采用社会生态学模型层面描述儿童肥胖决定因素的研究:范围综述,以确定差距并为未来研究提供指导。
Describing studies on childhood obesity determinants by Socio-Ecological Model level: a scoping review to identify gaps and provide guidance for future research.
机构信息
Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal.
出版信息
Int J Obes (Lond). 2019 Oct;43(10):1883-1890. doi: 10.1038/s41366-019-0411-3. Epub 2019 Jul 8.
Childhood obesity is increasing worldwide and is a major public health concern once children with obesity are at higher risk for several diseases and are often stigmatized. Children with obesity are more likely to become adults with obesity with greater needs of healthcare. Determinants of childhood obesity might be grouped in five levels according to the Socio-Ecological Model (SEM): individual, interpersonal, institutional, community and policies. This scoping review emerged from the need to identify which determinants of childhood obesity have been more frequently studied (and how) and which require more investigation. The main objectives were to quantify studies on the determinants of childhood obesity by SEM level addressed, to identify gaps in the literature regarding the studied SEM level(s), to describe the studies' characteristics and to provide guidance for SEM levels that need further investigation. This scoping review follows the five-stage protocol methodology proposed by Arksey and O'Malley in 2005. PubMed database was systematically searched, and hand-searches also took place. The search yielded 975 results from which 552 were excluded after title and abstract reading. The remaining 423 results were fully read and information about methodologic aspects, namely study design, sample size, sample constitution (children, dyads or/and parents) and children's age as well as the SEM level determinants addressed was retrieved. Despite the consensus about the appropriateness of SEM as a framework to comprehensively examine childhood obesity determinants, studies addressing all SEM levels determinants jointly or the policies level determinants alone were not found. Other gaps shown were: the small number of studies that included the policies level determinants alongside determinants from other levels (N = 10) and studies using cohorts study design (ranging from 2 to 28 per SEM level). These gaps should be considered when planning future research.
儿童肥胖症在全球范围内呈上升趋势,是一个主要的公共卫生关注点,因为肥胖儿童患多种疾病的风险更高,而且往往会受到歧视。肥胖儿童更有可能成为肥胖成年人,需要更多的医疗保健。根据社会生态模型(SEM),儿童肥胖的决定因素可以分为五个层次:个人、人际、机构、社区和政策。这项范围界定综述源于确定哪些儿童肥胖决定因素被更频繁地研究(以及如何研究)以及哪些决定因素需要更多研究的需要。主要目标是通过所涉及的 SEM 水平量化有关儿童肥胖决定因素的研究,确定文献中关于所研究的 SEM 水平的差距,描述研究的特征,并为需要进一步研究的 SEM 水平提供指导。这项范围界定综述遵循 2005 年 Arksey 和 O'Malley 提出的五个阶段方案方法。系统地搜索了 PubMed 数据库,并进行了手工搜索。搜索产生了 975 个结果,其中 552 个在阅读标题和摘要后被排除。剩下的 423 个结果被完整阅读,获取了有关方法学方面的信息,即研究设计、样本量、样本构成(儿童、对子或/和父母)以及儿童年龄以及所涉及的 SEM 水平决定因素。尽管 SEM 作为一个全面检查儿童肥胖决定因素的框架是合适的,但没有发现同时涉及所有 SEM 水平决定因素或单独涉及政策水平决定因素的研究。还显示出其他差距:包括政策水平决定因素以及其他水平决定因素的研究数量较少(N=10),以及使用队列研究设计的研究(每个 SEM 水平的范围从 2 到 28)。在规划未来研究时,应考虑这些差距。