Introduction
Effectiveness of obesity prevention and reduction policies depends jointly on policy content, implementation processes, and local context. whole-of-community approaches are widely promoted, yet evidence on which implementation strategies work in disadvantaged settings remains fragmented.
Purpose
To synthesise evidence on implementation strategies used in whole-of-community obesity prevention policies and their associations with: (1) obesity/overweight prevalence, BMI-related and other weight outcomes, or (2) nutrition, physical activity, sedentary behaviour, and screen-time outcomes. The synthesis focused on low-SES communities.
Method
The review followed PRISMA guidelines. Original studies were identified via searches of eight databases. Risk of bias was appraised with the Joanna Briggs Institute (JBI) tool. We mapped strategies to the the Expert Recommendations for Implementing Change (ERIC) framework. A strategy's effectiveness was considered supported if ≥66% of n ≥3 studies employing this strategy reported a significant improvement in a given outcome type.
Results
Twenty-nine studies met inclusion criteria. Fifteen ERIC strategies showed consistent links with favourable outcomes. Supported strategies included modifying incentive structures, assessing community readiness, and deploying data warehousing to guide iterative decision-making. Six additional non-ERIC strategies—such as cultural adaptation and grassroots mobilisation—also received support across outcome domains. Most studies (72%) were assessed as having a low risk of bias.
Conclusions
Across whole-of-community obesity-reducing policies implemented in low-SES settings, a defined subset of ERIC strategies was repeatedly associated with improved weight- and behaviour-related outcomes. Future policy implementation plans should prioritise such strategies as readiness assessment, incentive alignment, and robust data systems, while embedding culturally tailored, grassroots engagement to enhance equity and impact.