Applied Research Collaborations for Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada.
Int J Obes (Lond). 2012 Feb;36(2):178-85. doi: 10.1038/ijo.2011.80. Epub 2011 Apr 12.
Despite the existence of guidelines for obesity management, uncertainty remains as to what interventions comprise effective practice. This uncertainty could act as a barrier to busy health care professionals, who may lack the time and expertize to fully appraise the huge amount of literature that is published each year on obesity management. Therefore, the objectives of this review were to synthesize the available evidence, determine most effective and most promising practices for obesity management in adults, using an established methodology, and present this information according to its quality.
This synthesis review was conducted from January 2009. A detailed search of relevant databases was conducted to September 2010. Most effective and promising practices were defined using the Canadian Best Practice Initiative Methodology Background Paper, with systematic reviews (with/without meta analysis) as the most rigorous methodology for developing recommendations that were deemed most effective (level 1), and non-systematic reviews for developing recommendations deemed as most promising (level 2). Literature was reviewed and classified across these two levels of rigor, and supplemented with primary studies to further refine recommendations.
Evidence from systematic reviews and meta-analyses was classified into three intervention themes or areas of context, in which more specific most effective and/or promising practice recommendations could be nested. These intervention themes were (1) targeted multi-component interventions for weight management, (2) dietary manipulation strategies and (3) delivery of weight management interventions, including health professional roles and method of delivery. Specific recommendations accompanied each theme.
This review highlights the value of multi-component interventions that are delivered over the longer term, and reinforces the role of health care professionals. The findings will help to inform evidence-based practice for health care practitioners involved in obesity management and prevention.
尽管存在肥胖管理指南，但对于哪些干预措施构成有效实践仍存在不确定性。这种不确定性可能成为忙碌的医疗保健专业人员的障碍，他们可能缺乏时间和专业知识来充分评估每年发表的大量关于肥胖管理的文献。因此，本综述的目的是综合现有证据，使用既定方法确定成人肥胖管理中最有效和最有前途的实践，并根据其质量呈现这些信息。
本综合综述于 2009 年 1 月进行。详细搜索了相关数据库，直到 2010 年 9 月。使用加拿大最佳实践倡议方法背景文件定义了最有效和最有前途的实践，系统评价（有/无荟萃分析）是制定被认为最有效的建议的最严格方法（一级），非系统评价是制定被认为最有前途的建议的方法（二级）。对文献进行了审查和分类，分为这两个严格程度级别，并辅以初级研究，以进一步完善建议。
系统评价和荟萃分析的证据分为三个干预主题或背景领域，在这些领域中可以嵌套更具体的最有效和/或最有前途的实践建议。这些干预主题是：（1）针对体重管理的有针对性的多组分干预，（2）饮食干预策略和（3）体重管理干预的提供，包括卫生专业人员的角色和提供方式。每个主题都附有具体的建议。
本综述强调了长期提供多组分干预的价值，并强化了卫生保健专业人员的作用。研究结果将有助于为参与肥胖管理和预防的卫生保健从业者提供循证实践。
