Abstract：
OBJECTIVE: The purpose of this systematic review and meta-analysis was to examine the effectiveness of psychological interventions at improving physical or mental health outcomes for youth living in rural communities who have, or are at-risk for, any chronic medical condition in comparison to control interventions conducted in rural communities.
METHODS: Following prospective registration (OSF.IO/7TDQJ), 7 databases were searched through July 1, 2023. Studies were included if they were a randomized control trial of a psychological intervention conducted with youth living in a rural area who had, or were at-risk for, a chronic medical condition. Risk of bias was assessed with the Cochrane risk of bias version 2 tool. A qualitative synthesis and meta-analysis were conducted.
RESULTS: 15 studies met inclusion criteria. Obesity studies (n = 13) primarily focused on body mass index metrics, with limited significant findings across studies. Asthma treatment interventions (n = 2) showed no impact on hospitalizations. 3 studies evaluated mental health outcomes with no significant group differences observed. We meta-analytically analyzed 9 studies that evaluated body mass index z-scores and identified an overall null effect (Hedge\'s g = 0.01, 95% CI [-0.07, 0.09], p = .85).
CONCLUSIONS: Most included studies focused on pediatric obesity, and there was a limited range of health outcomes reported. Compared to controls, minimal significant improvements in health outcomes were identified for psychological interventions for youth living in rural communities. Future efforts may benefit from situating this work more systematically within a health disparities framework with a focus on understanding mechanisms of disparities and translating this work into interventions and policy changes.
METHODS: Following prospective registration (OSF.IO/7TDQJ), 7 databases were searched through July 1, 2023. Studies were included if they were a randomized control trial of a psychological intervention conducted with youth living in a rural area who had, or were at-risk for, a chronic medical condition. Risk of bias was assessed with the Cochrane risk of bias version 2 tool. A qualitative synthesis and meta-analysis were conducted.
RESULTS: 15 studies met inclusion criteria. Obesity studies (n = 13) primarily focused on body mass index metrics, with limited significant findings across studies. Asthma treatment interventions (n = 2) showed no impact on hospitalizations. 3 studies evaluated mental health outcomes with no significant group differences observed. We meta-analytically analyzed 9 studies that evaluated body mass index z-scores and identified an overall null effect (Hedge\'s g = 0.01, 95% CI [-0.07, 0.09], p = .85).
CONCLUSIONS: Most included studies focused on pediatric obesity, and there was a limited range of health outcomes reported. Compared to controls, minimal significant improvements in health outcomes were identified for psychological interventions for youth living in rural communities. Future efforts may benefit from situating this work more systematically within a health disparities framework with a focus on understanding mechanisms of disparities and translating this work into interventions and policy changes.
摘要：
目的：本系统评价和荟萃分析的目的是研究心理干预在改善农村社区青年的身心健康结果方面的有效性，或者有风险，与在农村社区进行的对照干预相比，任何慢性疾病。
方法：遵循预期注册（OSF。IO/7TDQJ），到2023年7月1日搜索了7个数据库。如果研究是对生活在农村地区的年轻人进行心理干预的随机对照试验，或者有风险，慢性疾病.使用Cochrane偏差风险2版工具评估偏差风险。进行了定性综合和荟萃分析。
结果：15项研究符合纳入标准。肥胖研究(n=13)主要集中在体重指数指标上，在整个研究中发现的重要结果有限。哮喘治疗干预（n=2）对住院没有影响。3项研究评估了心理健康结果，没有观察到显著的组间差异。我们对9项研究进行了荟萃分析，这些研究评估了体重指数z评分，并确定了总体无效效应(Hedge\sg=0.01，95%CI[-0.07，0.09]，p=.85）。
结论：大多数纳入的研究集中在儿童肥胖，报告的健康结果范围有限。与对照组相比，对生活在农村社区的青年进行心理干预,在健康结局方面的显著改善微乎其微.未来的努力可能会受益于将这项工作更系统地置于健康差异框架内，重点是理解差异机制并将这项工作转化为干预措施和政策变化。
方法：遵循预期注册（OSF。IO/7TDQJ），到2023年7月1日搜索了7个数据库。如果研究是对生活在农村地区的年轻人进行心理干预的随机对照试验，或者有风险，慢性疾病.使用Cochrane偏差风险2版工具评估偏差风险。进行了定性综合和荟萃分析。
结果：15项研究符合纳入标准。肥胖研究(n=13)主要集中在体重指数指标上，在整个研究中发现的重要结果有限。哮喘治疗干预（n=2）对住院没有影响。3项研究评估了心理健康结果，没有观察到显著的组间差异。我们对9项研究进行了荟萃分析，这些研究评估了体重指数z评分，并确定了总体无效效应(Hedge\sg=0.01，95%CI[-0.07，0.09]，p=.85）。
结论：大多数纳入的研究集中在儿童肥胖，报告的健康结果范围有限。与对照组相比，对生活在农村社区的青年进行心理干预,在健康结局方面的显著改善微乎其微.未来的努力可能会受益于将这项工作更系统地置于健康差异框架内，重点是理解差异机制并将这项工作转化为干预措施和政策变化。
