美国学校中关于饮食、活动和体重的社区参与干预措施：系统评价。
Community-engaged interventions on diet, activity, and weight outcomes in U.S. schools: a systematic review.
机构信息
Department of Preventive Medicine, University of California San Francisco, San Francisco, California, USA.
出版信息
Am J Prev Med. 2012 Jul;43(1):81-91. doi: 10.1016/j.amepre.2012.02.031.
CONTEXT
Community engagement literature suggests that capacity-building approaches and community partnership in health intervention design, delivery, and analysis improve outcomes. School communities influence childhood diet and activity patterns affecting lifelong obesity risk. This systematic review's purpose is to assess whether incorporating community engagement principles in school-based interventions influences weight-related outcomes.
EVIDENCE ACQUISITION
Obesity-prevention interventions (published January 2000-2011) in diverse U.S. schools, meeting a minimum threshold of community engagement and targeting weight-, diet- or activity-related outcomes were identified in MEDLINE, PsycINFO, and CINAHL (December 2010-March 2011). Two reviewers scored community engagement performance on 24 metrics of capacity building and partner involvement along four research stages. Outcome performance was calculated as percentage of targeted primary and/or secondary outcomes achieved.
EVIDENCE SYNTHESIS
Sixteen studies were included, targeting anthropometric (n = 12); dietary (n = 13); and activity (n = 10) outcomes in schoolchildren (mean age=10.7 years). Studies averaged 46% of targeted outcomes (95% CI = 0.33, 0.60) and met 60% of community engagement metrics. Positive correlations existed between community engagement performance and all-outcome performance (r = 0.66, 95% CI = 0.25, 0.87) and secondary-outcome performance (r = 0.67, 95% CI = 0.22, 0.89), but not primary-outcome performance (r = 0.26, 95% CI = -0.27, 0.67). Number of outcomes met was not correlated with number of outcomes targeted, number of partners, or study size. Specific qualitative and quantitative trends suggested that capacity-building efforts, engagement in needs assessments and results dissemination, and durable partnerships positively influence outcomes.
CONCLUSIONS
Results suggest that meaningful partnership of diverse school communities within obesity prevention interventions can improve health outcomes.
背景
社区参与文献表明，在卫生干预措施的设计、实施和分析中，能力建设方法和社区伙伴关系可以改善结果。学校社区影响儿童的饮食和活动模式，从而影响终身肥胖风险。本系统评价的目的是评估在基于学校的干预措施中纳入社区参与原则是否会影响与体重相关的结果。
证据获取
在 MEDLINE、PsycINFO 和 CINAHL（2010 年 12 月至 2011 年 3 月）中，确定了在美国不同学校中进行的肥胖预防干预措施（发表于 2000 年 1 月至 2011 年），这些干预措施满足了最低的社区参与门槛，并针对体重、饮食或活动相关结果。两位审查员按照四个研究阶段，对 24 项能力建设和合作伙伴参与的指标以及 16 项研究的社区参与绩效进行了评分。结果绩效计算为达到既定主要和/或次要结果的百分比。
证据综合
纳入了 16 项研究，针对儿童的人体测量学（n=12）、饮食（n=13）和活动（n=10）结果。研究平均实现了既定目标的 46%（95%CI=0.33，0.60），满足了 60%的社区参与指标。社区参与绩效与所有结果绩效（r=0.66，95%CI=0.25，0.87）和次要结果绩效（r=0.67，95%CI=0.22，0.89）呈正相关，但与主要结果绩效（r=0.26，95%CI=-0.27，0.67）无关。实现的结果数量与既定的结果数量、合作伙伴数量或研究规模均无相关性。具体的定性和定量趋势表明，在肥胖预防干预措施中，多元化的学校社区之间的实质性伙伴关系可以改善健康结果。
结论
结果表明，肥胖预防干预措施中，多元化的学校社区之间建立有意义的伙伴关系可以改善健康结果。
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