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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.

SUBMITTER: Ribeiro EHC

PROVIDER: S-EPMC7263802 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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

Ribeiro Evelyn Helena Corgosinho EHC Guerra Paulo Henrique PH Oliveira Ana Carolina de AC Silva Kelly Samara da KSD Santos Priscila P Santos Rute R Okely Anthony A Florindo Alex Antonio AA

Revista de saude publica 20200601

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. T ...[more]

PMID: 32491109

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Project description:BackgroundChildren and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions.ObjectiveThis review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization.MethodsPubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed.ResultsOn the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=-0.06; 95% CI -0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=-0.11; 95% CI -0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered.ConclusionsEvidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other.Trial registrationPROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417.

Project description:The objective of this systematic review and meta-analysis is to compare the effect of physical activity only with that of physical activity plus diet interventions on body mass index (BMI) in Latin American children and adolescents. We searched the Medline, Embase, Scopus, Web of Science, and Scielo databases from their inception until March 2020, including studies examining the effect of physical activity or physical activity plus diet interventions on BMI in children and adolescents and based on data from intervention studies. The DerSimonian and Laird method was used to compute a pooled standardized mean difference for BMI in terms of effect size (ES) and respective 95% confidence intervals (CIs). Eighteen studies were included. Analyses were performed based on intervention (four studies were included for physical activity only and four studies were included for physical activity plus diet). In the analysis of physical activity only versus control, there was no effect on BMI (ES = 0.00; 95% CI -0.17-0.17, I2 = 0.0%; p = 0.443). In the analysis of physical activity plus diet versus control, there was a decrease in BMI in favour of the intervention group (ES = -0.28; 95% CI -0.42--0.14, I2 = 74.5%; p = 0.001). When ES was estimated considering only the effect in intervention groups, there was no evidence of a decrease in BMI (ES = -0.17; 95% CI -0.44-0.11, I2 = 84.5%; p < 0.001) for physical activity only (eight studies). However, there was a statistically significant decrease in BMI (ES = -0.30; 95% CI -0.50-0.11, I2 = 95.8%; p < 0.001) for physical activity plus diet (ten studies). Some limitations of this review could compromise our results, but the main limitation that should be stated is the quality of the studies (mainly medium/moderate), especially as physical activity and diet interventions cannot be blinded, compromising the quality of these studies. In summary, this meta-analysis offers evidence that physical activity plus diet interventions produced a reduction in BMI in Latin American children and adolescents, but physical activity only interventions did not.

Project description:PurposeSedentary behavior has been identified as a major health risk. While interventions to reduce time spent sedentary have become increasingly prevalent, the vast majority of this work in adults has been focused on workplace sedentary behavior, and often pairs sedentary reduction interventions with increasing physical activity. As research designed to specifically decrease sedentary time that is not limited to the workplace becomes available, identifying strategies and approaches, along with feasibility and efficacy of these interventions, is warranted.MethodsElectronic databases were searched for sedentary interventions with eligibility criteria including: (a) interventions designed to explicitly reduce sedentary behavior that were not limited to the workplace, (b) outcomes specific to sedentary behavior, (c) adults aged at least 18 years, and (d) written in English.ResultsA total of 767 full-text manuscripts were identified, with thirteen studies meeting all eligibility criteria. While intervention characteristics and methodological quality varied greatly among studies, ten of the thirteen studies observed a significant reduction in objectively measured sitting time post-intervention. In those studies that collected participant feasibility/acceptability data, all reported that the intervention was viewed as "favorable to very favorable," would use again, and that participant burden was quite low, suggesting that these interventions were feasible.ConclusionSedentary behavior interventions not limited to the workplace appear to be largely efficacious. While results varied with respect to the magnitude of the decrease in time spent sedentary, they are encouraging. However, due to the small body of evidence and the variability of study designs, our ability to make overarching statements regarding "best practices" at this time is limited. Well-controlled trials of longer duration with larger samples, using theoretically-based interventions with consistent prescriptions for limiting sedentary time are needed.

Project description:BackgroundThe body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.ObjectivesThe overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.MethodsWe performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10-19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).ResultsData from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81-0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62-0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04-1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62-0.74) and television (TV) time (ES 0.58; 95 % CI 0.49-0.69), whereas in low-middle-income countries, the associations were strongest for 'other' screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07-1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.ConclusionThe associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

Project description:Diet, physical activity (PA) and sedentary behavior are important, yet modifiable, determinants of obesity. Recent research into the clustering of these behaviors suggests that children and adolescents have multiple obesogenic risk factors. This paper reviews studies using empirical, data-driven methodologies, such as cluster analysis (CA) and latent class analysis (LCA), to identify clustering patterns of diet, PA and sedentary behavior among children or adolescents and their associations with socio-demographic indicators, and overweight and obesity. A literature search of electronic databases was undertaken to identify studies which have used data-driven methodologies to investigate the clustering of diet, PA and sedentary behavior among children and adolescents aged 5-18 years old. Eighteen studies (62% of potential studies) were identified that met the inclusion criteria, of which eight examined the clustering of PA and sedentary behavior and eight examined diet, PA and sedentary behavior. Studies were mostly cross-sectional and conducted in older children and adolescents (? 9 years). Findings from the review suggest that obesogenic cluster patterns are complex with a mixed PA/sedentary behavior cluster observed most frequently, but healthy and unhealthy patterning of all three behaviors was also reported. Cluster membership was found to differ according to age, gender and socio-economic status (SES). The tendency for older children/adolescents, particularly females, to comprise clusters defined by low PA was the most robust finding. Findings to support an association between obesogenic cluster patterns and overweight and obesity were inconclusive, with longitudinal research in this area limited. Diet, PA and sedentary behavior cluster together in complex ways that are not well understood. Further research, particularly in younger children, is needed to understand how cluster membership differs according to socio-demographic profile. Longitudinal research is also essential to establish how different cluster patterns track over time and their influence on the development of overweight and obesity.

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

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

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