Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
- Goal 2.1—United Nations/Brazil: ensure access for all people, in particular for vulnerable and poor people, including children, to safe, nutritious and sufficient food throughout the year;
- Goal Brazil 2.2—reduce and eradicate forms of malnutrition related to overweight or obesity.
- Goal 3.4—United Nations/Brazil: reduce premature mortality from non-communicable diseases by one third through prevention and treatment—Indicator 3.4.1: mortality rate from diabetes mellitus;
- Goal 4.2—United Nations: ensure that all girls and boys have access to quality early childhood development, care and pre-school education so that they are ready for primary education—Brazil 4.2.1: Proportion of children under 5 years of age who have adequate health, learning and psychosocial well-being [22].
- : Interventions for prevention and treatment of obesity, diabetes and hypertension are effective.: Interventions to prevent and treat obesity, diabetes and hypertension are not effective;
- : There are innovative and intersectoral elements in the actions to combat and prevent NCDs. : There is an absence of innovative and intersectoral elements in actions to combat and prevent NCDs;
- : By adapting to local socioeconomic and cultural conditions, effective innovative and intersectoral actions are replicable. : Even with all necessary adjustments, effective innovative and intersectoral actions are not replicable.
2. Materials and Methods
2.1. Search Strategy
2.2. Selection, Inclusion and Exclusion of Studies
2.3. Data Extraction and Synthesis
2.4. Quality Assessment
3. Results
3.1. Selection of Studies
3.2. Characteristics of the Studies
3.2.1. Health Innovation with a Focus on Biomedical Technology
- (a)
- Effectiveness: It was shown to be effective by the biomedical approach with high bio-chemical mediators;
- (b)
- Innovation: Intervention involved high technological commitment, with sophisticated mechanisms of motivation for engagement and use of biomechanical components replacing ergometric equipment;
- (c)
- Limitations: Considering feasibility and replicability, as well as cost-effectiveness and cost-benefit, the study was shown to be very effective, focusing on precision. Nevertheless, it was found very costly, making it inaccessible to the vast majority of the NCD population. The focus on technological effectiveness, excludes several aspects of society such as socioeconomic and contextual anthropological approaches. The absence of these elements denotes the lack of a broader and intersectoral view as well as the social determinants of health [48].
3.2.2. Health Innovation with a Focus on Social Technology
3.3. Risk of Bias in Studies
3.4. Results of Individual Studies
3.5. Study Quality and Evidence Certainty
4. Discussion
4.1. Biomarkers: The Effect of Interventions
4.2. Intersectoral, Innovative and Effective Actions in the Prevention of NCDs
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study | R | T | n | Biomedic | Collective Focus | E | SCI | Average Age | Age Group | Intersectoral Actions | P | Effect. in Treat./Actions | D | Eff. of the Prop. Study | |||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Author | A1 | A2 | A3 | A4 | A5 | A6 | B1 | B2 | B6 | B7 | C1 | D1 | D2 | D3 | D4 | E1 | E2 | E3 | E4 | E5 | G1 | G2 | G3 | G4 | H2 | I1 | I2 | I3 | I4 | J1 | K1 | K2 | K3 | K4 | |||||
1 | Assunção Bezerra [42] | PE | 0 | 2400 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 12–17 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | ||||||||||||||||||
2 | Barbosa et al., 2017 [43] | PE | 1 | 1607 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0.5 | 20–75 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 2 | 0 | ||||||||||||||
3 | Bortolini et al., 2020 [44] | BR | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | |||||||||||||||||||||||||
4 | Burlandy et al., 2020 [45] | RJ | 0 | 0 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | |||||||||||||||||||||||||||
5 | Carvalho Malta, 2016 [46] | BR | 5 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | ||||||||||||||||||||||||
6 | Cecchetto; Pena; 2017 [47] | RS | 0.8 | 79 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0.5 | 7–11 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | ||||||||||||||
