采用 RE-AIM 框架对早期儿童保育和教育环境中肥胖预防干预措施实施情况的系统评价。
A systematic review of the implementation of obesity prevention interventions in early childcare and education settings using the RE-AIM framework.
机构信息
Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
Department of Psychology, DePaul University, Chicago, IL, USA.
出版信息
Transl Behav Med. 2020 Oct 12;10(5):1168-1176. doi: 10.1093/tbm/ibz179.
Previous systematic reviews have examined the efficacy of obesity prevention interventions within early childcare/education settings. Often lacking in these reviews is reporting on external validity, which continues to be underemphasized compared to internal validity. More attention to external validity would help better translate evidence-based interventions to real-world settings. This systematic review aimed to determine the availability of data on both internal and external validity across dimensions of the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework in studies reporting on obesity prevention interventions in early childcare/education settings. Inclusion criteria included: randomized controlled trials, early childcare/education setting, targeted children 2-6 years old, addressed both diet and physical activity, collected measures of weight status and diet and/or physical activity, and published within the last 10 years. Searches were conducted in ERIC, PsychInfo, and PubMed; 23 studies met inclusion criteria. A validated RE-AIM abstraction tool was used to code studies. Most commonly reported dimensions were Reach (62.3%), Implementation (53.5%), and Efficacy/Effectiveness (48.7%). Adoption (21.7%) and Maintenance (11.6%) were less often reported. All studies reported on primary outcomes, but few reported on RE-AIM indicators of characteristics of participation and adoption, quality of life, methods used to identify staff, staff inclusion/exclusion criteria and adoption rates, implementation fidelity, measures of cost to start-up and deliver the intervention, and indicators of maintenance. This systematic review underscores the need for more focus on external validity to inform replication, dissemination, and implementation so that evidence-based early childcare/education obesity interventions can be generalized to real-world settings.
先前的系统评价研究了在早期儿童保育/教育环境中预防肥胖的干预措施的效果。这些综述通常缺乏对外部有效性的报告，而与内部有效性相比，外部有效性仍然被低估。更多地关注外部有效性将有助于更好地将基于证据的干预措施转化为现实世界的环境。本系统评价旨在确定在报告早期儿童保育/教育环境中肥胖预防干预措施的研究中，RE-AIM（可达性、效果/有效性、采用、实施和维持）框架各个维度的内部和外部有效性数据的可用性。纳入标准包括：随机对照试验、早期儿童保育/教育环境、目标儿童为 2-6 岁、针对饮食和身体活动、收集体重状况以及饮食和/或身体活动测量数据、并在过去 10 年内发表的研究。在 ERIC、PsychInfo 和 PubMed 中进行了搜索；符合纳入标准的研究有 23 项。使用经过验证的 RE-AIM 抽象工具对研究进行编码。报告最多的维度是可达性（62.3%）、实施（53.5%）和效果/有效性（48.7%）。采用（21.7%）和维持（11.6%）较少报告。所有研究都报告了主要结果，但很少有研究报告关于参与和采用、生活质量、识别员工的方法、员工纳入/排除标准和采用率、实施保真度、启动和提供干预措施的成本、以及维持指标的 RE-AIM 指标。本系统评价强调需要更加关注外部有效性，以提供复制、传播和实施的信息，以便能够将基于证据的早期儿童保育/教育肥胖干预措施推广到现实世界的环境中。
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