Precision Health Approaches in Primary Childhood Obesity Prevention: A Systematic Review of Tailored and Risk-Based Interventions

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Abstract

BACKGROUND: Precision health represents an emerging paradigm in public health that uses individualised risk profiles to guide targeted prevention strategies. In childhood obesity, early-life determinants-such as genetics, growth patterns, family behaviours and environmental exposures-can inform interventions tailored to the specific needs of high-risk populations. Traditional universal approaches have shown limited long-term effectiveness, highlighting the need for more personalised prevention models. OBJECTIVE: This systematic review aimed to (1) evaluate the effectiveness of tailored and risk-based interventions for the primary prevention of childhood obesity in children aged 0-12 years, and (2) examine implementation characteristics and contextual factors influencing intervention outcomes. METHODS: Following PRISMA 2020 guidelines, we searched six databases (PubMed, Embase, Web of Science, Scopus, PsycINFO and CINAHL). The protocol was registered on PROSPERO (CRD420251103591). Eligible studies included RCTs, quasi-experimental, or pilot studies targeting obesity prevention using tailored or risk-stratified approaches in children aged 0-12, reporting anthropometric or behavioural outcomes. Data extraction and quality appraisal were conducted independently by two reviewers, with synthesis via narrative and thematic methods. RESULTS: Sixteen studies met inclusion criteria. Nine of 16 studies (56.3%) reported statistically significant reductions in BMI z-scores or obesity prevalence, with effect sizes ranging from -0.10 to -0.54 in BMI z-score units. Eleven studies (68.8%) observed significant improvements in dietary intake or physical activity behaviours. Culturally adapted, equity-focused interventions showed higher uptake and effectiveness. Key challenges included limited scalability, short follow-up periods and fidelity variability. CONCLUSIONS: Tailored, risk-based interventions hold promise for reducing early obesity risk and improving health behaviours. Precision health strategies, especially those that are family-centred and culturally sensitive, warrant further longitudinal evaluation to enhance equity and impact.

Abstract as published, via PubMed.