Identifying behavior change techniques (BCTs) in responsive feeding interventions to prevent childhood obesity—A systematic review

Background: Complex interventions that include responsive infant feeding components can potentially prevent childhood obesity. To develop a replicable responsive feeding intervention, an understanding of the most effective behavior change techniques (BCTs) and theory is needed. Objective: To identify the BCTs and theories used in interventions with responsive feeding components for caregivers of children ≤2 years. Methods: PsycINFO, CINAHL, Cochrane Library, EMBASE, and MIDIRS were searched from inception to May 2023. Studies of obesity prevention interventions with a responsive feeding component were included. BCT Taxonomy Version 1 and Michie and Prestwich theory coding method were applied. Findings: Eighteen interventions were identified; the number of BCTs ranged from 3 to 11 (mean = 5.5). The most used BCTs were “Instruction on how to perform a behaviour” (17/18) and “Adding objects to the environment” (13/18), which were commonly used in the nine trials demonstrating higher responsive feeding behaviours and the four trials reporting reduced likelihood of overweight or obesity, or rapid weight gain. Fifteen trials reported use of theory. Conclusion: BCT use was low in interventions with responsive feeding components. BCTs are replicable; their use in interventions, alongside theory, will ensure that key determinants of responsive feeding behavior are included in future obesity prevention interventions.