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以中低收入国家青少年营养双重负担和教育成果为目标的学校干预措施:系统评价方案。

School-based interventions targeting double burden of malnutrition and educational outcomes of adolescents in low- and middle-income countries: protocol for a systematic review.

机构信息

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 3rd Floor, 90 Smith Street, Boston, MA, 02120, USA.

Center for Inquiry into Mental Health, Pune, India.

出版信息

Syst Rev. 2021 Jul 10;10(1):204. doi: 10.1186/s13643-021-01756-9.


DOI:10.1186/s13643-021-01756-9
PMID:34246315
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8272909/
Abstract

BACKGROUND: Adolescence is a period of rapid physical growth and transition between childhood to adulthood. However, in many developing countries, nutritional and epidemiological transitions are contributing to surging overnutrition, which, together with prevalent undernutrition, is resulting in the double burden of malnutrition (DBM) among adolescents. Schools as social systems have tremendous but mostly underutilized capacity to facilitate change and address a range of nutritional and associated educational concerns of adolescents and young people. The main objective of this systematic review will be to describe school-based interventions that address the multiple forms of malnutrition, and synthesize their effects on nutrition and educational outcomes among adolescents (10 - 19 - years - old) from low- and middle-income countries (LMICs). METHODS: Comprehensive literature searches will be conducted in multiple electronic databases, including Medline (through PubMed), Embase, CENTRAL (through Cochrane Library), CINAHL, and Google Scholar. We will include randomized controlled trials (RCTs), non-RCTs including controlled before-after studies, examining the effects of nutrition interventions on nutrition and educational outcomes among adolescents in LMICs. Two reviewers will independently screen all citations and full-text articles and abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration's revised tool for assessing the risk of bias for RCTs and the Risk Of Bias In Non-randomized Studies of Interventions tool for controlled before-after studies and non-randomized controlled trials. DISCUSSION: To maximize the power of schools as a platform to reinforce the mutually beneficial relationship between adolescent nutrition and education, it is imperative to develop and implement integrated interventions connecting schools, adolescents, parents, communities, and the health care system. The results of this systematic review may provide a comprehensive state of current knowledge on the effectiveness of school-based interventions to enable future research that maximizes the impact and efficiency of integrated approaches to tackle multiple forms of malnutrition among school-going and out-of-school adolescents. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ID: CRD42020211109.

摘要

背景:青春期是身体快速生长和从儿童期向成年期过渡的时期。然而,在许多发展中国家,营养和流行病学的转变正在导致营养过剩的急剧增加,再加上普遍存在的营养不足,导致青少年面临双重营养负担(DBM)。学校作为社会系统,具有巨大但大多未得到充分利用的能力,可以促进变革,并解决青少年和年轻人的一系列营养和相关教育问题。本系统评价的主要目的是描述针对多种形式营养不良的基于学校的干预措施,并综合评估它们对中低收入国家(LMICs)青少年的营养和教育成果的影响。

方法:将在多个电子数据库中进行全面文献检索,包括 Medline(通过 PubMed)、Embase、CENTRAL(通过 Cochrane Library)、CINAHL 和 Google Scholar。我们将纳入随机对照试验(RCTs)、非随机对照试验,包括对照前后研究,以检查营养干预对 LMICs 青少年营养和教育成果的影响。两名评审员将独立筛选所有引用和全文文章,并提取摘要数据。将使用 Cochrane 协作修订的评估 RCT 偏倚风险的工具和评估干预前后对照研究和非随机对照试验偏倚风险的工具评估纳入研究的质量。

讨论:为了最大限度地发挥学校作为加强青少年营养与教育之间互利关系的平台的作用,必须制定和实施将学校、青少年、家长、社区和医疗保健系统联系起来的综合干预措施。本系统评价的结果可以全面了解基于学校的干预措施在提高青少年营养和教育成果方面的有效性,为今后的研究提供依据,最大限度地提高综合方法在解决在校和校外青少年多种形式营养不良方面的效果和效率。

系统评价注册:PROSPERO 注册号:CRD42020211109。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f860/8272909/32851ea2ae47/13643_2021_1756_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f860/8272909/32851ea2ae47/13643_2021_1756_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f860/8272909/32851ea2ae47/13643_2021_1756_Fig1_HTML.jpg

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本文引用的文献

[1]
Effectiveness of school-based nutrition interventions in sub-Saharan Africa: a systematic review.

Public Health Nutr. 2020-10

[2]
School-based interventions to promote adolescent health: A systematic review in low- and middle-income countries of WHO Western Pacific Region.

PLoS One. 2020-3-5

[3]
School-based Physical Activity Interventions in Children and Adolescents: A Systematic Review.

Int J Environ Res Public Health. 2020-2-5

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BMJ. 2020-1-16

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Implement Sci. 2020-1-6

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Nutrients. 2019-12-30

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Lancet. 2019-12-15

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A systematic review and meta-analysis of the overall effects of school-based obesity prevention interventions and effect differences by intervention components.

Int J Behav Nutr Phys Act. 2019-10-29

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