背景:与城市居民相比,美国农村居民的饮食和体力活动(PA)相关慢性病负担不成比例,由于资源和经济挑战。已经实施了多种预防慢性病的政策方法,以解决母乳喂养的障碍,健康饮食,和PA。因此,本文的目的是描述母乳喂养的政策支持,健康饮食,和/或PA发生在美国农村地区。
方法:2020年3月至6月进行了范围审查,以确定政策,系统,以及美国农村地区母乳喂养的环境变化方法,健康饮食,和PA。搜索程序由PRISMA-ScR指导,Arksey和O\'Malley\的作品(2007),和科学图书管理员.Medline,PubMed,WebofScience,和Agricola用于鉴定同行评审的研究。ProQuest论文和论文A&I被用来识别论文研究。灰色文献搜索包括谷歌,谷歌学者,政府页面,和公共卫生,联邦营养援助计划,合作推广服务,和相关的网页。报告了政策结果,纳入标准是:(1)母乳喂养,健康饮食,和/或PA重点;(2)关于政策因素;(3)特定于美国农村人口/地方;(4)英语。成果(研究/来源设计,目标(S),方法/测量,设置,人口特征,行为焦点,特定于政策的结果)被提取到标准化的Excel文档中。
结果:结果包括122个来源:原始研究,一些来源引用了多个行为,(n=74来源:8母乳喂养,41健康饮食,42PA),灰色文献(n=45来源:16例母乳喂养,15健康饮食27PA),和研究生研究(n=3来源:1母乳喂养,2健康饮食,1PA)。母乳喂养政策举措包括医院的政策或计划,增加对资源的访问,改善工作场所的文化或规范。健康饮食政策举措包括增加获得健康食品的机会,减轻财政负担,实施方案,粮食援助计划,以及医疗机构的健康食品处方。巴勒斯坦权力机构的政策举措侧重于完整的街道,共同或共同使用的努力,通往学校的安全路线,绿道总体规划,小径,和/或运输,学校健康计划,和儿童保育/学校标准。
结论:本范围审查的结果汇编并提供对改善母乳喂养的现有政策解决方案的评论,健康饮食,和/或PA在美国农村
BACKGROUND: Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas.
METHODS: A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O\'Malley\'s work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/
measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document.
RESULTS: Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards.
CONCLUSIONS: Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.