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基于社区的健康促进干预措施,以降低低收入和中等收入国家青少年和青年非传染性疾病的风险因素:系统评价与荟萃分析。

Community-based health promotion interventions to reduce risk factors of non-communicable diseases among adolescent and young adults in low- and middle-income countries: A systematic review and meta-analysis.

作者信息

M Rajashekhar, Joshi Mudita, Mundra Anuj, Kolhe Rutuja, Kirubakaran Richard, Raut Abhishek V, Nazli Khatib Mahalaqua

机构信息

Dept. of Community Medicine, MGIMS, Sevagram, Wardha, Maharashtra, India.

National Health Systems Resource Centre (NHSRC), New Delhi, India.

出版信息

Public Health. 2025 Jun;243:105714. doi: 10.1016/j.puhe.2025.03.026. Epub 2025 May 5.

Abstract

OBJECTIVE

To systematically review the effectiveness of community-based health promotion interventions in reducing risk factors for non-communicable diseases (NCDs) among adolescents and young adults in low- and middle-income countries (LMICs).

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A systematic review followed a registered protocol (PROSPERO 2022 CRD42022369054). A comprehensive search was performed across the databases, including Cochrane Library, PubMed, and ScienceDirect, resulting in 6,523 studies, of which 18 articles met the inclusion criteria. Studies were selected based on rigorous eligibility criteria, focusing on community-based interventions targeting modifiable risk factors for NCDs among individuals aged 10-30 years. Data extraction and quality assessment were independently performed by two reviewers, with results synthesised according to PRISMA guidelines.

RESULTS

The review included studies on a variety of interventions, with outcomes indicating no reduction in smoking prevalence and increased fruit intake in intervention groups compared to controls. Legislative measures and community engagement were particularly effective in reducing smoking rates in some studies, while other outcomes showed improvements in physical activity, dietary habits, and psychological well-being. The interventions demonstrated high feasibility, reach, and acceptance, suggesting potential for scalability. However, mixed results for risk factor reduction highlight the need for tailored approaches.

CONCLUSION

The effectiveness of community-based interventions in reducing NCD risk factors among adolescents and young adults in low- and middle-income countries (LMICs) remains uncertain, as outcomes differ across various demographics and types of interventions. Future research should prioritise long-term impacts, sustainable intervention models, and context-specific strategies, as well as cost-effectiveness, to improve the effectiveness of health promotion efforts.

摘要

目的

系统评价基于社区的健康促进干预措施在降低低收入和中等收入国家(LMICs)青少年和青年非传染性疾病(NCDs)风险因素方面的有效性。

研究设计

系统评价和荟萃分析。

方法

系统评价遵循注册方案(PROSPERO 2022 CRD42022369054)。对包括Cochrane图书馆、PubMed和ScienceDirect在内的数据库进行了全面检索,共检索到6523项研究,其中18篇文章符合纳入标准。根据严格的纳入标准选择研究,重点关注针对10 - 30岁个体非传染性疾病可改变风险因素的社区干预措施。由两名 reviewers 独立进行数据提取和质量评估,并根据PRISMA指南综合结果。

结果

该评价纳入了关于各种干预措施的研究,结果表明干预组与对照组相比,吸烟率没有降低,水果摄入量增加。在一些研究中,立法措施和社区参与在降低吸烟率方面特别有效,而其他结果显示身体活动、饮食习惯和心理健康有所改善。这些干预措施具有很高的可行性、覆盖面和接受度,表明具有可扩展性潜力。然而,风险因素降低的结果参差不齐,突出了需要采用量身定制的方法。

结论

基于社区的干预措施在降低低收入和中等收入国家(LMICs)青少年和青年非传染性疾病风险因素方面的有效性仍然不确定,因为不同人口统计学和干预类型的结果存在差异。未来的研究应优先考虑长期影响、可持续干预模式和因地制宜的策略,以及成本效益,以提高健康促进工作的有效性。

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