7 | Coelho-Júnior et al., 2018 [48] | SP | 0.6 | 183 | 1 | 1 | 1 | 1 | 1 | 1 | 60 | 1 | 1 | 1 | 2 | 1 | 0 | 0 | |||||||||||||||||||||
8 | Costa et al., 2021 [49] | BR | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | |||||||||||||||
9 | Da Silva Marinho et al., 2017 [50] | PE | 1 | 42,538 | 1 | 1 | 1 | 1 | 1 | 1 | 40 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | |||||||||||||||||||
10 | Fernandes et al., 2018 [51] | MG | 1 | 44 | 1 | 1 | 1 | 1 | 0.5 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | ||||||||||||||||||||||
11 | Fernandes; Calado; 2018 [52] | BR | 0.2 | 354 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | |||||||||||||||||||||||
12 | Ferrari, 2018 [53] | BR | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | |||||||||||||||||||||||
13 | Ferreira et al., 2008 [18] | SP | 2 | 401 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 50–70 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | |||||||||||||||
14 | Ferreira et al., 2019 [54] | SP | 0.6 | 45 | 1 | 1 | 1 | 1 | 0 | 14–19 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | ||||||||||||||||||
15 | Jaime et al., 2013 [55] | BR | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | |||||||||||||||||||||
16 | Leme et al., 2019 [56] | SP | 0.6 | 253 | 1 | 1 | 1 | 1 | 1 | 1 | 15 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 0 | 0 | ||||||||||||||||||
17 | LIN et al., 2016 [57] | BR | 2 | 10,585 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 3 | 3 | 3 | 35–74 | 1 | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 2 | |||||||||||||||
18 | Matsudo, 2012 [58] | SP | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | |||||||||||||||||||||||||||
19 | Pardino et al., 2019 [59] | MG | 1 | 411 | 1 | 1 | 1 | 1 | 1 | 1 | 6–11 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | |||||||||||||||||||
20 | Pérez-Escamilla., 2021 [60] | BR | 326 | 1 | 2 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | ||||||||||||||||||||||||
21 | Ramos et al., 2020 [61] | RJ | 4 | 92 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | |||||||||||||
22 | Ribeiro et al., 2011 [62] | MG | 0.5 | 28 | 1 | 1 | 1 | 45–60 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | ||||||||||||||||||||||||
23 | Santos et al., 2015 [63] | RS | 15 | 363 | 1 | 1 | 1 | 1 | 1 | 3 | 1 | 1 | 1 | 15 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | |||||||||||||||||
24 | Sarmiento et al., 2021 [64] | US | 0 | 0 | 1 | 1 | 1 | 1 | 6–17 | 1 | 1 | 1 | 3 | 0 | 1 | 1 | 0 | ||||||||||||||||||||||
25 | Sartori et al., 2020 [65] | PR | 0.4 | 200 | 1 | 1 | 1 | 1 | 1 | 1 | 50–59 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | ||||||||||||||||||||
26 | Vasconcellos et al., 2016 [66] | RJ | 0.4 | 30 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 12–17 | 1 | 1 | 1 | 1 | 1 | 2 | 0 | 0 | ||||||||||||||||||
27 | Viegas Andrade et al. [67] | MG | 5 | 555 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | >18 | 1 | 0 | 1 | 0 | 1 | 1 | 0 |
Bias Risk Level [Results in %] | Randomization Process | Deviations from Intended Interventions | Missing Outcome Data | Measurement of the Outcome | Selection of the Reported Result | Overall Bias |
---|---|---|---|---|---|---|
Assignment to intervention | ||||||
Total number of study = 27 | ||||||
Low risk | 57 | 85.5 | 100 | 68.7 | 88.3 | 47.5 |
Some concerns | 43 | 10.1 | 0 | 11.7 | 6.1 | 30.2 |
High risk | 0 | 4.5 | 0 | 19.6 | 5.6 | 22.3 |
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Kunihiro, S.; da Silva Vernasque, J.R.; da Silva, C.; Santos, M.F.d.; Cremasco, C.P.; Gabriel Filho, L.R.A. Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 13059. https://doi.org/10.3390/ijerph192013059
Kunihiro S, da Silva Vernasque JR, da Silva C, Santos MFd, Cremasco CP, Gabriel Filho LRA. Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(20):13059. https://doi.org/10.3390/ijerph192013059
Chicago/Turabian StyleKunihiro, Stephen, Juliana Ribeiro da Silva Vernasque, Celso da Silva, Marcela Facina dos Santos, Camila Pires Cremasco, and Luís Roberto Almeida Gabriel Filho. 2022. "Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 19, no. 20: 13059. https://doi.org/10.3390/ijerph192013059