兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Effectiveness of community-based cardiovascular disease prevention interventions to improve physical activity: A systematic review and meta-regression

2021-12

Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality globally. Despite preventive community-based interventions (CBIs) seem efficacious in reducing CVD risks, a comprehensive up-to-date synthesis on the effectiveness of such interventions in improving physical activity (PA) is lacking. We performed a systematic review and meta-analysis of community-based CVD preventive interventions aimed at improving PA level. MEDLINE, EMBASE, CINAHL, Cochrane register and PSYCINFO databases were searched in October 2019 for studies reported between January 2000 and June 2019. We assessed the methodological quality of included studies using the Cochrane risk of bias tools. We performed a random-effects meta-analysis and meta-regression to pool estimates of various effect measures. Results are reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline. Our study protocol was registered in the PROSPERO database (CRD42019119885). A total of 44 randomized and 20  non-randomized controlled studies involving 98,919 participants were included. Meta-analyses found that CBIs improved the odds of attaining the recommended PA level (at least 150 min of moderate and vigorous PA (MVPA)/week) at 12 month (OR:1.62; 95%CI: 1.25–2.11) and 18 to 24 months of follow-up (OR:1.46; 95%CI:1.12–1.91). Furthermore, interventions were effective in improving metabolic equivalents of task at 12 month (standardized mean difference (SMD):0.28; 95%CI:0.03–0.53), MVPA time at 12 to 18  months (SMD:0.34; 95%CI:0.05–0.64), steps per day (SMD:0.32; 95%CI:0.08–0.55), and sitting time (SMD: –0.25; 95%CI: 0.34 to 0.17). Subgroup analyses found that interventions in low- and middle-income countries showed a greater positive effect on attainment of recommended PA level (OR: 1.40; 95%CI: 1.02–1.92) than those in high-income countries (OR: 1.31; 95%CI: 0.96–1.78). Moreover, interventions targeting high-risk groups showed greater effectiveness than those targeting the general population (OR: 1.76; 95%CI: 1.30–2.39 vs. 1.17; 95%CI: 0.89–1.55). In conclusion, community-based CVD preventive interventions have a positive impact on improving the PA level, albeit that relevant studies in lower-middle and low-income countries are limited. With the rising burden of CVDs, rolling out CBIs targeting the general population and high-risk groups are needed to control the growing CVD-burden.

研究类型
Meta分析
人群
混合人群
主题
["基层卫生","心理/精神卫生"]
作者
Hassen HY; Ndejjo R; Musinguzi G; Van Geertruyden JP; Abrams S; Bastiaens H.
国家
Belgium
关键词
Cardiovascular disease; Community-based intervention; Effectiveness; Meta-analysis; Meta-regression; Physical activity.
来源期刊
Prev Med
发布日期
2021-12
相关网址
https://www.healthsystemsevidence.org/articles/62fe6fbcef088708d8e058a0-effectiveness-of-community-based-cardiovascular-disease-prevention-interventions-to-improve-physical-activity-a-systematic-review-and-meta-regression?source=saved_email
DOI
10.1016/j.ypmed.2021.106797
学科领域
DiseasesNon-communicable diseasesCardiovascular diseaseSectorsHome and community carePrimary careProvidersPhysiciansGeneralistsPhysiciansGeneralistsNursesLay/community health workers