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家庭日托中实施健康饮食、身体活动和肥胖预防政策、实践或计划的障碍和促进因素:混合方法系统评价。

Barriers and facilitators to the implementation of healthy eating, physical activity and obesity prevention policies, practices or programs in family day care: A mixed method systematic review.

机构信息

School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia.

School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW 2308, Australia.

出版信息

Prev Med. 2022 Apr;157:107011. doi: 10.1016/j.ypmed.2022.107011. Epub 2022 Mar 3.

Abstract

Family day care (FDC) services provide care to young children typically within the carer's own home and represents a unique setting to deliver public health programs to improve child health. To support the implementation of programs targeting healthy eating, physical activity and obesity prevention in the FDC setting, an understanding of the factors influencing their implementation is required. This mixed methods systematic review aimed to describe the barriers and facilitators to the implementation of healthy eating, physical activity or obesity prevention policies, practices and programs (hereafter referred to as programs) in the FDC setting, and synthesise these according to the Theoretical Domains Framework (TDF). Electronic searches were conducted in 7 databases up to July 2020 to identify studies reporting the barriers and/or facilitators to program implementation in the FDC setting. Methodological quality assessments of included studies were conducted using the Mixed Methods Appraisal Tool (MMAT). Twenty studies met the review inclusion criteria (12 qualitative, 6 quantitative, 2 mixed methods). Of the 20 included studies, 16 reported barriers and facilitators mapped to the 'environmental contexts and resources' TDF domain; 10 reported barriers mapped to the 'social influences' TDF domain. Ten of the 12 qualitative studies and none of the quantitative or mixed method studies met all relevant MMAT criteria. This review comprehensively describes barriers and facilitators that need to be addressed to improve the implementation of healthy eating, physical activity and obesity prevention programs in FDC to ensure the expected health benefits of such programs reach children attending FDC.

摘要

家庭日托(FDC)服务通常在照顾者自己的家中为幼儿提供照顾,是提供公共卫生计划以改善儿童健康的独特环境。为了支持在 FDC 环境中实施针对健康饮食、身体活动和肥胖预防的计划,需要了解影响其实施的因素。本混合方法系统评价旨在描述 FDC 环境中实施健康饮食、身体活动或肥胖预防政策、实践和计划(以下简称计划)的障碍和促进因素,并根据理论领域框架(TDF)对这些因素进行综合分析。电子检索了 7 个数据库,截至 2020 年 7 月,以确定报告 FDC 环境中计划实施障碍和/或促进因素的研究。使用混合方法评估工具(MMAT)对纳入研究进行了方法学质量评估。20 项研究符合审查纳入标准(12 项定性、6 项定量、2 项混合方法)。在 20 项纳入的研究中,有 16 项报告了与 TDF 环境背景和资源领域相关的障碍和促进因素;有 10 项报告了与社会影响 TDF 领域相关的障碍。12 项定性研究中有 10 项符合所有相关 MMAT 标准,而没有 1 项定量或混合方法研究符合。本综述全面描述了需要解决的障碍和促进因素,以改善 FDC 中健康饮食、身体活动和肥胖预防计划的实施,确保此类计划对参加 FDC 的儿童产生预期的健康益处。

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