Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Health and Human Performance, University of Houston, Houston, Texas, USA.
Clin Obes. 2022 Dec;12(6):e12557. doi: 10.1111/cob.12557. Epub 2022 Sep 21.
Heterogeneity of response to paediatric obesity interventions is one of the greatest challenges to obesity care. While evaluating school-based interventions by mean changes compared to control is important, it does not provide an understanding of the individual variability in response to intervention. The objective of this study was to comprehensively review school-based interventions that reported study results in terms of response and identify definitions of response used. A scoping review was conducted using a systematic search of five scientific databases from 2009 to 2021. Inclusion criteria included randomized controlled trial design, school-based setting, weight-based outcomes (e.g., BMI, BMI z-score), weight-based outcomes analysed among youth with overweight/obesity, a study conducted in a developed country and publication in English. A total of 26 reports representing 25 unique studies were included. Overall, 19% (5/26) of articles reported response. Response was defined in three ways: maintenance/decrease in BMI z-score, decrease in BMI z-score ≥0.10, and decrease in BMI z-score ≥0.20. Few school-based interventions identified an a priori intervention goal or identified the proportion of participants who responded to the intervention. Without such evaluation participants who do not benefit are likely to be overlooked.
儿童肥胖干预措施反应的异质性是肥胖症治疗的最大挑战之一。虽然通过与对照组的平均变化来评估基于学校的干预措施很重要，但它并不能理解干预措施反应的个体差异。本研究的目的是全面审查报告干预反应结果的基于学校的干预措施，并确定所使用的反应定义。使用系统搜索五个科学数据库，从 2009 年到 2021 年进行了范围综述。纳入标准包括随机对照试验设计、基于学校的环境、体重相关结果（例如 BMI、BMI z 分数）、在超重/肥胖青少年中分析体重相关结果、在发达国家进行的研究以及英文发表。共纳入 26 份报告，代表 25 项独特的研究。总体而言，19%（5/26）的文章报告了反应。反应定义为三种方式：BMI z 分数的维持/降低、BMI z 分数降低≥0.10 和 BMI z 分数降低≥0.20。很少有基于学校的干预措施确定了预先干预目标或确定了对干预措施有反应的参与者比例。没有这样的评估，可能会忽略没有受益的参与者。
