March Sebastià, Torres Elena, Ramos María, Ripoll Joana, García Atanasio, Bulilete Oana, Medina David, Vidal Clara, Cabeza Elena, Llull Micaela, Zabaleta-del-Olmo Edurne, Aranda José Manuel, Sastre Silvia, Llobera Joan
Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain.
IUNICS-IdISPa, UIB, 07010 Palma, Spain; Registro de Cáncer, Servicio de Epidemiología, Dirección General de Salud Pública y Consumo, Conselleria de Salut, Família i Benestar Social, Camí de Jesús 38 A, 07010 Palma, Spain.
Prev Med. 2015 Jul;76 Suppl:S94-104. doi: 10.1016/j.ypmed.2015.01.016. Epub 2015 Jan 24.
To examine evidence on the effectiveness of health-promoting community interventions carried out in primary health care.
Systematic review of originals and systematic reviews of health-promoting community interventions with the participation of primary health care. A working definition of community activities was used in the inclusion criteria. Databases searched up to 2013: PUBMED, EMBASE, CINHAL, Web of SCIENCE, IBECS, IME, and PSICODOC. No restrictions on year of publication or design. Articles were reviewed by separate researchers to identify risks of bias.
Fifty-one articles published between 1966 and 2013 were included: 11 systematic reviews and 40 originals that described 39 community interventions. There is evidence on the effectiveness of community interventions in reducing cardiovascular risk factors, encouraging physical exercise, preventing falls and improving self-care among chronic patients compared with usual individual care. The effectiveness of some interventions increases when the community is involved in their development. Most assessments show positive results despite design limitations.
The community approach may be more effective than the individual in usual preventive interventions in primary care. There is a lack of evidence on many community interventions in primary care and further research is needed.
探讨在初级卫生保健中开展的促进健康社区干预措施的有效性证据。
对原始文献以及有初级卫生保健参与的促进健康社区干预措施的系统评价进行系统综述。纳入标准采用了社区活动的工作定义。检索截至2013年的数据库：PUBMED、EMBASE、CINHAL、科学引文索引数据库、IBECS、IME和PSICODOC。对发表年份或研究设计无限制。由不同的研究人员对文章进行评审以识别偏倚风险。
纳入了1966年至2013年间发表的51篇文章：11篇系统综述和40篇原始文献，这些文献描述了39项社区干预措施。有证据表明，与常规的个体护理相比，社区干预在降低心血管危险因素、鼓励体育锻炼、预防跌倒以及改善慢性病患者的自我护理方面是有效的。当社区参与某些干预措施的制定时，其有效性会增加。尽管存在设计局限性，但大多数评估显示出积极结果。
在初级保健的常规预防干预中，社区方法可能比个体方法更有效。关于初级保健中许多社区干预措施的证据不足，需要进一步研究。
