C2: waiting list control			26	‐	21	21	81
	total:			93		71	71	76
(3) Golley 2007	I: parent intervention + lifestyle education	Sample size calculation was based on a fall in BMI z score reflecting a weight gain of only 50% of that expected over 12 months with normal growth. A sample size of 28 per group was estimated to have 80% power to detect a 12‐month fall in mean BMI z score from a baseline of 0.26 (SD 0.49), assuming no change in the control group, at a 2‐sided significance level of 0.05. To account for a drop‐out rate of up to one‐third (commonly 20‐50% in child weight‐management studies), 42 children per study group were sought (126 children)	262/115	38	‐	31	31	82	24 weeks post 24‐week intervention (48 weeks)
	C1: parent intervention			37	‐	29	29	78
	C2: waiting list control			36	‐	31	31	86
	total:			111		101	101	‐
(2) Golan 2006	I: parent‐only	The study was designed to detect differences of 10% weight loss with a power of 90% and a significance level of 0.05, given a drop‐out rate of 10% with a sample of 12 in each group	102	14	‐	10	10	71	1 year post 26‐week intervention (18 months)
	C: parent‐child		102	18	‐	17	17	94
	total:			32		27	27	84
(1) Aragona 1975	I1: parent‐only with reinforcement	‐	‐	5	‐	4	4	80	12 weeks (51 weeks' follow‐up)
	I2: parent‐only			5	‐	3	3	60
	C: waiting list control			5	‐	5	2	40
	total:			15		12	9	60
*Grand total*	*All interventions*	‐		*1773^c*			*1276*
	*All comparators*			*1284^c*			*942*
	*All interventions and comparators*			*3057^c*			*2218*
^aAccording to power calculation in trial publication or report ^bDuration of intervention or follow‐up (or both) under randomised conditions until end of trial ^cSome trials had more than one intervention/comparator group "‐" denotes not reported BMI: body mass index; C: comparator; CBT: cognitive behavioural therapy; I: intervention; ITT: intention‐to‐treat; IVR: interactive voice response; n: number of participants; NOURISH: nourishing our understanding of role modelling to improve support and health; PCP: primary care providers; SD: standard deviation; YHC: Youth Health Care

Table 1. Overview of study populations

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Comparison 1. Parent‐only interventions versus parent‐child interventions

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 BMI z score change post intervention Show forest plot	3	277	Mean Difference (IV, Random, 95% CI)	‐0.06 [‐0.13, 0.02]

1.1 Parent‐only vs. parent‐child	2	112	Mean Difference (IV, Random, 95% CI)	‐0.05 [‐0.13, 0.04]
1.2 Parent‐only vs. parent‐child physical activity	1	84	Mean Difference (IV, Random, 95% CI)	‐0.15 [‐0.26, ‐0.04]
1.3 Parent‐only vs. parent‐child physical activity + diet	1	81	Mean Difference (IV, Random, 95% CI)	0.0 [‐0.11, 0.11]
2 BMI z score change longest follow‐up Show forest plot	3	267	Mean Difference (IV, Random, 95% CI)	‐0.04 [‐0.15, 0.08]

2.1 Parent‐only vs. parent‐child	2	102	Mean Difference (IV, Random, 95% CI)	0.06 [‐0.05, 0.16]
2.2 Parent‐only vs. parent‐child physical activity	1	84	Mean Difference (IV, Random, 95% CI)	‐0.16 [‐0.36, 0.04]
2.3 Parent‐only vs. parent‐child physical activity + diet	1	81	Mean Difference (IV, Random, 95% CI)	‐0.11 [‐0.31, 0.09]

Comparison 1. Parent‐only interventions versus parent‐child interventions

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Comparison 2. Parent‐only interventions versus waiting list interventions

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 BMI z score change post intervention Show forest plot	2	153	Mean Difference (IV, Random, 95% CI)	‐0.12 [‐0.21, ‐0.04]

2 BMI z score change longest follow‐up Show forest plot	2	136	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.19, ‐0.01]

2.1 Parent‐only vs. waiting list	2	92	Mean Difference (IV, Fixed, 95% CI)	‐0.11 [‐0.21, ‐0.01]
2.2 Parent‐only intensive education vs. waiting list	1	44	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.29, 0.25]
3 BMI percentile change post intervention Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 BMI percentile change longest follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 BMI change post intervention Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5.1 Parent‐only reinforcement vs. waiting list	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Parent‐only vs. waiting list	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 BMI change longest follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

