Abstract：
Obesity and its sequelae are an increasing problem, disproportionally affecting Māori and Pacific peoples, secondary to multifactorial systemic causes, including the effects of colonisation and the impact of globalisation. There is limited synthesised evidence on interventions to address obesity in these populations. The objective of this review is to identify evaluated interventions for prevention and management of obesity amongst Māori and Pacific adults, assess the effectiveness of these interventions, and identify enablers and barriers to their uptake.
Systematic review of databases (Medline, PubMed, EMBASE, CINAHL, Scopus, CENTRAL), key non-indexed journals, and reference lists of included articles were searched from inception to June 2021. Eligibility criteria defined using a Population, Intervention, Control, Outcome format and study/publication characteristics. Quantitative and qualitative data were extracted and analysed using narrative syntheses. Study quality was assessed using modified GRADE approach.
From the 8190 articles identified, 21 were included, with 18 eligible for quantitative and five for qualitative analysis. The studies were heterogenous, with most graded as low quality. Some studies reported small but statistically significant improvements in weight and body mass index. Key enablers identified were social connection, making achievable sustainable lifestyle changes, culturally-centred interventions and incentives including money and enjoyment. Barriers to intervention uptake included difficulty in maintaining adherence to a programme due to intrinsic programme factors such as lack of social support and malfunctioning or lost equipment.
Normal weight trajectory is progressive increase over time. Modest weight loss or no weight gain after several years may have a positive outcome in lowering progression to diabetes, or improvement of glycaemic control in people with diabetes. We recommend urgent implementation of Māori and Pacific-led, culturally-tailored weight loss programmes that promote holistic, small and sustainable lifestyle changes delivered in socially appropriate contexts.
Systematic review of databases (Medline, PubMed, EMBASE, CINAHL, Scopus, CENTRAL), key non-indexed journals, and reference lists of included articles were searched from inception to June 2021. Eligibility criteria defined using a Population, Intervention, Control, Outcome format and study/publication characteristics. Quantitative and qualitative data were extracted and analysed using narrative syntheses. Study quality was assessed using modified GRADE approach.
From the 8190 articles identified, 21 were included, with 18 eligible for quantitative and five for qualitative analysis. The studies were heterogenous, with most graded as low quality. Some studies reported small but statistically significant improvements in weight and body mass index. Key enablers identified were social connection, making achievable sustainable lifestyle changes, culturally-centred interventions and incentives including money and enjoyment. Barriers to intervention uptake included difficulty in maintaining adherence to a programme due to intrinsic programme factors such as lack of social support and malfunctioning or lost equipment.
Normal weight trajectory is progressive increase over time. Modest weight loss or no weight gain after several years may have a positive outcome in lowering progression to diabetes, or improvement of glycaemic control in people with diabetes. We recommend urgent implementation of Māori and Pacific-led, culturally-tailored weight loss programmes that promote holistic, small and sustainable lifestyle changes delivered in socially appropriate contexts.
摘要：
未经批准：肥胖及其后遗症是一个日益严重的问题，不成比例地影响毛利人和太平洋人民，继发于多因素系统性原因，包括殖民的影响和全球化的影响。关于在这些人群中解决肥胖问题的干预措施的综合证据有限。本综述的目的是确定毛利人和太平洋成年人预防和管理肥胖的评估干预措施，评估这些干预措施的有效性，并确定其吸收的推动者和障碍。
UNASSIGNED：数据库的系统审查(Medline，PubMed,EMBASE,CINAHL,Scopus,CENTRAL),关键非索引期刊，从开始到2021年6月，检索了收录文章的参考列表。使用人口定义的资格标准，干预,Control,成果格式和研究/出版特征。使用叙事综合提取和分析定量和定性数据。使用改进的GRADE方法评估研究质量。
未经评估：从确定的8190篇文章中，包括21个，其中18人符合定量分析条件，5人符合定性分析条件。这些研究是异质的，大多数分级为低质量。一些研究报告称体重和体重指数的改善很小，但具有统计学意义。确定的关键促成因素是社会联系，实现可持续的生活方式改变，以文化为中心的干预措施和激励措施，包括金钱和享受。采取干预措施的障碍包括由于缺乏社会支持以及设备故障或丢失等内在计划因素而难以维持对计划的遵守。
UNASSIGNED：正常体重轨迹是随着时间的推移逐渐增加。几年后适度的体重减轻或没有体重增加可能在降低糖尿病的进展方面有积极的结果。或改善糖尿病患者的血糖控制。我们建议紧急实施毛利人和太平洋领导的，文化定制的减肥计划，促进整体，在社会适当的环境中实现小而可持续的生活方式改变。
UNASSIGNED：数据库的系统审查(Medline，PubMed,EMBASE,CINAHL,Scopus,CENTRAL),关键非索引期刊，从开始到2021年6月，检索了收录文章的参考列表。使用人口定义的资格标准，干预,Control,成果格式和研究/出版特征。使用叙事综合提取和分析定量和定性数据。使用改进的GRADE方法评估研究质量。
未经评估：从确定的8190篇文章中，包括21个，其中18人符合定量分析条件，5人符合定性分析条件。这些研究是异质的，大多数分级为低质量。一些研究报告称体重和体重指数的改善很小，但具有统计学意义。确定的关键促成因素是社会联系，实现可持续的生活方式改变，以文化为中心的干预措施和激励措施，包括金钱和享受。采取干预措施的障碍包括由于缺乏社会支持以及设备故障或丢失等内在计划因素而难以维持对计划的遵守。
UNASSIGNED：正常体重轨迹是随着时间的推移逐渐增加。几年后适度的体重减轻或没有体重增加可能在降低糖尿病的进展方面有积极的结果。或改善糖尿病患者的血糖控制。我们建议紧急实施毛利人和太平洋领导的，文化定制的减肥计划，促进整体，在社会适当的环境中实现小而可持续的生活方式改变。
