Latin American interventions in children and adolescents’ sedentary behavior: a systematic review

ABSTRACT OBJECTIVE To identify and evaluate the effects of community-based interventions on the sedentary behavior (SB) of Latin American children and adolescents. METHODS A systematic review on community-based trials to reduce and/or control SB in Latin American countries (Prospero: CRD42017072157). Five databases (PubMed, Web of Science, Scopus, SciELO and Lilacs) and a reference lists were searched. RESULTS Ten intervention studies met the eligibility criteria and composed the descriptive synthesis. These studies were conducted in Brazil (n=5), Mexico (n=3), Ecuador (n=1) and Colombia (n=1). Most interventions were implemented in schools (n=8) by educational components, such as meetings, lessons, and seminars, on health-related subjects (n=6). Only two studies adopted specific strategies to reduce/control SB; others focused on increasing physical activity and/or improving diet. Only one study used an accelerometer to measure SB. Seven studies investigated recreational screen time. Eight studies showed statistically significant effects on SB reduction (80%). CONCLUSIONS Latin America community-based interventions reduced children and adolescents’ SB. Further studies should: define SB as a primary outcome and implement strategies to reduce such behaviour; focus in different SBs and settings, other than recreational screen time or at-home sitting time; and use objective tools together with questionnaires to measure sedentary behaviour in.

【摘要】
研究目的：明确并评估以社区为基础的干预措施对拉丁美洲儿童青少年久坐行为（Sedentary Behavior，SB）的影响。
方法：本研究为针对拉丁美洲国家旨在减少和/或控制久坐行为的社区干预试验的系统综述（Prospero注册号：CRD42017072157）。检索了PubMed、Web of Science、Scopus、SciELO及Lilacs共5个数据库，并对参考文献列表进行了追溯检索。
结果：共有10项符合纳入标准的干预研究被纳入描述性综合分析。这些研究分别在巴西（n=5）、墨西哥（n=3）、厄瓜多尔（n=1）及哥伦比亚（n=1）开展。其中8项干预措施依托学校实施，通过举办健康主题的会议、课程及研讨会等教育活动，此类方式共应用于6项研究中。仅有2项研究采用了专门针对减少/控制久坐行为的干预策略；其余研究均聚焦于增加身体活动量和/或改善膳食结构。仅1项研究使用加速度计测量久坐行为。7项研究调查了休闲屏幕暴露时长。8项研究显示其对减少久坐行为具有统计学意义的干预效果，占纳入研究总数的80%。
结论：拉丁美洲地区的以社区为基础的干预措施可有效降低儿童青少年的久坐行为。未来研究应：将久坐行为设为主要结局指标，并制定针对性的干预策略以减少此类行为；聚焦于休闲屏幕暴露及居家久坐之外的其他类型久坐行为与干预场景；同时采用客观测量工具与问卷相结合的方式来评估久坐行为。