6.1 Parent‐only reinforcement vs. waiting list	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Parent‐only vs. waiting list	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Parent‐only interventions versus waiting list interventions

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Comparison 3. Parent‐only interventions versus minimal contact interventions

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 BMI z score change post intervention Show forest plot	1	170	Mean Difference (IV, Random, 95% CI)	‐0.00 [‐0.08, 0.08]

1.1 Parent‐only IVR vs. control	1	87	Mean Difference (IV, Random, 95% CI)	‐0.02 [‐0.13, 0.09]
1.2 Parent‐only vs. control	1	83	Mean Difference (IV, Random, 95% CI)	0.02 [‐0.09, 0.13]
2 BMI z score change longest follow‐up Show forest plot	1	165	Mean Difference (IV, Fixed, 95% CI)	0.01 [‐0.07, 0.09]

2.1 Parent‐only interactive voice response vs. control	1	86	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.13, 0.09]
2.2 Parent‐only vs. control	1	79	Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.07, 0.15]
3 BMI percentile change post intervention Show forest plot	4		Mean Difference (IV, Random, 95% CI)	Totals not selected

3.1 Parent‐only vs. minimal contact control	3		Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Parent motivational interviewing vs. minimal contact control	1		Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
3.3 Parent motivational interviewing + dietician vs. minimal contact control	1		Mean Difference (IV, Random, 95% CI)	0.0 [0.0, 0.0]
4 BMI percentile change longest follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 BMI change post intervention Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

6 BMI change longest follow‐up Show forest plot	2	614	Mean Difference (IV, Random, 95% CI)	‐0.12 [‐0.39, 0.15]

Comparison 3. Parent‐only interventions versus minimal contact interventions

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Comparison 4. Parent‐only intervention versus parent‐only intervention

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 BMI z score change post intervention Show forest plot	5	507	Mean Difference (IV, Fixed, 95% CI)	‐0.22 [‐0.28, ‐0.17]

1.1 Parent‐only interactive voice response vs. parent‐only	1	132	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.16, 0.08]
1.2 Parent‐only intensive vs. parent‐only	1	57	Mean Difference (IV, Fixed, 95% CI)	‐0.09 [‐0.38, 0.20]
1.3 Parent health lifestyle vs. healthy lifestyle	1	136	Mean Difference (IV, Fixed, 95% CI)	‐0.07 [‐0.29, 0.15]
1.4 Parent‐only vs. decrease	1	52	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.17, 0.09]
1.5 Parent‐only vs. increase	1	49	Mean Difference (IV, Fixed, 95% CI)	‐0.01 [‐0.14, 0.12]
1.6 Parent‐only vs. substitute	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.70 [‐0.86, ‐0.54]
1.7 Parent‐only vs. traditional	1	41	Mean Difference (IV, Fixed, 95% CI)	‐0.69 [‐0.83, ‐0.55]
2 BMI z score change longest follow‐up Show forest plot	5	467	Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐0.10, 0.03]

2.1 Parent‐only interactive voice response vs. parent‐only	1	119	Mean Difference (IV, Fixed, 95% CI)	‐0.06 [‐0.18, 0.06]
2.2 Parent‐only intensive vs. parent‐only	1	60	Mean Difference (IV, Fixed, 95% CI)	‐0.09 [‐0.32, 0.14]
2.3 Parent health lifestyle vs. healthy lifestyle	1	106	Mean Difference (IV, Fixed, 95% CI)	0.03 [‐0.24, 0.30]
2.4 Parent‐only vs. decrease	1	52	Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.19, 0.11]
2.5 Parent‐only vs. increase	1	49	Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.17, 0.13]
2.6 Parent‐only vs. substitute	1	41	Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐0.24, 0.18]
2.7 Parent‐only vs. traditional	1	40	Mean Difference (IV, Fixed, 95% CI)	0.01 [‐0.17, 0.19]
3 BMI change post intervention Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 BMI change longest follow‐up Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

5 BMI percentile change post intervention [%] Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 4. Parent‐only intervention versus parent‐only intervention

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The Cochrane Library

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Intervenciones sólo en padres para el sobrepeso y la obesidad en niños de 5 a 11 años de edad

Appendices

Appendix 1. Search strategies

Appendix 2. Description of interventions

Appendix 3. Baseline characteristics (I)

