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针对增加身体活动的同伴主导自我管理项目的系统评价与荟萃分析

Systematic Review and Meta-Analysis of Peer-Led Self-Management Programs for Increasing Physical Activity.

作者信息

Best Krista L, Miller William C, Eng Janice J, Routhier Francois

机构信息

Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.

Rehabilitation Research Program, Vancouver Coastal Research Institute, GF Strong Rehabilitation Centre, Vancouver, BC, V5Z 2G9, Canada.

出版信息

Int J Behav Med. 2016 Oct;23(5):527-38. doi: 10.1007/s12529-016-9540-4.

Abstract

PURPOSE

Approximately 85 % of Canadians are not physically active enough to achieve health benefits. Peer-led self-management programs are becoming an increasingly popular strategy for modifying health behaviors, including physical activity. The purpose of this study was to systematically review and meta-analyze the effect of peer-led self-management interventions on physical activity.

METHODS

PubMed, MEDLINE, PsycINFO, EMBASE, CINAHL, and Cochrane Database of Systematic Reviews databases were systematically searched to identify all relevant randomized controlled trials that evaluated the effect of peer-led self-management on physical activity. The studies were described and effect size data were included in meta-analyses. Subgroup analyses were performed according to type of physical activity outcome (i.e., duration, frequency, other).

RESULTS

Twenty-one studies were included in the review and 14 reported statistically significant improvements in physical activity. A meta-analysis of 17 studies showed a statistically significant moderate pooled effect (standardized mean difference (SMD) = 0.4, p < 0.001) of peer-led self-management programs on physical activity immediately post-intervention. The intervention had a large statistically significant effect based on the four studies that included follow-up measures (SMD = 1.5, p = 0.03). Meta-analysis of nine studies that used similar outcomes (i.e., minutes of physical activity) revealed a statistically significant small effect (SMD = 0.2, p < 0.001).

CONCLUSION

Peer-led self-management programs appear to be effective at increasing weekly duration of physical activity in various populations, but the effect size is small. Training peers to encourage increased physical activity may provide an effective method for reaching various clinical and non-clinical populations. More research is needed using validated and consistent physical activity outcomes.

摘要

目的

约85%的加拿大人身体活动量未达到有益健康的水平。同伴主导的自我管理项目正日益成为一种改变健康行为(包括身体活动)的流行策略。本研究的目的是系统评价和荟萃分析同伴主导的自我管理干预对身体活动的影响。

方法

系统检索PubMed、MEDLINE、PsycINFO、EMBASE、CINAHL和Cochrane系统评价数据库,以识别所有评估同伴主导的自我管理对身体活动影响的相关随机对照试验。对这些研究进行描述,并将效应量数据纳入荟萃分析。根据身体活动结果类型(即持续时间、频率、其他)进行亚组分析。

结果

该评价纳入了21项研究,其中14项报告身体活动有统计学显著改善。对17项研究的荟萃分析显示,同伴主导的自我管理项目在干预后立即对身体活动有统计学显著的中度合并效应(标准化均数差(SMD)=0.4,p<0.001)。基于4项包括随访测量的研究,该干预有统计学显著的大效应(SMD=1.5,p=0.03)。对9项使用相似结果(即身体活动分钟数)的研究进行荟萃分析,显示有统计学显著的小效应(SMD=0.2,p<0.001)。

结论

同伴主导的自我管理项目似乎能有效增加不同人群的每周身体活动持续时间,但效应量较小。培训同伴以鼓励增加身体活动可能为覆盖不同临床和非临床人群提供一种有效方法。需要使用经过验证且一致的身体活动结果进行更多研究。

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