普及社区参与式儿童肥胖干预措施在改善儿童和青少年体重相关和行为结果方面的有效性：系统评价和荟萃分析。
Effectiveness of Universal Community Engagement Childhood Obesity Interventions at Improving Weight-Related and Behavioral Outcomes among Children and Adolescents: A Systematic Review and Meta-Analysis.
机构信息
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore.
出版信息
Nutrients. 2024 Oct 12;16(20):3465. doi: 10.3390/nu16203465.
BACKGROUND
Universal community engagement interventions can address childhood obesity.
OBJECTIVES
This review aimed to evaluate the effectiveness of these interventions in improving body mass index (BMI) (primary outcome) as well as dietary choices and activity levels (secondary outcomes) among children and adolescents.
METHODS
Eight electronic databases were searched from inception dates to January 2024. A meta-analysis was conducted using the random-effect model, when appropriate; otherwise, the findings were narratively synthesized. Heterogeneity was determined by the I statistics and Cochran's Q chi-squared test. The Cochrane ROB tool and the GRADE approach were used to assess the quality appraisal at the study and outcome levels, respectively.
RESULTS
Twenty-two studies were included in this review. The results showed that these interventions had a limited effect in improving children's standardized BMI (BMI-z) scores post-intervention. A meta-analysis on BMI-z scores showed that the intervention group had a statistically non-significantly lower BMI-z score than the control group (MD = -0.02, 95%CI = [-0.07, 0.03], Z = 0.83, = 0.40) at immediate post-intervention. It was also reported that universal community engagement interventions had a limited effect in improving children's dietary choices and activity levels. Only the meta-analysis on children's daily sugar-sweetened beverage intake measured using continuous data reported a statistically significant small effect favoring the intervention group (SMD = -0.25, 95%CI = [-0.38, -0.13], Z = 3.98, < 0.0001) at immediate post-intervention.
CONCLUSIONS
Universal community engagement interventions have the potential to address childhood obesity. Children and adolescents could benefit more from interventions that focus on implementing both environmental and behavioral changes, and interventions that include parental involvement.
背景
普及社区参与干预措施可以解决儿童肥胖问题。
目的
本综述旨在评估这些干预措施在改善儿童和青少年的体重指数（BMI）（主要结果）以及饮食选择和活动水平（次要结果）方面的有效性。
方法
从建库日期到 2024 年 1 月，我们对 8 个电子数据库进行了检索。当适合时，我们使用随机效应模型进行了荟萃分析；否则，我们进行了叙述性综合。异质性通过 I ²统计量和 Cochran's Q 卡方检验来确定。我们使用 Cochrane ROB 工具和 GRADE 方法分别评估研究和结局水平的质量评估。
结果
本综述纳入了 22 项研究。结果表明，这些干预措施对改善儿童干预后标准化 BMI（BMI-z）评分的效果有限。对 BMI-z 评分的荟萃分析表明，干预组的 BMI-z 评分显著低于对照组（MD = -0.02，95%CI = [-0.07, 0.03]，Z = 0.83， = 0.40），差异无统计学意义。干预组的儿童饮食选择和活动水平也有一定的改善。只有对使用连续数据测量的儿童每日含糖饮料摄入量的荟萃分析报告了干预组具有统计学意义的小效应（SMD = -0.25，95%CI = [-0.38, -0.13]，Z = 3.98， < 0.0001），差异有统计学意义。
结论
普及社区参与干预措施有可能解决儿童肥胖问题。儿童和青少年可能会从注重实施环境和行为改变的干预措施以及包括父母参与的干预措施中受益更多。
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