Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada.
Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
Pediatrics. 2022 May 1;149(Suppl 5). doi: 10.1542/peds.2021-053852L.
School-aged children (SAC; 5-9 years) remain understudied in global efforts to examine intervention effectiveness and scale up evidence-based interventions.
This review summarizes the available evidence describing the effectiveness of key strategies to deliver school-age interventions.
We searched Medline, PsycINFO, Campbell Collaboration, and The Cochrane Library during November 2020.
Systematic reviews and meta-analyses that: target SAC, examine effective delivery of well-established interventions, focus on low- and middle-income countries (LMICs), were published after 2010, and focus on generalizable, rather than special, populations.
Two reviewers conducted title and abstract screening, full-text screening, data extraction, and quality assessments.
Sixty reviews met the selection criteria, with 35 containing evidence from LMICs. The outcomes assessed and the reported effectiveness of interventions varied within and across delivery strategies. Overall, community, school, and financial strategies improved several child health outcomes. The greatest evidence was found for the use of community-based interventions to improve infectious disease outcomes, such as malaria control and prevention. School-based interventions improved child development and infectious disease-related outcomes. Financial strategies improved school enrollment, food security, and dietary diversity.
Relatively few LMIC studies examined facility, digital, and self-management strategies. Additionally, we found considerable heterogeneity within and across delivery strategies and review authors reported methodological limitations within the studies.
Despite limited research, available information suggests community-based strategies can be effective for the introduction of a range of interventions to support healthy growth and development in SAC. These also have the potential to reduce disparities and reach at-risk and marginalized populations.
在全球范围内，学龄儿童（SAC；5-9 岁）仍然是研究的薄弱环节，难以评估干预措施的有效性并推广基于证据的干预措施。
本综述总结了现有证据，描述了向学龄儿童提供干预措施的关键策略的有效性。
我们于 2020 年 11 月在 Medline、PsycINFO、Campbell 协作数据库和 The Cochrane Library 进行了检索。
系统评价和荟萃分析，其：以 SAC 为目标，考察已确立的干预措施的有效实施，关注中低收入国家（LMICs），发表于 2010 年后，且关注具有普遍性而非特殊性的人群。
两名审查员进行了标题和摘要筛选、全文筛选、数据提取和质量评估。
有 60 篇综述符合入选标准，其中 35 篇来自 LMICs。评估的结果和干预措施的报告效果在不同的实施策略内和之间存在差异。总体而言，社区、学校和财务策略改善了多项儿童健康结果。使用基于社区的干预措施来改善传染病结果（如疟疾控制和预防）的证据最多。学校为基础的干预措施改善了儿童发展和传染病相关结果。财务策略提高了入学率、粮食安全和饮食多样性。
相对较少的 LMIC 研究考察了机构、数字和自我管理策略。此外，我们在实施策略内和之间发现了相当大的异质性，且综述作者报告了研究中的方法学局限性。
尽管研究有限，但现有信息表明，基于社区的策略可以有效地引入一系列干预措施，以支持 SAC 的健康成长和发展。这些策略还有可能减少差距，覆盖高危和边缘人群。