Appendix 4. Baseline characteristics (II)

Appendix 5. Matrix of study endpoints (publications and trial documents)

Appendix 6. Examination of outcome reporting bias according to ORBIT classification

Appendix 7. Definition of endpoint measurement

Appendix 8. Adverse events

Appendix 9. Checklist to aid consistency and reproducibility of GRADE assessments

Appendix 10. Survey of study investigators providing information on included trials

Appendix 11. Health‐related quality of life: instruments

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	Endpoints quoted in trial document(s) (ClinicalTrials.gov, FDA/EMA document, manufacturer's website, published design paper)^a	Study results/ publications available in trials register	Endpoints quoted in publication(s)^b,c	Endpoints quoted in abstract of publication(s)^b,c
Resnicow 2015	Source: NCT01335308 Primary outcome measure(s): BMI percentile	No (last verified: March 2011) History of changes: 0 documented changes	Primary outcome measure(s): BMI percentile	Primary outcome measure(s): BMI percentile
	Secondary outcome measure(s): fruit + vegetable consumption, sweetened beverage consumption, change in physical activity		Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Mazzeo 2014	Source: NCT00628030 Primary outcome measure(s): child BMI	Yes (last verified: July 2015) History of changes: 7 documented changes	Primary outcome measure(s): BMI	Primary outcome measure(s): child BMI
	Secondary outcome measure(s): child feeding child quality of life parental BMI parental dietary intake		Secondary outcome measure(s): Three Factor Eating Questionnaire; Child Feeding Questionnaire; dietary intake (Block Food Screener); Pediatric Health‐Related Quality of Life; Pubertal status (self report)	Secondary outcome measure(s): parents satisfaction, parent behaviour change
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
van Grieken 2013	Source: ISRCTN04965410, NTR921 Primary outcome measure(s): BMI, waist circumference	No (last verified: July 2015) History of changes: no documented changes	Primary outcome measure(s): BMI, waist circumference	Primary outcome measure(s): BMI
	Secondary outcome measure(s): levels of the 4 target overweight‐reducing and overweight‐inducing behaviours, i.e. being physically active, eating breakfast daily, drinking sweet beverages and watching TV or playing on a computer; health‐related quality of life; attitudes of parents regarding the 4 target behaviours; absence or presence of indicators of negative adverse effects, i.e. worry, stigmatisation, lowered self esteem and development of relative underweight		Secondary outcome measure(s): height, overweight prevalence, process evaluation, child‐health behaviours (breakfast, sweet beverages, playing outside and TV viewing)	Secondary outcome measure(s): minutes of outside play or TV viewing, having breakfast, number drinks of sweet beverages
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Small 2013	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not specified as primary or secondary: BMI percentile; waist circumference; waist for height ratio	Other outcome measure(s): waist circumference, waist‐by‐height ratio, BMI and BMI percentile
Esfarjani 2013	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not reported as primary or secondary: height, weight, BMI, waist circumference, hip circumference, fasting blood glucose (data not extracted), triglyceride (data not extracted), total cholesterol (data not extracted), HDL‐cholesterol (data not extracted, LDL cholesterol (data not extracted), food consumption (data not extracted), watching TV (data not extracted), playing on computer (data not extracted), walking time (data not extracted)	Other outcome measure(s): weight, waist and hip circumference, cholesterol, serum triglycerides, food group consumption, TV and computer time, walking time
Moens 2012	Source: N/T		Primary outcome measure(s): see below	Primary outcome measure(s): ‐
			Secondary outcome measure(s): see below	Secondary outcome measure(s): ‐
			Outcomes not reported as primary or secondary: height, weight, Dutch eating behaviour questionnaire (child and parent versions); Ghent Parental Behaviour Scale; health principles questionnaire, Hollingshead Index of Social Position	Other outcome measure(s): BMI, parental report of child's eating behaviour, familial health principles
Raynor 2012b	Source: NCT00259324 Primary outcome measure(s): BMI z score	No (last verified: July 2015) History of changes: 6 documented changes	Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
	Secondary outcome measure(s): eating and activity behaviours		Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
	Other outcome measure(s):		Outcomes not specified as primary or secondary: weight, height, BMI and BMI z score; dietary intake (food diaries); leisure time activity (Previous Day Physical Activity Recall)	Other outcome measure(s): BMI z score, energy intake
