Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, USA.
Obes Rev. 2018 Oct;19(10):1371-1384. doi: 10.1111/obr.12714. Epub 2018 Aug 29.
Childhood obesity increases the risk for poor health during childhood, as well as for adult obesity and its associated comorbidities. Children from racial/ethnic minority groups or who live in poverty experience elevated rates of obesity. One potential method for reducing childhood obesity disparities is to involve community health workers (frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served). The purpose of this systematic review and meta-analysis was to explore the role and effectiveness of community health workers in childhood obesity interventions. Eleven studies met inclusion criteria, of which nine were eligible for inclusion in the meta-analysis. Results demonstrated that community health workers played various roles in childhood obesity interventions in the home, clinic, school, and community setting. Interventions focused primarily on children from underserved populations. Meta-analytic findings demonstrated a small but significant impact on BMIz and BMI percentile (BMIz [7 studies]: -0.08, 95% CI: -0.15, -0.01, p = 0.03, I = 39.4%; BMI percentile [2 studies]: -0.25, 95% CI: -0.38, -0.11, p < 0.01, I = 0%). Findings from this review demonstrate that partnering with community health workers may be an important strategy for reducing childhood obesity disparities and advancing health equity.
儿童肥胖增加了儿童期健康不良的风险,以及成年肥胖及其相关合并症的风险。来自种族/族裔少数群体或生活贫困的儿童肥胖率较高。减少儿童肥胖差异的一种潜在方法是让社区卫生工作者(一线公共卫生工作者,他们是所服务社区的信任成员,并且/或者对该社区有不寻常的深入了解)参与进来。本系统评价和荟萃分析的目的是探讨社区卫生工作者在儿童肥胖干预中的作用和有效性。符合纳入标准的研究有 11 项,其中 9 项符合纳入荟萃分析的条件。结果表明,社区卫生工作者在家庭、诊所、学校和社区环境中的儿童肥胖干预中发挥了各种作用。干预措施主要针对服务不足的人群中的儿童。荟萃分析结果表明,BMIz 和 BMI 百分位数有较小但显著的影响(BMIz [7 项研究]:-0.08,95%CI:-0.15,-0.01,p=0.03,I=39.4%;BMI 百分位数 [2 项研究]:-0.25,95%CI:-0.38,-0.11,p<0.01,I=0%)。本综述的结果表明,与社区卫生工作者合作可能是减少儿童肥胖差异和促进健康公平的重要策略。