The review question and supporting inclusion criteria were broadly stated. A satisfactory number of sources were searched for relevant literature. The authors stated that study selection was performed in duplicate to reduce reviewer error and bias, but it was unclear whether this was true for data extraction.
The authors did not state that they assessed the quality of included studies, but most were pre/post intervention studies with no comparable control group (as acknowledged by the authors). The evidence base was generally small, as acknowledged by the authors. The synthesis was somewhat limited. The authors also acknowledged that there was inconsistency in the outcome measures assessed. Most studies were conducted in the USA, so it was unclear whether the findings would be generalisable to other countries/settings. Follow-up was generally short term; it was unclear whether the knowledge gained would be maintained in the long term, or could translate into behaviour change.
The authors' conclusions are appropriately cautious. However, given the uncertainties surrounding methodological reporting in the review and the limitations of the evidence base and synthesis, their conclusions should still be interpreted with care as they may not be reliable.