Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013.
Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013.
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DOI：
10.5888/pcd13.150406
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发表时间：
2016-01-07
影响因子：
5.5
通讯作者：
Valko C
中科院分区：
文献类型：
--
作者：
Umstattd Meyer MR;Perry CK;Sumrall JC;Patterson MS;Walsh SM;Clendennen SC;Hooker SP;Evenson KR;Goins KV;Heinrich KM;O'Hara Tompkins N;Eyler AA;Jones S;Tabak R;Valko C
城乡居民健康状况存在差异；尤其是农村居民慢性病和肥胖率较高。有证据支持预防肥胖和促进健康公平的政策和环境战略的有效性。 2009年，疾病控制和预防中心推荐了24项政策和环境战略供当地社区使用：预防肥胖的共同社区措施（COCOMO）； 12 项策略侧重于身体活动。本次综述的目的是综合关于农村社区肥胖预防的体力活动相关政策和环境战略的实施情况、相关性和有效性的证据。在 PubMed、PsycINFO、Web of Science、CINHAL 和 PAIS 数据库中对 2002 年至 2013 年 5 月发表的文章进行了文献检索，这些文章报告了在美国或加拿大进行的身体活动相关政策或环境干预措施的发现。每篇文章均由2位研究人员独立摘录。在 2,002 篇文章中，代表 26 项不同研究的 30 篇文章符合纳入标准。学校是最常见的环境（n = 18 项研究）。 22 项研究将 COCOMO 策略应用于农村社区； 2 个最常见的 COCOMO 策略是“加强支持步行的基础设施”（n = 11）和“增加课外体育活动的机会”（n = 9）。大多数研究 (n = 21) 至少应用 8 种非 COCOMO 策略中的一种；最常见的是增加学校体育课之外的体育活动机会（n = 8）。只有 14 项研究测量或报告了体力活动结果（10 项研究仅使用自我报告）； 10 人报告了积极的变化。 12 项 COCOMO 身体活动相关策略中有 7 项在 2 项或多项研究中成功实施，表明这 7 项策略在农村社区相关，而其他 5 项可能不太适用于农村社区。需要使用稳健的研究设计和测量进行进一步研究，以更好地确定 COCOMO 和非 COCOMO 策略在农村社区的实施成功和有效性。
Health disparities exist between rural and urban residents; in particular, rural residents have higher rates of chronic diseases and obesity. Evidence supports the effectiveness of policy and environmental strategies to prevent obesity and promote health equity. In 2009, the Centers for Disease Control and Prevention recommended 24 policy and environmental strategies for use by local communities: the Common Community Measures for Obesity Prevention (COCOMO); 12 strategies focus on physical activity. This review was conducted to synthesize evidence on the implementation, relevance, and effectiveness of physical activity–related policy and environmental strategies for obesity prevention in rural communities. A literature search was conducted in PubMed, PsycINFO, Web of Science, CINHAL, and PAIS databases for articles published from 2002 through May 2013 that reported findings from physical activity–related policy or environmental interventions conducted in the United States or Canada. Each article was extracted independently by 2 researchers. Of 2,002 articles, 30 articles representing 26 distinct studies met inclusion criteria. Schools were the most common setting (n = 18 studies). COCOMO strategies were applied in rural communities in 22 studies; the 2 most common COCOMO strategies were “enhance infrastructure supporting walking” (n = 11) and “increase opportunities for extracurricular physical activity” (n = 9). Most studies (n = 21) applied at least one of 8 non-COCOMO strategies; the most common was increasing physical activity opportunities at school outside of physical education (n = 8). Only 14 studies measured or reported physical activity outcomes (10 studies solely used self-report); 10 reported positive changes. Seven of the 12 COCOMO physical activity–related strategies were successfully implemented in 2 or more studies, suggesting that these 7 strategies are relevant in rural communities and the other 5 might be less applicable in rural communities. Further research using robust study designs and measurement is needed to better ascertain implementation success and effectiveness of COCOMO and non-COCOMO strategies in rural communities.