Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Int J Obes (Lond). 2022 Dec;46(12):2070-2087. doi: 10.1038/s41366-022-01219-8. Epub 2022 Sep 14.
Child health promotion has used peer-led interventions for decades, but their effectiveness for childhood obesity is unknown. This review assesses the effectiveness of peer-led interventions on child and adolescent obesity using a range of adiposity outcomes. We included studies that used a peer-led approach for delivering behavior change communications with a minimum intervention duration of four weeks. Studies needed to report results for any of the outcomes: BMI, BMI z-score or BMI percentile. The review included 14 studies of moderate to high quality from high-income countries. A meta-analysis involving 2506 children from 9 studies showed that programs were effective with a mean difference in BMI of -0.15 kg/m (95% confidence interval [-0.26, -0.03]), p = 0.01. Heterogeneity was low (I = 28%, p = 0.19) for children in the intervention group. The mean difference varied with subgroups with significantly greater effects from interventions that focused on physical activity alone or with longer duration of implementation. Sensitivity analysis showed similar significant findings to the primary meta-analysis. We found moderately strong evidence to support the advantageous effect of peer-led interventions for obesity prevention in children and adolescents. However, given the small number of studies included, and possible reporting bias, the results must be interpreted cautiously.
儿童健康促进已经使用同伴主导的干预措施数十年了，但它们对儿童肥胖的效果尚不清楚。本综述评估了同伴主导的干预措施对儿童和青少年肥胖的有效性，使用了一系列肥胖指标。我们纳入了使用同伴主导方法进行行为改变交流且干预持续时间至少为四周的研究。研究需要报告任何结果：BMI、BMI z 评分或 BMI 百分位数。该综述纳入了来自高收入国家的 14 项高质量研究，其中 9 项为高质量研究。一项涉及 9 项研究的 2506 名儿童的荟萃分析表明，这些项目有效，干预组的 BMI 平均差异为-0.15kg/m（95%置信区间[-0.26，-0.03]），p=0.01。干预组的异质性较低（I=28%，p=0.19）。亚组分析表明，仅关注体育活动或实施时间更长的干预措施具有更大的效果，差异具有统计学意义。敏感性分析显示与主要荟萃分析相似的显著结果。我们发现有中等强度的证据支持同伴主导的干预措施对预防儿童和青少年肥胖的有利影响。然而，鉴于纳入的研究数量较少，以及可能存在的报告偏倚，结果必须谨慎解释。
