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】目的 明确并评估基于社区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 本研究针对拉丁美洲国家中旨在减少和/或控制久坐行为的社区干预试验开展系统综述（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回溯筛查。结果 共有10项符合纳入标准的干预研究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。其中多数干预措施依托学校场景实施（n=8），采用健康主题相关的教育形式，如会议、课程及研讨会（n=6）。仅2项研究采用了专门针对减少/控制久坐行为的策略；其余研究则聚焦于增加身体活动量和/或改善膳食结构。仅有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使用时长。8项研究显示对减少久坐行为具有统计学意义的干预效果（占比80%）。结论 拉丁美洲基于社区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，并实施针对性干预策略以减少此类行为；关注除休闲屏幕使用时长或居家久坐时长之外的不同类型久坐行为及干预场景；同时结合客观测量工具与问卷来评估久坐行为。