Core outcome set for early intervention trials to prevent obesity in childhood (COS-EPOCH): Agreement on "what" to measure

BACKGROUND: Heterogeneity in the outcomes collected and reported in trials of interventions to prevent obesity in the first five years of life highlights the need for a core outcome set to streamline evaluation and synthesis. This study aimed to develop a core outcome set for early childhood obesity prevention intervention studies in children from birth to five years (COS-EPOCH). METHODS: Following published guidelines, we conducted (1) a systematic scoping review of outcomes in early childhood obesity prevention trials; (2) a multi-stakeholder e-Delphi study to prioritise outcomes; and (3) a stakeholder consensus meeting. Stakeholders included parents/caregivers of children ≤5 years, policy-makers/funders, researchers, health professionals, and community/organizational stakeholders. RESULTS: Twenty-two outcomes across nine domains (anthropometry, dietary intake, sedentary behaviour, physical activity, sleep, parent/caregiver outcomes, environmental, emotional/cognitive functioning, economics) were included: infant tummy time; child diet quality, dietary intake, fruit and vegetable intake, non-core food intake, non-core beverage intake, meal patterns, weight-based anthropometry, screen time, time spent sedentary, physical activity, sleep duration, wellbeing; parent/caregiver physical activity, sleep and nutrition parenting practices; food environment, sedentary behaviour or physical activity home environment, family meal environment, early childhood education and care environment, household food security; and economic evaluation. CONCLUSIONS: This stakeholder-informed COS identifies the minimum outcomes recommended for collection and reporting in early childhood obesity prevention trials. Future work will recommend measurement instruments for each outcome. The COS will standardise outcome measurement and reporting to facilitate evidence comparison and synthesis and maximise the value of data collected across studies.