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Meta-Analysis
. 2014 Sep;39(8):949-62.
doi: 10.1093/jpepsy/jsu042. Epub 2014 Jun 16.

Systematic review and meta-analysis of health promotion interventions for children and adolescents using an ecological framework

Christopher C Cushing  1 , Erin E Brannon  2 , Kristina I Suorsa  2 , Dawn K Wilson  2
Affiliations
Meta-Analysis

Systematic review and meta-analysis of health promotion interventions for children and adolescents using an ecological framework

Christopher C Cushing et al. J Pediatr Psychol. 2014 Sep.

Abstract

Objective: To evaluate and quantify the evidence for health promotion interventions in children and adolescents.

Method: 96 independent samples of smoking, physical activity, and diet studies were included. Outcomes included both objective and self-reports of health behavior, as well as proxy measures such as fitness.

Results: The aggregated effect was significant (g = .20, 95% confidence interval [CI] = 0.08-0.32, n = 96). A significant effect of intervention was observed at approximately 1-year follow-up (g = .07, 95% CI = 0.02-0.14, n = 20). The greatest risk of bias was failure to blind outcome assessment, which occurred in 21% of studies. Most studies lacked sufficient detail to determine the quality of their randomization sequence (58%). Additional concerns about risk of bias for individual studies were minimal. Overall, the quality of this finding was moderate using the Grading of Recommendations Assessment, Development, and Evaluation criteria.

Conclusion: Health promotion interventions are effective for modifying health behavior; however, effect sizes are small.

Keywords: health behavior; health promotion and prevention; meta-analysis; public health.

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Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Risk of bias graph.
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