Schroeder Krista, Travers Jasmine, Smaldone Arlene
Columbia University School of Nursing, 617 West 168th Street, New York, NY 10032..
J Sch Health. 2016 May;86(5):309-21. doi: 10.1111/josh.12386.
Schools are a key setting for childhood obesity interventions, yet nurses are not often included in delivering these interventions. The objective of this systematic review and meta-analysis was to examine school-based interventions involving nurses in a role beyond anthropometric measurement for effect on change in body measures.
We performed a systematic review and meta-analysis of these papers.
The literature search produced 2412 articles. Eleven met inclusion criteria for the systematic review (4 randomized controlled trail [RCT], 7 quasi-experimental) and 8 for the meta-analysis. None have been included in prior meta-analyses. Four studies restricted eligibility to overweight and/or obese children; 7 included all children regardless of body weight. Random effects meta-analytic models represent data from 6050 (body mass index [BMI]), 5863 (BMIz), and 416 (BMI percentile) children, respectively. Pooled analyses demonstrated statistically significant decreases in BMI (6 studies: -0.48 [95% CI -0.84, -0.12]; I(2) =91.2%, Q=68.1), BMIz (5 studies: -0.10 [95% CI: -0.15, -0.05]; I(2) =0, Q=2.3), and BMI percentile (3 studies: -0.41 [95% CI: -0.60, -0.21]; I(2) =0, Q=2.0).
These findings are similar to those of other meta-analyses of school-based interventions and suggest that school nurses can play a key role in implementing sustainable, effective school-based obesity interventions.
学校是儿童肥胖干预的关键场所，但护士在实施这些干预措施时并不常被纳入其中。本系统评价和荟萃分析的目的是研究以学校为基础、护士角色超出人体测量范畴的干预措施对身体指标变化的影响。
我们对这些论文进行了系统评价和荟萃分析。
文献检索共得到2412篇文章。11篇符合系统评价的纳入标准（4篇随机对照试验[RCT]，7篇准实验研究），8篇符合荟萃分析的纳入标准。此前的荟萃分析均未纳入这些研究。4项研究将纳入标准限定为超重和/或肥胖儿童；7项研究纳入了所有儿童，无论其体重如何。随机效应荟萃分析模型分别代表了6050名（体重指数[BMI]）、5863名（BMIz）和416名（BMI百分位数）儿童的数据。汇总分析显示，BMI（6项研究：-0.48[95%CI -0.84，-0.12]；I² =91.2%，Q=68.1）、BMIz（5项研究：-0.10[95%CI：-0.15，-0.05]；I² =0，Q=2.3）和BMI百分位数（3项研究：-0.41[95%CI：-0.60，-0.21]；I² =0，Q=2.0）均有统计学意义的下降。
这些发现与其他以学校为基础的干预措施的荟萃分析结果相似，表明学校护士在实施可持续、有效的以学校为基础的肥胖干预措施中可发挥关键作用。
