Development of a checklist to assess potentially effective components in combined lifestyle interventions for children with overweight or obesity

In the Netherlands, Combined Lifestyle Interventions (CLIs), offered in primary care, aim to reduce the number of children with overweight or obesity. CLIs are carried out by a multidisciplinary team and focus on dietary advice and guidance, exercise and behaviour change. These CLIs are not uniformly designed and vary in protocols to suit the local circumstances. Due to the variation in content of CLIs it is difficult to investigate their effectiveness. To enable a proper evaluation of CLIs, we first need to unravel the 'black boxes' of CLIs by identifying the various potentially effective components. First of all we identified potentially effective components in literature. Subsequently we organized an online consultation with experts with diverse backgrounds and asked if they could add potentially effective components. These components were then assembled into a checklist meant to determine the presence or absence of potentially effective components in CLIs for children. 42 experts participated. We identified 65 potentially effective components for CLIs for children with overweight or obesity that we categorized into three themes: content, organisation and implementation. Based on literature and expert opinions we developed a practical 65-item checklist to determine the presence of potentially effective components in a CLI. This checklist can be used in the development of CLIs as well as evaluation of CLIs.