Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
School of Education, College of Design and Social Context, RMIT, PO Box 71, Bundoora, VIC, 3083, Australia.
Int J Behav Nutr Phys Act. 2018 May 15;15(1):43. doi: 10.1186/s12966-018-0676-2.
People from socioeconomically disadvantaged population groups are less likely to be physically active and more likely to experience adverse health outcomes than those who are less disadvantaged. In this umbrella review we examined across all age groups, (1) the effectiveness of interventions to improve physical activity among socioeconomically disadvantaged groups, (2) the characteristics of effective interventions, and (3) directions for future research.
PubMed/MEDLINE and Scopus were searched up to May 2017 to identify systematic reviews reporting physical activity interventions in socioeconomically disadvantaged populations or sub-groups. Two authors independently conducted study screening and selection, data extraction (one author, with data checked by two others) and assessment of methodological quality using the 'Assessment of Multiple Systematic Reviews' scale. Results were synthesized narratively.
Seventeen reviews met our inclusion criteria, with only 5 (30%) reviews being assessed as high quality. Seven (41%) reviews focused on obesity prevention and an additional four focused on multiple behavioural outcomes. For pre school children, parent-focused, group-based interventions were effective in improving physical activity. For children, school-based interventions and policies were effective; few studies focused on adolescents and those that did were generally not effective; for adults, there was mixed evidence of effectiveness but characteristics such as group-based interventions and those that focused on physical activity only were associated with effectiveness. Few studies focused on older adults. Across all ages, interventions that were more intensive tended to be more effective. Most studies reported short-term, rather than longer-term, outcomes and common methodological limitations included high probability of selection bias, low response rates, and high attrition.
Interventions can be successful at improving physical activity among children from socioeconomically disadvantaged groups, with evidence for other age groups weak or inconclusive. More high-quality studies in this population group are needed, which adopt strategies to increase recruitment rates and reduce attrition, report longer term outcomes, and provide adequate intervention details, to allow determination of the characteristics of effective interventions. We recommend that the benefits of physical activity be recognised more broadly than obesity prevention in future studies, as this may have implications for the design and appeal of interventions.
与社会经济地位较低的人群相比，这些人不太可能积极参加体育活动，并且更有可能出现不良健康后果。在本次伞式审查中，我们研究了所有年龄段的人群：（1）改善社会经济弱势群体体育活动的干预措施的有效性；（2）有效干预措施的特点；（3）未来研究方向。
截至 2017 年 5 月，我们通过 PubMed/MEDLINE 和 Scopus 检索系统综述，以确定针对社会经济弱势群体或亚群的体育活动干预措施。两名作者独立进行了研究筛选和选择、数据提取（一名作者，另外两名作者检查数据）以及使用“多重系统评价评估”量表评估方法学质量。结果以叙述性方式进行综合。
有 17 篇综述符合我们的纳入标准，其中只有 5 篇（30%）被评为高质量。有 7 篇（41%）综述侧重于肥胖预防，另有 4 篇综述侧重于多种行为结果。对于学龄前儿童，以家长为中心的小组干预措施可有效提高身体活动水平。对于儿童，学校干预措施和政策是有效的；很少有研究关注青少年，而且这些研究通常效果不佳；对于成年人，干预效果存在混合证据，但一些特征，如小组干预和仅关注身体活动的干预与效果相关。很少有研究关注老年人。在所有年龄段，干预措施越密集，效果越好。大多数研究报告了短期结果，而不是长期结果，常见的方法学局限性包括选择偏倚的可能性高、响应率低和高流失率。
干预措施可以成功提高社会经济地位较低的儿童的身体活动水平，而针对其他年龄段人群的证据较弱或不确定。需要在这一人群中开展更多高质量的研究，这些研究应采用增加招募率和降低流失率、报告长期结果以及提供充分干预细节的策略，以确定有效干预措施的特征。我们建议，在未来的研究中，更广泛地认识到身体活动的益处，而不仅仅是预防肥胖，因为这可能对干预措施的设计和吸引力产生影响。
