PDF(Pubmed)
Abstract：
BACKGROUND: Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents\' device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings.
METHODS: A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents\' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked.
UNASSIGNED: CRD42021282874.
RESULTS: Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.
CONCLUSIONS: Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents\' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents\' PA/SB, including policy and environmental variables.
METHODS: A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents\' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked.
UNASSIGNED: CRD42021282874.
RESULTS: Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.
CONCLUSIONS: Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents\' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents\' PA/SB, including policy and environmental variables.
摘要：
背景：尽管体育锻炼（PA）与显着的健康益处相关，只有一小部分青少年达到建议的PA水平.这篇系统综述用荟萃分析探讨了青少年基于设备的PA和/或久坐行为(SB)的可修改决定因素，在以前的干预措施中进行了评估，并检查了PA/SB与这些决定因素之间的关联。
方法：对五个电子数据库进行了搜索，包括2010年1月至2023年7月发表的论文。随机对照试验（RCT）或对照试验（CT）至少在两个时间点测量青少年基于设备的PA/SB及其可修改的决定因素：干预前和干预后被认为是合格的。PA/SB和决定因素是主要结果。在采用社会生态观点进行数据提取后，对可修改的决定因素进行了分类。根据每个研究设置进行稳健贝叶斯荟萃分析(RoBMA)。仅在一项研究中确定的结果以叙述方式呈现。评估每个研究的偏倚风险和每个荟萃分析的证据的确定性。还检查了发表偏倚。
■CRD42021282874。
结果：14项RCT（学校有8项，三个在学校和家庭，包括一个在家庭环境中）和一个CT（在学校环境中）。确定了54个可修改的决定因素，并将其合并为33个更广泛的决定因素(21个个体心理学，四种个人行为，七个人际关系，和一个机构)。在所有设置中，ROBMA对PA/SB或决定因素没有或可忽略的合并干预作用。干预措施对结果影响的证据的确定性从非常低到低。叙事,在学校环境中检测到有利于实验组的干预效果的决定因素：实践PA的环境知识，d=1.84,95CI(1.48,2.20),行为改变技术，d=0.90,95CI(0.09,1.70),提供的选择，d=0.70，95CI（0.36，1.03），但未发现对PA或SB的相应影响。
结论：发现了关于已确定的可修改决定因素与青少年基于设备的PA/SB之间关联的证据，可能是由于干预无效。精心设计和实施良好的多组分干预措施应进一步探索各种可修改的青少年决定因素\'PA/SB，包括政策和环境变量。
方法：对五个电子数据库进行了搜索，包括2010年1月至2023年7月发表的论文。随机对照试验（RCT）或对照试验（CT）至少在两个时间点测量青少年基于设备的PA/SB及其可修改的决定因素：干预前和干预后被认为是合格的。PA/SB和决定因素是主要结果。在采用社会生态观点进行数据提取后，对可修改的决定因素进行了分类。根据每个研究设置进行稳健贝叶斯荟萃分析(RoBMA)。仅在一项研究中确定的结果以叙述方式呈现。评估每个研究的偏倚风险和每个荟萃分析的证据的确定性。还检查了发表偏倚。
■CRD42021282874。
结果：14项RCT（学校有8项，三个在学校和家庭，包括一个在家庭环境中）和一个CT（在学校环境中）。确定了54个可修改的决定因素，并将其合并为33个更广泛的决定因素(21个个体心理学，四种个人行为，七个人际关系，和一个机构)。在所有设置中，ROBMA对PA/SB或决定因素没有或可忽略的合并干预作用。干预措施对结果影响的证据的确定性从非常低到低。叙事,在学校环境中检测到有利于实验组的干预效果的决定因素：实践PA的环境知识，d=1.84,95CI(1.48,2.20),行为改变技术，d=0.90,95CI(0.09,1.70),提供的选择，d=0.70，95CI（0.36，1.03），但未发现对PA或SB的相应影响。
结论：发现了关于已确定的可修改决定因素与青少年基于设备的PA/SB之间关联的证据，可能是由于干预无效。精心设计和实施良好的多组分干预措施应进一步探索各种可修改的青少年决定因素\'PA/SB，包括政策和环境变量。