Raynor 2012a	Source: NCT00200265 Primary outcome measure(s): BMI z score	No (last verified: July 2015) History of changes: 6 documented changes	Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
	Secondary outcome measure(s): eating and activity behaviours		Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
	Other outcome measure(s): ‐		Outcomes not specified as primary or secondary: weight, height, BMI and BMI z score; dietary intake (food diaries); leisure time activity (Previous Day Physical Activity Recall)	Other outcome measure(s): BMI z score, energy intake
Magarey 2011	Source: ACTRN12606000120572 Primary outcome measure(s): BMI z score	No (last verified: February 2013) History of changes: no documented changes	Primary outcome measure(s): BMI z score	Primary outcome measure(s): BMI z score
	Secondary outcome measure(s): waist circumference, fasting lipids, triglyceride, insulin, and glucose, blood pressure, health‐related quality of life, body satisfaction, parenting, parental BMI, eating and activity behaviours, health belief, programme evaluation		Secondary outcome measure(s): Program Impact (Parenting Sense of Competence Scale); Parenting (Alabama Parenting questionnaire); health‐related quality of life, waist circumference, fasting lipids, triglycerides, insulin, glucose, blood pressure, body satisfaction, eating and activity behaviours, health belief, programme satisfaction	Secondary outcome measure(s): waist z score
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Jansen 2011	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not specified as primary or secondary: weight; height; BMI percentile, eating psychopathology (Child Eating Disorders Examination Questionnaire), eating behaviours (self report), physical activity (Baecke Questionnaire), self esteem (Self‐Perception Profile for Children), negative thoughts (Heavy Thoughts Questionnaire), knowledge test, motivation (therapist rated)	Other outcome measure(s): BMI percentile, relapse, psychopathology, self esteem and negative thoughts
Collins 2011	Source: NCT00107692 Primary outcome measure(s): ‐	No (last verified: September 2006) History of changes: 5 documented changes	Primary outcome measure(s): BMI z score and waist circumference	Primary outcome measure(s): BMI z score, waist measurements
	Secondary outcome measure(s): ‐		Secondary outcome measure(s): blood pressure, cholesterol, C‐reactive protein, triglycerides, glucose, insulin, energy intake, physical activity, movement and skill proficiency, perceived athletic competence, screen behaviours	Secondary outcome measure(s): metabolic outcomes
	Outcomes not stated as primary or secondary: BMI SD score, height, weight, and waist circumference; metabolic profile measures: blood pressure; cholesterol, triglycerides; glucose and insulin; physical activity energy expenditure and sedentary activities: total kilocalories expended and time spent in sedentary activities; dietary energy intake: 4‐day weighed food record (2 week days and the weekend), parent selection of lower fat items in the household grocery shopping and behaviour changes related to a healthy lifestyle; actual and perceived competence: Test of Gross Motor Development and the Self‐Perception Profile for Children. Activity of daily living: Sit‐to‐stand transfer		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Boutelle 2011	Source: N/T		Primary outcome measure(s): weight, BMI (basis of non‐inferiority test)	Primary outcome measure(s): inferiority of treatment group on child weight loss
			Secondary outcome measure(s): dietary intake (Block Kids questionnaire), physical activity (Physical Activity Questionnaire for Older Children), BMI percentile, BMI z score	Secondary outcome measure(s): parent weight loss and child physical activity, caloric intake
			Other outcome measure(s): ‐	Other outcome measure(s): ‐
West 2010	Source: N/T		Primary outcome measure(s): BMI z score	Primary outcome measure(s): child BMI z score
			Secondary outcome measure(s): weight‐related problem behaviour and parenting self efficacy (Lifestyle Behaviour Checklist); ineffective parenting (Parenting Scale)	Secondary outcome measure(s): weight‐related problem behaviour, confidence in managing children's weight‐related behaviour
			Other outcome measure(s): ‐	Other outcome measure(s): ‐
Resnick 2009	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not specified as primary or secondary: sources of information, parent confidence, behavioural questions, patient satisfaction (all self report measures), BMI	Other outcome measure(s): BMI
Estabrooks 2009	Source: NCT00433901 Primary outcome measure(s): child BMI	No (last verified: July 2010) History of changes: 2 documented changes	Primary outcome measure(s): BMI z score	Primary outcome measure(s): child BMI z scores
