Effects of community health worker-based interventions on physical activity levels in children: a systematic review.

Paulo Henrique Guerra,Tiago Henrique Toldo De Mello,Filipe Ferreira Da Costa,Rafael Silvestre,Ana Luiza Babo Sedlacek Carvalho,Alex Antonio Florindo

doi:10.1590/1984-0462/2022/40/2020232

Abstract

ABSTRACTObjective: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents.Data source: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age.Data synthesis: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior.Conclusions: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.

Highlights

The scientific literature points out that the regular practice of physical activity (PA) positively impacts several domains of the lives of children and adolescents, with special emphasis on its relevance in health promotion,[1] in the social aspect[2] and in academic performance.[3]
Studies written in Spanish, English or Portuguese that developed interventions implemented by community health workers (CHW) involving theoretical contents and/or PA practices focused on children and/or adolescents in the age group between 3 and 19 years were sought
No restrictions were imposed with regard to the designs of the intervention studies, research contexts, interventions with the presence of other themes of health, need for a link between the CHW and the local health system, nor regarding samples composed of children/adolescents with chronic non-communicable diseases (NCD)

Summary

Introduction

The scientific literature points out that the regular practice of physical activity (PA) positively impacts several domains of the lives of children and adolescents, with special emphasis on its relevance in health promotion,[1] in the social aspect[2] and in academic performance.[3]. In view of the different negative health indicators that are associated with physical inactivity in the first decades of life,[6] strategies for its promotion are recommended.[4] in this age group, it is worth noting that the practice of PA is determined by individual issues.[7,8] Recognizing that the contexts (economic, social and environmental) of an individual are determinants for his/her health, various public policies have idealized the introduction of community health workers (CHW) in various countries, to expand access to care especially in places where there is little offer of services and specialized professionals.[9]. 12 in view of the benefits of PA to integral development of children, as well as the important role of CHW in care actions in various countries, this study sought to identify the effects of interventions conducted by CHW on the levels of PA in populations of children and/or adolescents. We sought to evaluate the strategies used in interventions

Methods

Results

Conclusion