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Summary: This systematic review with the Delphi study aimed to identify effective and resource‐efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school‐based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school‐based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher‐order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre‐existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school‐based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size. [ABSTRACT FROM AUTHOR]

Summary: Heterogeneity of response to paediatric obesity interventions is one of the greatest challenges to obesity care. While evaluating school‐based interventions by mean changes compared to control is important, it does not provide an understanding of the individual variability in response to intervention. The objective of this study was to comprehensively review school‐based interventions that reported study results in terms of response and identify definitions of response used. A scoping review was conducted using a systematic search of five scientific databases from 2009 to 2021. Inclusion criteria included randomized controlled trial design, school‐based setting, weight‐based outcomes (e.g., BMI, BMI z‐score), weight‐based outcomes analysed among youth with overweight/obesity, a study conducted in a developed country and publication in English. A total of 26 reports representing 25 unique studies were included. Overall, 19% (5/26) of articles reported response. Response was defined in three ways: maintenance/decrease in BMI z‐score, decrease in BMI z‐score ≥0.10, and decrease in BMI z‐score ≥0.20. Few school‐based interventions identified an a priori intervention goal or identified the proportion of participants who responded to the intervention. Without such evaluation participants who do not benefit are likely to be overlooked. [ABSTRACT FROM AUTHOR]