	Secondary outcome measure(s): parent BMI, objective measure of physical activity using child accelerometer, Kids Eating Disorder Survey (KEDS), Peds QOL survey, SE (self efficacy), self report of physical activity, self report of sedentary activity, children's block food frequency survey, parent's home environment survey, parent self efficacy, parent demographics, parent quality of life, parent rapid assessment of physical activity, parent fat and fibre survey, parent health literacy, child/family medical history, economic survey type of medical weight management services		Secondary outcome measure(s): physical activity and sedentary behaviour (Youth Behavioural Risk Survey question); fruit, vegetable and sugared‐drink consumption (Block Kids Questionnaire); eating disorder symptoms (Kids Eating Disorders Survey); health‐related quality of life (Peds QOL survey), self efficacy	Secondary outcome measure(s): symptoms of eating disorders and body image
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Munsch 2008	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not specified as primary or secondary: per cent overweight; depression (Depressionsinventar für Kinder und Jugendliche); anxiety (State‐Trait Anxiety Inventory for children) Social Anxiety Scale for Children‐Revised); behaviour problems (Child Behaviour CheckList), mental disorders (Diagnostisches Interview bei psychischen Störungen im Kindes‐ und Jugendalter (K‐DIPS)), binge eating (screening interview)	Other outcome measure(s): % overweight, general behaviour problems (externalising and internalising behaviour problems), global and social anxiety, and depression
Janicke 2008	Source: N/T		Primary outcome measure(s): BMI z score (basis of power calculation)	Primary outcome measure(s): BMI z score,
			Secondary outcome measure(s): Youth/Adolescent Food Frequency Questionnaire	Secondary outcome measure(s): self esteem, cost
			Other outcome measure(s): ‐	Other outcome measure(s): ‐
Golley 2007	Source: ACTRN12606000119594 Primary outcome measure(s): BMI z score	No (last verified: February 2013) History of changes: no documented changes	Primary outcome measure(s): BMI z score	Primary outcome measure(s): BMI z score
	Secondary outcome measure(s): waist circumference, fasting lipids, triglyceride, insulin, and glucose, blood pressure, health‐related quality of life, body satisfaction, parental weight status and waist circumference, eating and activity behaviours, parental competency, parental satisfaction		Secondary outcome measure(s): waist circumference, blood pressure; fasting glucose; total cholesterol; high‐density lipoprotein cholesterol; low‐density lipoprotein cholesterol; triacylglycerol; programme evaluation; satisfaction; health related quality of life	Secondary outcome measure(s): waist circumference z score
	Other outcome measure(s): ‐		Other outcome measure(s): ‐	Other outcome measure(s): ‐
Golan 2006	Source: N/T		Primary outcome measure(s): weight loss (basis of power calculation)	Primary outcome measure(s): % overweight at end of programme (6 months) and 1‐year follow‐up
			Secondary outcome measure(s): weight; height, BMI z score; family eating questionnaire; parenting style (Parental Authority Questionnaire)	Secondary outcome measure(s): food stimuli in the home (from Family Eating and Activity questionnaire), parent's weight
			Other outcome measure(s): ‐	Other outcome measure(s): ‐
Aragona 1975	Source: N/T		Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
			Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
			Outcomes not stated as primary or secondary: weight, height	Other outcome measure(s): weight change
‐ denotes not reported ^aTrial document(s) refers to all available information from published design papers and sources other than regular publications (e.g. FDA/EMA documents, manufacturer's website's, trial registers) ^bPublication(s) refers to trial information published in scientific journals (primary reference, duplicate publications, companion documents or multiple reports of a primary study) ACTRN: Australian New Zealand Clinical Trials Registry; BMA: body mass index; EMA: European Medicines Agency; FDA: Food and Drug Administration (US); ISRCTN: International Standard Randomised Controlled Trial Number; LDL: low‐density lipoprotein; N/A: not applicable; N/T: no trial document available; TV: television

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Appendices

Appendix 1. Search strategies

Appendix 2. Description of interventions

Appendix 3. Baseline characteristics (I)

Appendix 4. Baseline characteristics (II)

Appendix 5. Matrix of study endpoints (publications and trial documents)

Appendix 6. Examination of outcome reporting bias according to ORBIT classification

Appendix 7. Definition of endpoint measurement

Appendix 8. Adverse events

Appendix 9. Checklist to aid consistency and reproducibility of GRADE assessments

Appendix 10. Survey of study investigators providing information on included trials

Appendix 11. Health‐related quality of life: instruments

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