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社区卫生工作者参与戒烟计划的效果:系统评价。

Effectiveness of community health workers involvement in smoking cessation programme: A systematic review.

机构信息

Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Malaysia.

出版信息

PLoS One. 2020 Nov 19;15(11):e0242691. doi: 10.1371/journal.pone.0242691. eCollection 2020.

Abstract

BACKGROUND

Sustainable Development Goals (SDG) has set the target to reduce premature mortalities from non-communicable diseases (NCDs) by one-third. One of the ways to achieve this is through strengthening the countries' implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Community health workers (CHWs) involvement has shown promising results in the prevention of NCDs. This systematic review is aimed at critically evaluating the available evidence on the effectiveness of involving CHWs in smoking cessation.

MATERIALS AND METHODS

We systemically searched PubMed and CENTRAL up to September 2019. We searched for published interventional studies on smoking cessation interventions using the usual care that complemented with CHWs as compared to the usual or standard care alone. Our primary outcome was abstinence of smoking. Two reviewers independently extracted data and assessed study risks of bias.

RESULT

We identified 2794 articles, of which only five studies were included. A total of 3513 smokers with 41 CHWs were included in the studies. The intervention duration range from 6 weeks to 30 months. The studies used behavioral intervention or a combination of behavioral intervention and pharmacological treatment. Overall, the smoking cessation intervention that incorporated involvement of CHWs had higher smoking cessation rates [OR 1.95, 95% CI (1.35, 2.83)]. Significant smoking cessation rates were seen in two studies.

CONCLUSION

Higher smoking cessation rates were seen in the interventions that combined the usual care with interventions by CHWs as compared to the usual care alone. However, there were insufficient studies to prove the effectiveness. In addition, there was high heterogeneity in terms of interventions and participants in the current studies.

摘要

背景

可持续发展目标(SDG)设定了将非传染性疾病(NCD)导致的过早死亡率降低三分之一的目标。实现这一目标的方法之一是加强各国对世界卫生组织烟草控制框架公约(WHO FCTC)的执行。社区卫生工作者(CHWs)的参与在预防 NCD 方面已显示出良好的效果。本系统评价旨在批判性评估现有关于将 CHWs 纳入戒烟的有效性的证据。

材料和方法

我们系统地检索了 PubMed 和 CENTRAL 数据库,截至 2019 年 9 月。我们搜索了使用常规护理并辅以 CHWs 的戒烟干预措施的已发表的干预性研究,与单独使用常规或标准护理相比。我们的主要结果是吸烟的戒断。两名审查员独立提取数据并评估了研究的偏倚风险。

结果

我们共检索到 2794 篇文章,其中只有 5 项研究符合纳入标准。共有 3513 名吸烟者和 41 名 CHWs 纳入了这些研究。干预持续时间从 6 周到 30 个月不等。这些研究采用了行为干预或行为干预联合药物治疗。总的来说,纳入 CHWs 参与的戒烟干预措施具有更高的戒烟率[OR 1.95,95%CI(1.35,2.83)]。两项研究中观察到了显著的戒烟率。

结论

与单独使用常规护理相比,将常规护理与 CHWs 的干预措施相结合的干预措施具有更高的戒烟率。然而,现有的研究数量不足以证明其有效性。此外,目前的研究在干预措施和参与者方面存在很大的异质性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cca7/7676728/9915c0a1585b/pone.0242691.g001.jpg

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