Turner Kyle, Foster Charlie, Allender Steven, Plugge Emma
Nuffield Department of Population Health, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7LF United Kingdom ; World Health Organization Collaborating Centre for Population Approaches to Non-Communicable Disease Prevention, University of Oxford, Oxford, UK.
World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Burwood, 3125, Victoria Australia.
BMC Obes. 2015 Mar 8;2:13. doi: 10.1186/s40608-015-0045-5. eCollection 2015.
Obesity in early childhood is a robust predictor of obesity later in life. Schools provide unparalleled access to children and have subsequently become major intervention sites. However, empirical evidence supporting the effectiveness of school-based interventions against childhood obesity is of limited scope and unknown quality. The aim of this systematic review is to critically assess how researchers have characterized the school environment in determining its effect on childhood weight status in order to improve the quality and consistency of research in this area. We conducted a narrative review with a systematic search of the literature in line with PRISMA guidelines (2009). Original peer-reviewed research articles in English were searched from Medline, EMBASE, CENTRAL, CINAHL and PsycINFO databases from earliest record to January 2014. We included empirical research that reported at least one measure of the primary/elementary school environment and its relationship with at least one objective adiposity-related variable for students aged 4-12 years. Two authors independently extracted data on study design, school-level factors, student weight status, type of analysis and effect.
Five studies met the inclusion criteria. Each study targeted different parts of the school environment and findings across the studies were not comparable. The instruments used to collect school-level data report no validity or reliability testing.
Our review shows that researchers have used instruments of unknown quality to test if the school environment is a determinant of childhood obesity, which raises broader questions about the impact that schools can play in obesity prevention.
儿童期早期肥胖是成年后肥胖的有力预测指标。学校为接触儿童提供了无与伦比的机会，因此已成为主要的干预场所。然而，支持以学校为基础的干预措施对儿童肥胖有效性的实证证据范围有限且质量不明。本系统评价的目的是严格评估研究人员如何描述学校环境以确定其对儿童体重状况的影响，从而提高该领域研究的质量和一致性。我们根据PRISMA指南（2009年）对文献进行了系统检索，并进行了叙述性综述。从最早记录到2014年1月，在Medline、EMBASE、CENTRAL、CINAHL和PsycINFO数据库中检索了英文的原始同行评审研究文章。我们纳入了实证研究，这些研究报告了至少一项针对小学/基础教育学校环境的测量指标及其与4至12岁学生至少一项客观肥胖相关变量的关系。两位作者独立提取了关于研究设计、学校层面因素、学生体重状况、分析类型和效果的数据。
五项研究符合纳入标准。每项研究针对学校环境的不同部分，各项研究的结果不可比。用于收集学校层面数据的工具未报告有效性或可靠性测试。
我们的综述表明，研究人员使用质量不明的工具来测试学校环境是否是儿童肥胖的决定因素，这引发了关于学校在预防肥胖中所能发挥作用的更广泛问题。
