Transtria LLC, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
Prevention Research Center in St. Louis, Brown School, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
Am J Prev Med. 2014 Jan;46(1):e1-16. doi: 10.1016/j.amepre.2013.08.022.
Investigators developed a review system to evaluate the growing literature on policy and environmental strategies to prevent childhood obesity. More than 2000 documents published between January 2000 and May 2009 in the scientific and grey literature were identified (2008-2009) and systematically analyzed (2009-2012). These focused on policy or environmental strategies to reduce obesity/overweight, increase physical activity, and/or improve nutrition/diet among youth (aged 3-18 years). Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, investigators abstracted studies of 24 intervention strategies and assessed evidence for their effectiveness (i.e., study design, intervention duration, and outcomes) and population impact (i.e., effectiveness and reach--participation or exposure, and representativeness) in 142 evaluation study groupings and 254 associational study groupings (n=396 groupings of 600 peer-reviewed studies). The 24 strategies yielded 25 classifications (school wellness policies yielded nutrition and physical activity classifications): 1st-tier effective (n=5); 2nd-tier effective (n=6); "promising" (n=5); or "emerging" (n=9). Evidence for intervention effectiveness was reported in 56% of the evaluation, and 77% of the associational, study groupings. Among the evaluation study groupings, only 49% reported sufficient data for population impact ratings, and only 22% qualified for a rating of high population impact. Effectiveness and impact ratings were summarized in graphic evidence maps, displaying effects/associations with behavioral and obesity/overweight outcomes. This paper describes the results and products of the review, with recommendations for policy research and practice.
研究人员开发了一个审查系统，以评估有关预防儿童肥胖的政策和环境策略的日益增多的文献。（2008-2009 年）确定并系统分析了 2000 年 1 月至 2009 年 5 月期间（2009-2012 年）在科学和灰色文献中发表的 2000 多篇文献。这些文献集中于减少肥胖/超重、增加体力活动和/或改善青少年营养/饮食的政策或环境策略（年龄 3-18 岁）。研究人员以 RE-AIM（覆盖范围、有效性、采用、实施和维护）框架为指导，抽象了 24 项干预策略的研究，并评估了其有效性（即研究设计、干预持续时间和结果）和人群影响（即有效性和覆盖范围-参与或暴露以及代表性）在 142 个评估研究分组和 254 个关联研究分组（n=396 个 600 个同行评审研究的分组）中。这 24 项策略产生了 25 种分类（学校健康政策产生营养和体育活动分类）：一级有效（n=5）；二级有效（n=6）；“有前途”（n=5）；或“新兴”（n=9）。评估中报告了 56%的干预有效性证据，关联研究分组中报告了 77%的证据。在评估研究分组中，只有 49%报告了足够的数据进行人群影响评级，只有 22%有资格获得高人群影响评级。有效性和影响评级总结在图形证据图中，显示了与行为和肥胖/超重结果的关联。本文介绍了审查的结果和产品，并提出了政策研究和实践的建议。
