在幼儿教育环境中针对肥胖相关结果的政策、系统和环境干预措施中使用的实施策略：一项系统综述。

Implementation strategies used in policy, systems, and environmental interventions addressing obesity-related outcomes in early childhood education settings: a systematic review.

作者信息

Neshteruk Cody D, Luecking Courtney T, Kracht Chelsea L, Burkart Sarah, Melnick Emily M, Anderson Robert E, Lane Hannah G

机构信息

Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Suite 210, Durham, NC, 27708, USA.

Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA.

出版信息

Implement Sci Commun. 2025 Mar 31;6(1):31. doi: 10.1186/s43058-025-00718-9.

DOI:10.1186/s43058-025-00718-9

PMID:40165293

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11956485/

Abstract

BACKGROUND

Policy, systems, and environmental (PSE) approaches, including those enacted in early childhood education (ECE) settings, can improve child health outcomes. The use of implementation strategies, or the ways in which these approaches are enacted across settings, may modify intervention impact. Therefore, the purpose of this review was to examine the implementation strategies used among interventions utilizing PSE approaches in the ECE setting.

METHODS

Seven databases including MEDLINE, PubMed, Web of Science, and EMBASE, were searched for interventions in ECE settings including children (0-6 years) that utilized ≥ 1 PSE approach. Eligible studies included either a child-level outcome (i.e., weight, physical activity, or diet) or an environmental outcome (i.e., nutrition and physical activity environment). Data extracted included study characteristics, description of the intervention, and description of the implementation of the intervention. Implementation strategies were coded using the School Implementation Strategies Translating ERIC Resources (SISTER) taxonomy. The Downs and Black checklist was completed to assess study quality.

RESULTS

One hundred and four studies representing 97 interventions were identified. Fourteen (14%) did not report any implementation strategies. Of the remaining 83 interventions reporting implementation strategies, the mean number of implementation strategies employed per intervention was 3.8 (± 2.3) (range 1-11). However, few interventions (5/83, 6%) clearly named and defined implementation strategies. Most implementation strategies came from the "train and educate stakeholders" SISTER domain (177/318, 56%), and the most frequently used implementation strategy was "conduct educational meetings (50/83, 60%). Most studies were classified as good (59/104, 57%) or fair (40/104, 38%) quality.

CONCLUSIONS

In this review, many interventions appeared to use multiple implementation strategies to support ECE PSE interventions, though few explicitly documented or described those strategies. These findings suggest that more precise documentation of implementation strategies is needed to enhance replication and scalability of ECE interventions.

REGISTRATION

PROSPERO# CRD42022306670.

摘要

背景

政策、系统和环境（PSE）方法，包括在幼儿教育（ECE）环境中实施的那些方法，可以改善儿童健康结果。实施策略的使用，即这些方法在不同环境中的实施方式，可能会改变干预效果。因此，本综述的目的是研究在ECE环境中利用PSE方法的干预措施中所使用的实施策略。

方法

检索了包括MEDLINE、PubMed、科学网和EMBASE在内的七个数据库，以查找在ECE环境中针对0至6岁儿童且使用了≥1种PSE方法的干预措施。符合条件的研究包括儿童层面的结果（即体重、身体活动或饮食）或环境结果（即营养和身体活动环境）。提取的数据包括研究特征、干预措施描述以及干预实施描述。使用学校实施策略转化ERIC资源（SISTER）分类法对实施策略进行编码。完成唐斯和布莱克清单以评估研究质量。

结果

确定了代表97项干预措施的104项研究。14项（14%）未报告任何实施策略。在其余83项报告实施策略的干预措施中，每项干预措施采用的实施策略平均数量为3.8（±2.3）（范围为1至11）。然而，很少有干预措施（5/83，6%）明确命名并定义实施策略。大多数实施策略来自“培训和教育利益相关者”SISTER领域（177/318，56%），最常用的实施策略是“召开教育会议”（50/83，60%）。大多数研究被归类为质量良好（59/104，57%）或中等（40/104，38%）。