Dunker Karin Louise Lenz, de Carvalho Pedro Henrique Berbert, Amaral Ana Carolina Soares
AMBULIM, Eating Disorders Program, Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
NICTA, Body Image and Eating Disorder Research Group, Federal University of Juiz de Fora, Governador Valadares, Brazil.
Int J Eat Disord. 2023 Apr;56(4):691-707. doi: 10.1002/eat.23916. Epub 2023 Feb 15.
This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries.
A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies.
Twenty-two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance-based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow-ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow-up in ED/disordered eating risk behaviors/symptoms, negative affect, body-ideal internalization, and body image disturbances.
This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs.
The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245.
本系统评价旨在评估和总结拉丁美洲国家现有的饮食失调(ED)预防项目。
截至2022年7月31日,使用Cochrane对照试验注册库、PubMed和虚拟健康图书馆数据库进行了系统的文献检索。所有以英文、西班牙文或葡萄牙文发表的ED预防研究均符合条件,无论研究设计、样本特征和预防项目类型如何。Cochrane协作网偏倚风险标准用于评估纳入研究的质量。
纳入了22项研究。大多数是试点研究,为非随机研究,存在较高偏倚风险,来自墨西哥和巴西,采用选择性干预措施。基于认知失调的项目和社会认知理论是干预中常用的方法,其中大多数在青春期女孩和女性中进行了测试。随访时间较短,从1个月到6个月不等。许多研究发现,干预后和/或随访时,ED/饮食失调风险行为/症状、负面影响、身体理想内化和身体形象障碍显著减少。
本评价突出了拉丁美洲国家在预防ED方面做出的有前景的努力。开展研究存在一些障碍,包括资金限制、不允许向参与者支付报酬或补偿的法律以及培训成本高昂。尽管如此,迄今为止开发和评估的项目结果足够积极,值得在ED预防方面进一步开展工作。未来研究人员应努力招募具有不同特征的样本,采用稳健的设计和数据分析技术,并扩大预防项目的可及性。
开发能够广泛实施的有效饮食失调(ED)预防项目是一项公共卫生优先事项。然而,关于拉丁美洲国家ED预防项目的特征及其效果的证据有限。在本研究中,我们回顾了拉丁美洲采用的现有ED预防项目,描述了它们的特征和结果,指出了现有项目的局限性,并讨论了这些发现对拉丁美洲预防ED发展努力的影响。迄今为止开发和评估的项目结果足够积极,值得开发和严格评估未来项目,并在拉丁美洲国家广泛传播。PROSPERO注册号CRD42021275245。