Frerichs L, Ataga O, Corbie-Smith G, Tessler Lindau S
Center for Health Equity Research, University of North Carolina, Chapel Hill, USA.
Department of Social Medicine, School of Medicine, University of North Carolina, Chapel Hill, USA.
Obes Rev. 2016 Dec;17(12):1276-1286. doi: 10.1111/obr.12468. Epub 2016 Oct 17.
A growing number of childhood obesity interventions involve children and youth in participatory roles, but these types of interventions have not been systematically reviewed. We aimed to identify child and youth participatory interventions in the peer-reviewed literature in order to characterize the approaches and examine their impact on obesity and obesity-related lifestyle behaviours. We searched PubMed/Medline, psychINFO and ERIC for quasi-experimental and randomized trials conducted from date of database initiation through May 2015 that engaged children or youth in implementing healthy eating, physical activity or weight management strategies. Eighteen studies met our eligibility criteria. Most (n = 14) trained youth to implement pre-defined strategies targeting their peers. A few (n = 4) assisted youth to plan and implement interventions that addressed environmental changes. Thirteen studies reported at least one statistically significant weight, physical activity or dietary change outcome. Participatory approaches have potential, but variation in strategies and outcomes leave questions unanswered about the mechanisms through which child and youth engagement impact childhood obesity. Future research should compare child-delivered or youth-delivered to adult-delivered health promotion interventions and more rigorously evaluate natural experiments that engage youth to implement environmental changes. With careful attention to theoretical frameworks, process and outcome measures, these studies could strengthen the effectiveness of child and youth participatory approaches.
越来越多的儿童肥胖干预措施让儿童和青少年参与其中，但这类干预措施尚未得到系统的综述。我们旨在在同行评审文献中识别儿童和青少年参与式干预措施，以便描述其方法并研究它们对肥胖及与肥胖相关的生活方式行为的影响。我们在PubMed/Medline、psychINFO和ERIC数据库中检索了从建库之日至2015年5月期间进行的准实验和随机试验，这些试验让儿童或青少年参与实施健康饮食、体育活动或体重管理策略。18项研究符合我们的纳入标准。大多数研究（n = 14）培训青少年实施针对同龄人预先定义的策略。少数研究（n = 4）协助青少年规划和实施应对环境变化的干预措施。13项研究报告了至少一项具有统计学意义的体重、体育活动或饮食变化结果。参与式方法具有潜力，但策略和结果的差异使得关于儿童和青少年参与影响儿童肥胖的机制问题仍未得到解答。未来的研究应比较由儿童或青少年实施的与由成年人实施的健康促进干预措施，并更严格地评估让青少年参与实施环境变化的自然实验。通过仔细关注理论框架、过程和结果测量，这些研究可以增强儿童和青少年参与式方法的有效性。
