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

PREVENTIVE MEDICINE

卷:153

Review

Hassen, Hamid Yimam¹  Ndejjo, Rawlance^1,4  Musinguzi, Geofrey^1,4  Van Geertruyden, Jean-Pierre²  Abrams, Steven^2,3  Bastiaens, Hilde^1,2 

[1] Univ Antwerp, Dept Primary & Interdisciplinary Care, Fac Med & Hlth Sci, B-2610 Antwerp, Belgium

[2] Univ Antwerp, Global Hlth Inst, Fac Med & Hlth Sci, B-2610 Antwerp, Belgium

[3] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat, Data Sci Inst, B-3590 Diepenbeek, Belgium

[4] Makerere Univ, Sch Publ Hlth, Dept Dis Control & Environm Hlth, Kampala, Uganda

关键词: Community-based intervention;    Cardiovascular disease;    Effectiveness;    Physical activity;    Meta-analysis;    Meta-regression;   

DOI  :  10.1016/j.ypmed.2021.106797

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

Free