Knowledge Utilization Research Centre, Tehran University of Medical Sciences, 21, Dameshgh st, Vali-e Asr Avenue, Tehran 1416753955, Iran.
School of Public Health and Preventive Medicine, Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia.
Health Promot Int. 2021 Mar 12;36(1):165-177. doi: 10.1093/heapro/daaa039.
Health professionals require education and training to implement obesity management guidelines and ultimately impact on the health outcomes experienced by their patients. Therefore, a systematic review of systematic reviews that evaluated interventions designed to change the practice of health professionals when addressing diet and physical activity with their patients was conducted. MEDLINE Complete; Cochrane database of systematic reviews; PsycINFO; CINAHL Complete; Global Health; Embase; INFORMIT: Health Subset; Health System Evidence and RX for change were searched in March 2019, with no date or language limits. Identified references underwent screening, full-text analyses and data extraction in duplicate. The search identified 15 230 references. Five systematic reviews that provided a narrative syntheses of a combined 38 studies were included. Health professional participants generally reported being satisfied with the training interventions. Heterogeneity between and within included reviews, non-controlled designs of individual studies and low quality of evidence at an individual study level and review level made it difficult to draw firm conclusions regarding what interventions are most effective in changing health professionals' knowledge, skills, self-efficacy, attitudes and practice. However, similar gaps in the literature were identified across included reviews. Key areas that could be addressed in future interventions including organization and system-level barriers to providing advice, health professionals' attitudes and motivation and weight stigma have been highlighted. Health professionals and patients could be more involved in the planning and development of interventions that work towards improving diet and physical activity advice and support provided in healthcare.
健康专业人员需要接受教育和培训,以实施肥胖管理指南,并最终影响患者的健康结果。因此,对评估旨在改变健康专业人员在为患者提供饮食和身体活动建议时的实践的干预措施的系统评价进行了系统综述。2019 年 3 月,在没有日期或语言限制的情况下,检索了 MEDLINE Complete;Cochrane 系统评价数据库;PsycINFO;CINAHL Complete;全球卫生;Embase;INFORMIT:健康子集;卫生系统证据和 RX for change。确定的参考文献经过了双重筛选、全文分析和数据提取。检索确定了 15230 条参考文献。纳入了 5 篇系统评价,这些系统评价对 38 项研究进行了综合叙述。健康专业人员参与者普遍对培训干预措施表示满意。纳入的综述之间以及各研究之间存在异质性,个别研究的非对照设计以及个体研究和综述水平的证据质量低,使得难以确定哪些干预措施在改变健康专业人员的知识、技能、自我效能、态度和实践方面最有效。然而,在纳入的综述中也发现了类似的差距。未来的干预措施可以重点解决组织和系统层面提供建议的障碍、健康专业人员的态度和动机以及体重污名等关键领域。可以让健康专业人员和患者更多地参与到旨在改善医疗保健中提供的饮食和身体活动建议和支持的干预措施的规划和制定中。