Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Laumb Consulting, LLC, Minneapolis, Minnesota, USA.
Obes Rev. 2019 May;20(5):713-724. doi: 10.1111/obr.12825. Epub 2019 Jan 11.
Rural adults have a higher risk of developing obesity than urban adults. Several evidence-based interventions have targeted rural regions, but their impact, defined as reach (number and representativeness of participants) by effectiveness, has not been examined. The purpose of this review was to determine the impact of rural weight loss interventions and the availability of data across dimensions of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. A systematic review was conducted to identify rural weight loss interventions that targeted adults. RE-AIM-related data were abstracted from each article. We performed a meta-analysis to examine effectiveness. Sixty-four articles reported on rural weight loss interventions, describing 50 unique interventions. The median number of participants was 107. Median participation rate differed between values reported by the authors (62%) and values computed using a standard method (32%). Two studies reported on sample representativeness; none reported comparisons made between target and actual delivery settings. Median weight loss per participant was 3.64 kg. Meta-analyses revealed the interventions achieved a significant weight reduction, and longer-duration interventions resulted in greater weight loss. Rural weight loss interventions appear to be effective in supporting clinically meaningful weight loss but reach and cost outcomes are still difficult to determine.
农村成年人比城市成年人更容易肥胖。已经有一些基于证据的干预措施针对农村地区，但尚未评估其效果（即参与人数和代表性）。本研究旨在确定农村减肥干预措施的效果，以及在可达性、有效性、采用、实施和维持（RE-AIM）框架的各个维度上数据的可用性。进行了系统评价以确定针对成年人的农村减肥干预措施。从每篇文章中提取与 RE-AIM 相关的数据。我们进行了荟萃分析以检查效果。64 篇文章报道了农村减肥干预措施，描述了 50 项独特的干预措施。参与者的中位数为 107 人。参与率中位数在作者报告的值（62%）和使用标准方法计算的值（32%）之间存在差异。有两项研究报告了样本代表性；没有一项研究报告了目标和实际提供环境之间的比较。每个参与者的平均体重减轻量为 3.64 公斤。荟萃分析显示，这些干预措施确实可以显著减轻体重，并且持续时间较长的干预措施会导致更大的体重减轻。农村减肥干预措施似乎在支持有临床意义的体重减轻方面有效，但仍难以确定可达性和成本结果。
